Older Americans Act Amendments of 1987
PL 100-175 (H.R.1451), enacted 11/29/1987

101 STAT. 926 
PUBLIC LAW 100-175—NOV. 29, 1987 
Public Law 100-175 
100th Congress 
An Act 
Nov. 29, 1987 
[H.R. 1451] 
Older Americans 
Act 
Amendments of 
1987. 
42 u s e 3001 
note. 
To amend the Older Americans Act of 1965 to authorize appropriations for the fiscal 
years 1988, 1989, 1990, and 1991; to amend the Native Americans Programs Act of 
1974 to authorize appropriations for such fiscal years; and for other purposes. 
Be it enacted by the Senate and House of Representatives of the 
United States of 
America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
This Act may be cited as the "Older Americans Act Amendments 
of 1987". 
TABLE OF CONTENTS 
Sec. 1. Short title; table of contents. 
TITLE I—AMENDMENTS TO THE OLDER AMERICANS ACT OF 1965 
PART A—OBJECTIVES AND ADMINISTRATION 
Sec. 101. Objectives. 
Sec. 102. Establishment of Administration on Aging. 
Sec. 103. Data collection; reports. 
Sec. 104. Veterans' programs. 
Sec. 105. Mental health. 
Sec. 106. Older individuals with disabilities. 
Sec. 107. Older Native Americans. 
Sec. 108. Federal Council on Aging. 
Sec. 109. Regulations. 
Sec. 110. Publication of goals. 
Sec. 111. Assessment of unsatisfied demand for supportive services provided at 
senior centers and other sites. 
PART B—GRANTS FOR SUPPORTIVE SERVICES, NUTRITION, AND OTHER ACTIVITIES 
Sec. 121. Purpose. 
Sec. 122. Reauthorization for State and community programs on aging. 
Sec. 123. Administrative expenses of area agencies on aging. 
Sec. 124. Area agencies on aging as separate units. 
Sec. 125. Area plans. 
Sec. 126. Daycare and respite services provided by volunteers. 
Sec. 127. Coordination of certain programs relating to older victims of Alzheimer's 
disease. 
Sec. 128. Public hearings. 
Sec. 129. Ombudsman office and program. 
Sec. 130. Flexibility of services; legal assistance. 
Sec. 131. Documentation regarding minority participation. 
Sec. 132. Targeting of services. 
Sec. 133. Coordination relating to mental health services. 
Sec. 134. Services to older Native Americans. 
Sec. 135. Outreach regarding tuition free post-secondary education. 
Sec. 136. Services to individuals with disabilities. 
Sec. 137. Confidentiality of information relating to legal assistance provided. 
Sec. 138. Coordination of community-based services. 
Sec. 139. Pajnnents. 
Sec. 140. In-home services for frail older individuals. 
Sec. 141. Assistance for special needs. 
Sec. 142. State plan information regarding services to older individuals residing in 
rural areas. 
Sec. 143. Health education and promotion for older individuals. 
Sec. 144. Prevention of abuse of older individuals. 
" 
: 
Sec. 145. Limitation on certain authority to make appropriations. 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 927 
Sec. 146. Assistive technology information. 
PART C—DEMONSTRATION GRANTS 
Sec. 151. Demonstration projects; purpose. 
Sec. 152. Demonstration projects. 
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Sec. 153. Volunteer opportunities. 
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Sec. 154. Special projects in comprehensive long-term care. 
Sec. 155. Outreach to SSI, medicaid, and food stamp recipients. 
Sec. 156. Demonstration grants for individuals with disabilities. 
Sec. 157. Consumer protection demonstration projects for services provided in the 
home. 
Sec. 158. Authorization of appropriations for training, research, and discretionary 
projects and programs. 
Sec. 159. Limitation on certain authority to make appropriations. 
PART D—COMMUNITY SERVICE EMPLOYMENT 
,:.";' 
Sec. 161. Administrative costs of employment projects. 
Sec. 162. Community service employment special needs assurance. 
Sec. 163. Information on age discrimination prohibitions. 
Sec. 164. Definitions. 
Sec. 165. Authorization of appropriations for community service employment for 
older Americans. 
Sec. 166. Employment assistance and other programs. 
PART E—NATIVE AMERICAN PROGRAMS 
Sec. 171. Native American programs. 
PART F—MISCELLANEOUS AND TECHNICAL AMENDMENTS 
Sec. 181. Repeal of older Americans personal health education and training pro-
gram. 
Sec. 182. Technical amendments. 
PART G—CONSUMER PRICE INDEX FOR OLDER AMERICANS 
Sec. 191. Index authorized. 
TITLE 11—1991 WHITE HOUSE CONFERENCE ON AGING 
Sec. 201. White House conference authorized. 
Sec. 202. Authorization of the conference. 
Sec. 203. Conference administration. 
Sec. 204. Conference committees. 
Sec. 205. Report of the conference. 
Sec. 206. Definitions. 
Sec. 207. Authorization of appropriations. 
TITLE III—ALZHEIMER'S DISEASE RESEARCH 
Sec. 301. Requirement for clinical trials. 
Sec. 302. Authorization of appropriations. 
TITLE IV—NATIONAL SCHOOL LUNCH ACT AMENDMENT 
Sec. 401. Participation of older persons and chronically impaired disabled persons 
in child care food program. 
TITLE V—NATIVE AMERICAN PROGRAMS 
Sec. 501. Short title. 
Sec. 502. Review of applications for assistance. 
Sec. 503. Procedural requirements. 
Sec. 504. Inclusion of other Native American Pacific Islanders. 
Sec. 505. Authorization of appropriations. 
Sec. 506. Revolving loan fund for Native Hawaiians. 
TITLE VI—HEALTH CARE SERVICES IN THE HOME 
Sec. 601. Short title. 
Sec. 602. Establishment of grant programs for demonstration projects. 
TITLE VII—GENERAL PROVISIONS 
Sec. 701. Effective dates; application of amendments. 
101 STAT. 928 
PUBLIC LAW 100-175—NOV. 29, 1987 
TITLE I—AMENDMENTS TO THE OLDER 
AMERICANS ACT OF 1965 
, 
. 
PART A—OBJECTIVES A N D ADMINISTRATION 
SEC. 101. OBJECTIVES. 
Section 101 of the Older Americans Act of 1965 (42 U.S.C. 3001) is 
amended— 
...„..^ (1) in the matter preceding paragraph (1)— 
(A) by striking "United States and" and inserting 
"United States,", and 
Indians. 
(B) by inserting ", and of Indian tribes" after "sub-
divisions", 
(2) in paragraph (3) by striking "Suitable" and inserting 
"Obtaining and maintaining suitable", 
(3) in paragraph (7) by striking "Pursuit o f and inserting 
"Participating in and contributing to", and 
(4) in paragraph (10)— 
(A) by striking "lives and" and inserting "lives,", and 
(B) by inserting ", and protection against abuse, neglect, 
and exploitation' before the period at the end. 
SEC. 102. ESTABLISHMENT OF ADMINISTRATION ON AGING. 
Section 201(a) of the Older Americans Act of 1965 (42 U.S.C. 
3011(a)) is amended in the third and fourth sentences by striking 
"the Office of. 
SEC. 103. DATA COLLECTION; REPORTS. 
^ 
» > - "«^ » 
(a) COLLECTION REQUIRED.—Section 202(a) of the Older Americans 
Act of 1965 (42 U.S.C. 3012(a)) is amended— 
(1) in paragraph (17) by striking "and" at the end, 
(2) in paragraph (18) by striking the period at the end and 
inserting "; and', and 
(3) by adding at the end the following: 
"(19) collect for each fiscal year, for fiscal years beginning 
after September 30,1988, directly or by contract, statistical data 
regarding programs and activities carried out with funds pro-
vided under this Act, including— 
"(A) with respect to each type of service provided with 
such funds— 
"(i) the aggregate amount of such funds expended to 
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provide such service; 
"(ii) the number of individuals who received such 
service; and 
"(iii) the number of units of such service provided; 
"(B) the number of senior centers which received such 
funds; and 
"(C) the extent to which each area agency on aging 
designated under section 305(a) satisfied the requirements 
of paragraphs (2) and (5)(A) of section 306(a).". 
(b) REPORTS.—The last sentence of section 207(a) of the Older 
Americans Act of 1965 (42 U.S.C. 3018(a)) is amended to read as 
follows: "Such annual reports shall include— 
"(1) statistical data reflecting services and activities provided 
to individuals during the preceding fiscal year; 
"(2) statistical data collected under section 202(aX19); 
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PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 929 
"(3) an analysis of the information received under section 
306(b)(2)(D) by the Commissioner; and 
"(4) statistical data and an analysis of information regarding 
the effectiveness of the State agency and area agencies on aging 
in targeting services to older individuals with the greatest 
1 
economic or social needs, with particular attention to low-
income minority individuals, low-income individuals, and frail 
'' 
individuals (including individuals with any physical or mental 
functional impairment).", 
(c) REPORT TO CONGRESS ON OMBUDSMAN PROGRAM.—Section 207 
of the Older Americans Act of 1965 (42 U.S.C. 3018) is amended by 
striking subsection (b) and inserting the following: 
"0)X1) Not later than January 15 of each year, the Commissioner 
shall compile a report— 
"(A) summarizing and analyzing the data collected under 
section 307(a)(12)(C) for the then most recently concluded fiscal 
year; 
"(B) identifying significant problems and issues revealed by 
r 
such data (with special emphasis on problems relating to quality 
of care and residents' rights); 
) 
"(C) discussing current issues concerning the long-term care 
ombudsman programs of the States; and 
"(D) making recommendations regarding legislation and 
administrative actions to resolve such problems. 
"(2) The Commissioner shall submit the report required by para-
graph (1) to— 
"(A) the Select Committee on Aging of the House of 
Representatives; 
"(B) the Special Committee on Aging of the Senate; 
7 
"(C) the Committee on Education and Labor of the House of 
;* 
Representatives; and 
"(D) the Committee on Labor and Human Resources of the 
Senate. 
"(3) The Commissioner shall provide the report required by para-
graph (1), and make the State reports required by section 
307(a)(12XHXi) available, to— 
"(A) the Administrator of the Health Care Finance Adminis-
tration; 
"(B) the Office of the Inspector General of the Department of 
Health and Human Services; 
"(C) the Office of Civil Rights of the Department of Health 
and Human Services; 
"(D) the Administrator of the Veterans' Administration; and 
"(E) the public agencies and private organizations designated 
under section 307(aX12XA).". 
SEC. 104. VETERANS' PROGRAMS. 
(a) CONSULTATION.—Section 203(b) of the Older Americans Act of 
1965 (42 U.S.C. 3013(b)) is amended— 
(1) in paragraph (13) by striking "and" at the end, 
(2) in paragraph (14) by striking the period at the end and 
inserting ", and", and 
(3) by adding at the end the following: 
"(15) parts II and III of title 38, United States Code.". 
Ot)) TECHNICAL ASSISTANCE AND COOPERATION UNDER TITLE III.— 
Section 301(bX2) of the Older Americans Act of 1965 (42 U.S.C. 
lo 
State and local 
governments. 
Minorities. 
Handicapped 
persons. 
State and local 
governments. 
101 STAT. 930 
PUBLIC LAW 100-175—NOV. 29, 1987 
3021(b)(2)) is amended by inserting ", the Veterans' Administra-
tion," after "Office of Community Services". 
(c) AREA PLANS.—Section 306(a)(6)(F) of the Older Americans Act 
of 1965 (42 U.S.C. 3026(a)(6)(F)) is amended by inserting "providers of 
veterans' health care (if appropriate)," after "elected officials,". 
(d) TECHNICAL ASSISTANCE AND COOPERATION UNDER TITLE IV.— 
Section 402(b) of the Older Americans Act of 1965 (42 U.S.C. 
3030bb03)) is amended by inserting "the Veterans' Administration," 
after "National Institutes of Health,". 
SEC. 105. MENTAL HEALTH. 
(a) FUNCTIONS OF COMMISSIONER.—Section 202(a)(5) of the Older 
Americans Act of 1965 (42 U.S.C. 3012(a)(5)) is amended by inserting 
"(including mental health)" after "health". 
Grants. 
(b) FEDERAL AGENCY CONSULTATION.—Section 203(b)(10) of the 
Older Americans Act of 1965 (42 U.S.C. 30130b)(10)) is amended by 
inserting ", including block grants under title XIX of such Act 
before the comma. 
(c) ADMINISTRATION OF TITLE III.—Section 3010t>)(2) of the Older 
Americans Act of 1965 (42 U.S.C. 302ia))(2)), as amended by section 
.r ' 
1040)), is amended by inserting "the Alcohol, Drug Abuse, and 
Mental Health Administration," after "Veterans' Administration,". 
(d) ADMINISTRATION OF TITLE IV.—Section 402ft)) of the Older 
Americans Act of 1965 (42 U.S.C. 3030bb0))), as amended by section 
104(d), is amended by inserting "Alcohol, Drug Abuse, and Mental 
Healtii Administration," after "Veterans' Administration,". 
(e) EDUCATION AND TRAINING.—(1) Section 411(aXl) of the Older 
Americans Act of 1965 (42 U.S.C. 3031(a)(1)) is amended by inserting 
"(including mental health)" after "health". 
(2) The first sentence of section 412(a) of the Older Americans Act 
of 1965 (42 U.S.C. 3032(a)) is amended by inserting "(including 
,; 
mental health)" after "health". 
(f) SPECIAL PROJECTS IN COMPREHENSIVE LONG-TERM CARE.—The 
second sentence of section 423(a)(3) of the Older Americans Act of 
1965 (42 U.S.C. 3035b(a)(3)) is amended by inserting "mental health 
services;" after "in-home services;". 
SEC. 106. OLDER INDIVIDUALS WITH DISABILITIES. 
(a) PLANNING.—Section 2020))(1) of the Older Americans Act of 
1965 (42 U.S.C. 3012(b)(1)) is amended— 
(1) by striking "and" and inserting a comma, and 
(2) by inserting after "Act" the following: ", with the Alcohol, 
. Drug Abuse, and Mental Health Administration and the 
Administration on Developmental Disabilities". 
(h) AGENCY CONSULTATION.—Section 203(b) of the Older Ameri-
cans Act of 1965 (42 U.S.C. 3013(b)), as amended by section 104(a), is 
amended— 
(1) in paragraph (14) by striking "and" at the end, 
(2) in paragraph (15) by striking the period at the end and 
inserting a comma, and 
r. 
(3) by adding after paragraph (15) the following: 
"(16) the Rehabilitation Act of 1973, and 
"(17) the Developmental Disabilities and Bill of Rights Act.". 
A. 
(c) EVALUATION.—The second sentence of section 206(c) of the 
^ 
Older Americans Act of 1965 (42 U.S.C. 3017(c)) is amended by 
inserting "and older individuals with disabilities" before the period 
at the end. 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 931 
SEC. 107. OLDER NATIVE AMERICANS. 
Indians. 
(a) 
IMPROVED ADMINISTRATION FOR NATIVE 
AMERICAN 
PRO-
GRAMS.—Section 201 of the Older Americans Act of 1965 (42 U.S.C. 
3011) is amended by adding at the end the following: 
"(c)(1) There is established in the Administration on Aging an 
Office for American Indian, Alaskan Native, and Native Hawaiian 
Programs. 
"(2) The Office shall be headed by an Associate Commissioner on 
American Indian, Alaskan Native, and Native Hawaiian Aging 
appointed by the Commissioner. 
"(3) The Associate Commissioner on American Indian, Alaskan 
Native, and Native Hawaiian Aging shall— 
"(A)(i) evaluate the adequacy of outreach under title III and 
title VI for older Native Americans and recommend to the 
Commissioner necessary action to improve service delivery, 
outreach, coordination between title III and title VI services, 
and particular problems faced by older Indians and Native 
Hawaiians; and 
"(ii) include a description of the results of such evaluation and Reports. 
recommendations in the annual report required by section 
207(a) to be submitted by the Commissioner; 
"(B) serve as the effective and visible advocate in behalf of 
older Native Americans within the Department of Health and 
Human Services and with other departments and agencies of 
the Federal Government regarding all Federal policies affecting 
older Native Americans; 
"(C) coordinate activities between other Federal departments 
and agencies to assure a continuum of improved services 
through memoranda of agreements or through other appro-
priate means of coordination; 
"(D) administer and evaluate the grants provided under this Grants. 
Act to Indian tribes, public agencies and nonprofit private 
organizations serving Native Hawaiians; 
"(E) recommend to the Commissioner policies and priorities 
with respect to the development and operation of programs and 
activities conducted under the Act relating to older Native 
Americans; 
"(F) collect and disseminate information related to problems 
experienced by older Native Americans; 
"(G) develop research plans, and conduct and arrange for 
research, in the field of American Native aging with a special 
emphasis on the gathering of statistics on the status of older 
Native Americans; and 
"(H) develop and provide technical assistance and training 
programs to grantees under title VI.". 
Ot)) FEDERAL COUNCIL ON AGING.—The third sentence of section 
204(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 3015(a)(1)) is 
amended by inserting "Indian tribes" after "minorities". 
(c) CONTRACTING AUTHORITY.—Section 212 of the Older Americans 
Act of 1965 (42 U.S.C. 3020c) is amended by inserting after "State 
agency" the following: "(or in the case of a grantee under title VI, 
subject to the recommendation of the Associate Commissioner on 
American Indian, Alaskan Native, and Native Hawaiian Aging and 
the approval of the Commissioner)". 
91-194 O - 90 - 31 : QL.3 Part 1 
101 STAT. 932 
PUBLIC LAW 100-175—NOV. 29, 1987 
«t« 
SEC. 108. FEDERAL COUNCIL ON AGING. 
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(a) MEMBERSHIP.—The fourth sentence of section 204(a)(1) of the 
Older Americans Act of 1965 (42 U.S.C. 3015(a)(1)) is amended by 
striking "two" and inserting "three". 
(b) REAUTHORIZATION.—Section 204(g) of the Older Americans Act 
of 1965 (42 U.S.C. 3015(g)) is amended to read as follows: 
Appropriation 
"(g) There are authorized to be appropriated to carry out the 
authorizations. 
provisions of this section $210,000 for the fiscal year 1988, $221,000 
for the fiscal year 1989, $232,000 for the fiscal year 1990, and 
$243,000 for the fiscal year 1991.". 
SEC. 109. REGULATIONS. 
Section 205(c) of the Older Americans Act of 1965 (42 U.S.C. 
3016(c)) is amended by striking "1984" and inserting "1987". 
SEC. 110. PUBLICATION OF GOALS. 
Section 205 of the Older Americans Act of 1965 (42 U.S.C. 3016) is 
amended— 
j -^. , 
(1) by redesignating subsection (d) as subsection (e), and 
(2) by inserting after subsection (c) the following: 
"(d) Not later than September 1 of each fiscal year, the Commis-
sioner shall make available to the public, for the purpose of facilitat-
ing informed public comment, a statement of proposed specific goals 
to be achieved by implementing this Act in the first fiscal year 
beginning after the date on which such statement is made 
available.". 
SEC. 111. ASSESSMENT OF UNSATISFIED DEMAND FOR SUPPORTIVE 
SERVICES PROVIDED AT SENIOR CENTERS AND OTHER SITES. 
42 use 3027 
(a) REPORT.—Not later than September 30, 1989, the Commis-
"°te. 
sioner on Aging shall submit to the Congress a report— 
(1) assessing the national unmet need for supportive services, 
nutrition 
services, and 
multipurpose 
senior 
centers 
by 
summarizing in detail for each State the results of the most 
recent evaluation conducted by the State agency under the then 
current plan (including any revision thereof) submitted under 
section 307(a)(3)(A) of the Older Americans Act of 1965 (42 
U.S.C. 3027(a)(3)(A)), and 
(2) containing the recommendations of the Secretary with 
respect to the need for administrative action and legislation 
relating to satisfying the demand for supportive services pro-
vided at senior centers established under such title and at other 
sites. 
Ot)) ISSUANCE OF REGULATIONS.—For purposes of obtaining ade-
quate information to be included in the report required by subsec-
tion (a), the Commissioner on Aging shall issue, under the authority 
of section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)), such regulations as may be necessary to ensure that the 
evaluations required to be summarized in such report include data 
that are objectively collected and statistically valid. 
fSft'il*"K„' 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 933 
PART B—GRANTS FOR SUPPORTIVE SERVICES, 
NUTRITION, AND OTHER ACTIVITIES 
SEC. 121. PURPOSE. 
Section 301(a) of the Older Americans Act of 1965 (42 U.S.C. 
3021(a)) is amended by inserting ", with Indian tribes, tribal 
organizations, and Native Hawaiian organizations," after "agen-
cies" the second place it appears. 
SEC. 122. REAUTHORIZATION FOR STATE AND COMMUNITY PROGRAMS 
ON AGING. 
(a) SUPPORTIVE SERVICES AND SENIOR CENTERS.—Section 303(a) of 
the Older Americans Act of 1965 (42 U.S.C. 3023(a)) is amended to 
read as follows: 
"(a) There are authorized to be appropriated $379,575,000 for the 
fiscal year 1988, $398,554,000 for the fiscal year 1989, $418,481,000 
for the fiscal year 1990, and $439,406,000 for the fiscal year 1991, for 
the purpose of making grants under part B of this title (relating to 
supportive services and senior centers).". 
(b) NUTRITION SERVICES.—Section 303(b) of the Older Americans 
Act of 1965 (42 U.S.C. 3023(b)) is amended to read as follows: 
"Ot))(l) There are authorized to be appropriated $414,750,000 for 
the fiscal year 1988, $435,488,000 for the fiscal year 1989, 
$457,262,000 for the fiscal year 1990, and $480,125,000 for the fiscal 
year 1991, for the purpose of making grants under subpart 1 of part 
C of this title (relating to congregate nutrition services). 
"(2) There are authorized to be appropriated $79,380,000 for the 
fiscal year 1988, $83,349,000 for the fiscal year 1989, $87,516,000 for 
the fiscal year 1990, and $91,892,000 for the fiscal year 1991, for the 
purpose of making grants under subpart 2 of part C of this title 
(relating to home delivered nutrition services).". 
(c) SURPLUS COMMODITIES PROGRAM.—(1) Section 311(aX4) of the 
Older Americans Act of 1965 (42 U.S.C. 3030a(aX4)) is amended— 
(A) by striking "fiscal year 1986 and during each fiscal year 
thereafter" and inserting "fiscal years 1986 through 1991", and 
(B) by striking the second and third sentences, 
(2) Subparagraph (A) of section 311(c)(1) of the Older Americans 
Act of 1965 (42 U.S.C. 3030a(c)(l)(A)) is amended to read as follows: 
"(A) There are authorized to be appropriated $151,000,000 for the 
fiscal year 1988, $166,000,000 for the fiscal year 1989, $183,000,000 
for the fiscal year 1990, and $201,000,000 for the fiscal year 1991, to 
carry out the provisions of this section (other than subsection 
(a)(1)).". 
SEC. 123. ADMINISTRATIVE EXPENSES OF AREA AGENCIES ON AGING. 
Section 304(dXl)(A) of the Older Americans Act of 1965 (42 U.S.C. 
3024(dXlXA)) is amended by striking "8.5" and inserting "10". 
SEC. 124. AREA AGENCIES ON AGING AS SEPARATE UNITS. 
Section 305(c) of the Older Americans Act of 1965 (42 U.S.C. 
3025(c)) is amended— 
(1) in paragraph (2) by inserting "to function only" after 
"designated", 
(2) in paragraph (3) by inserting "only" after "act", and 
(3) in paragraph (4)— 
Indians. 
Appropriation 
authorizations. 
Grants. 
101 STAT. 934 
PUBLIC LAW 100-175—NOV. 29, 1987 
State and local 
governments. 
Contracts. 
Grants. 
42 use 3027 
note. 
(A) by inserting ", or any separate organizational unit 
within such agency," after "area' the first place it appears, 
and 
(B) by striking "engage" and inserting "and will engage 
only". 
SEC. 125. AREA PLANS. 
Section 306(a)(6)(A) of the Older Americans Act of 1965 (42 U.S.C. 
3026(a)(6)(A)) is amended by inserting ", and public hearings on," 
after "evaluations of. 
SEC. 1
2
6
. 
DAYCARE 
AND 
RESPITE 
SERVICES 
PROVIDED 
BY 
VOLUNTEERS. 
Section 306(a)(6)(E) of the Older Americans Act of 1965 (42 U.S.C. 
3026(a)(6)(E)) is amended— 
(1) by inserting "or adults, and respite for families," after "for 
children", and 
(2) by inserting ", adults, and families" after "to children". 
SEC. 127. COORDINATION OF CERTAIN PROGRAMS RELATING TO OLDER 
VICTIMS OF ALZHEIMER'S DISEASE. 
Section 306(a)(6) of the Older Americans Act of 1965 (42 U.S.C. 
3026(a)(6)) is amended— 
(1) in subparagraph (J) by striking "and" at the end, 
(2) in subparagraph (K) by striking the period at the end and 
I 
inserting "; and", and 
(3) by adding at the end the following: 
"(L) coordinate the categories of services specified in 
paragraph (2) for which the area agency on aging is 
f: 
required to expend funds under part B, with activities of 
community-based organizations established for the benefit 
•'; . 
of victims of Alzheimer's disease and the families of such 
''t 
' 
victims.". 
SEC. 128. PUBLIC HEARINGS. 
Section 307(a)(8) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)(8)) is amended by inserting ", and public hearings on," after 
"evaluations of. 
SEC. 129. OMBUDSMAN OFFICE AND PROGRAM. 
(a) TECHNICAL ASSISTANCE.—Section 301 of the Older Americans 
Act of 1965 (42 U.S.C. 3021) is amended by adding at the end the 
following: 
"(c) The Commissioner shall provide technical assistance and 
training (by contract, grant, or otherwise) to State long-term care 
ombudsman programs established under section 307(a)(12), and to 
individuals designated under such section to be representatives of a 
long-term care ombudsman, in order to enable such ombudsmen and 
such representatives to carry out the ombudsman 
program 
effectively.". 
(b) STUDY OF OMBUDSMAN PROGRAM.—(1) The Commissioner on 
Aging shall conduct a study concerning involvement in the ombuds-
man program established under section 307(a)(12) of the Older 
Americans Act of 1965 (42 U.S.C. 3027(a)(12)) and its impact upon 
issues and problems affecting— 
(A) residents of board and care facilities and other similar 
adult care homes who are older individuals (as defined in 
section 302(10) of such Act), including recommendations for 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 935 
Reports. 
Contracts. 
' 
expanding and improving ombudsman services in such facili-
ties, and 
(B) the effectiveness of recruiting, supervising, and retaining Voluntarism 
volunteer ombudsmen. 
(2) The Commissioner shall prepare and submit a report to the 
Congress on the findings and recommendations of the study 
described in paragraph (1) not later than December 31,1989. 
(c) AUTHORIZATION OF APPROPRIATIONS.—(1) Section 303(a) of the 
Older Americans Act of 1965 (42 U.S.C. 3023(a)), as amended by 
section 122(a), is amended— 
(A) by inserting "(1)" after "(a)", and 
(B) by adding at the end the following: 
"(2) Subject to subsection (h), there are authorized to be appro-
priated $20,000,000 for fiscal year 1988 and such sums as may be 
necessary for each of the fiscal years 1989, 1990, and 1991 to carry 
out section 307(a)(12).". 
(2) Section 308(b)(5) of the Older Americans Act of 1965 (42 U.S.C. 
3028(b)(5)) is amended— 
(A) in subparagraph (A) by striking "subsection (a)" and 
inserting "subsection (a)(1)", and 
(B) in subparagraph (B) by inserting "subsections (a)(1) and (b) 
o f after "under" the first place it appears. 
(d) STATE PLANS.—Section 307(a)(12) of the Older Americans Act of 
1965 (42 U.S.C. 3027(a)(12)) is amended to read as follows: 
"(12) The plan shall provide the following assurances, with 
respect to a long-term care ombudsman program: 
"(A) The State agency will establish and operate, either 
directly or by contract or other arrangement with any 
public agency or other appropriate private nonprofit 
organization, other than an agency or organization which is 
responsible for licensing or certifying long-term care serv-
ices in the State or which is an association (or an affiliate of 
,f}i:, 
such an association) of long-term care facilities (including 
any other residential facility for older individuals), an 
Office of the State Long-Term Care Ombudsman (in this 
paragraph referred to as the 'Office') and shall carry out 
through the Office a long-term care ombudsman program 
which provides an individual who will, on a full-time 
basis— 
V ?. 
"(i) investigate and resolve complaints made by or on 
behalf of older individuals who are residents of long-
term care facilities relating to action, inaction, or deci-
sions of providers, or their representatives, of long-term 
care services, of public agencies, or of social service 
agencies, which may adversely affect the health, safety, 
i 
welfare, or rights of such residents; 
"(ii) provide for training staff and volunteers and 
promote the development of citizen organizations to 
participate in the ombudsman program; and 
"(iii) carry out such other activities as the Commis-
sioner deems appropriate. 
"(B) The State agency will establish procedures for appro-
priate access by the ombudsman to long-term care facilities 
If 1 and patients' records, including procedures to protect the 
confidentiality of such records and ensure that the identity 
of any complainant or resident will not be disclosed without 
Classified 
information. 
101 STAT. 936 
PUBLIC LAW 100-175—NOV. 29, 1987 
j< 
Reports. 
the written consent of such complainant or resident, or 
upon court order. 
"(C) The State agency will establish a statewide uniform 
reporting system to collect and analyze data relating to 
complaints and conditions in long-term care facilities for 
the purpose of identifying and resolving significant prob-
lems, with provision for submission of such data to the 
agency of the State responsible for licensing or certifying 
long-term care facilities in the State and to the Commis-
sioner on a regular basis. 
"(D) The State agency will establish procedures to assure 
that any files maintained by the ombudsman program shall 
be disclosed only at the discretion of the ombudsman 
having authority over the disposition of such files, except 
that the identity of any complainant or resident of a long-
term care facility shall not be disclosed by such ombudsman 
unless— 
"(i) such complainant or resident, or the individual's 
legal representative, consents in writing to such disclo-
sure; or 
"(ii) such disclosure is required by court order. 
"(E) In planning and operating the ombudsman program, 
the State agency will consider the views of area agencies on 
aging, older individuals, and provider agencies. 
"(F) The State agency will— 
"(i) ensure that no individual involved in the designa-
tion of the long-term care ombudsman (whether by 
appointment or otherwise) or the designation of the 
head of any subdivision of the Office is subject to a 
conflict of interest; 
"(ii) ensure that no officer, employee, or other rep-
resentative of the Office is subject to a conflict of 
interest; and 
"(iii) ensure that mechanisms are in place to identify 
and remedy any such or other similar conflicts. 
"(G) The State agency will— 
"(i) ensure that adequate legal counsel is available to 
the Office for advice and consultation and that legal 
representation is provided to any representative of the 
Office against whom suit or other legal action is 
brought in connection with the performance of such 
representative's official duties; and 
"(ii) ensure that the Office has the ability to pursue 
administrative, legal, and other appropriate remedies 
on behalf of residents of long-term care facilities. 
"(H) The State agency will require the Office to— 
"(i) prepare an annual report containing data and 
findings regarding the types of problems experienced 
and complaints received by or on behalf of individuals 
residing in long-term care facilities, and to provide 
' ' 
policy, regulatory, and legislative recommendations to 
solve such problems, resolve such complaints, and im-
prove the quality of care and life in long-term care 
facilities; 
"(ii) analyze and monitor the development and 
implementation of Federal, State, and local laws, regu-
lations, and policies with respect to long-term care 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 937 
J/^^i/'O. 
facilities and services in that State, and recommend 
any changes in such laws, regulations, and policies 
deemed by the Office to be appropriate; 
"(iii) provide information to public agencies, legisla-
tors, and others, as deemed necessary by the Office, 
regarding the problems and concerns, including rec-
ommendations related to such problems and concerns, 
of older individuals residing in long-term care facilities; 
"(iv) provide for the training of the Office staff, 
including volunteers and other representatives of the 
Office, in— 
"(I) Federal, State, and local laws, regulations, 
and policies with respect to long-term care facili-
ties in the State; 
"(II) investigative techniques; and 
"(III) such other matters as the State deems 
appropriate; 
"(v) coordinate ombudsman services with the protec-
tion and advocacy systems for individuals with devel-
opmental disabilities and mental illness established 
under part A of the Developmental Disabilities Assist-
ance and Bill of Rights Act (42 U.S.C. 6001 et seq.) and 
under the Protection and Advocacy for Mentally 111 
Individuals Act of 1986 (Public Law 99-319); and 
"(vi) include any area or local ombudsman entity 
designated by the State Long-Term Care Ombudsman 
as a subdivision of the Office. Any representative of an 
entity designated in accordance with the preceding 
sentence (whether an employee or an unpaid volunteer) 
shall be treated as a representative of the Office for 
purposes of this paragraph. 
"(I) The State will ensure that no representative of the 
Office will be liable under State law for the good faith 
performance of official duties. 
"(J) The State will— 
"(i) ensure that willful interference with representa-
tives of the Office in the performance of their official 
duties (as defined by the Commissioner) shall be 
unlawful; 
"(ii) prohibit retaliation and reprisals by a long-term 
care facility or other entity with respect to any resident 
or employee for having filed a complaint with, or 
providing information to, the Office; 
"(iii) provide for appropriate sanctions with respect 
to such interference, retaliation, and reprisals; and 
"(iv) ensure that representatives of the Office shall 
have— 
"(I) access to long-term care facilities and their 
residents; and 
"(II) with the permission of a resident or resi-
dent's legal guardian, have access to review the 
resident's medical and social records or, if a resi-
dent is unable to consent to such review and has no 
legal guardian, appropriate access to the resident's 
medical and social records. 
"(K) The State agency will prohibit any officer, employee, 
or other representative of the Office to investigate any 
Public 
information. 
Education. 
Health and 
medical care. 
Handicapped 
persons. 
101 STAT. 938 
PUBLIC LAW 100-175—NOV. 29, 1987 
iltfV, 
State and local 
governments. 
State and local 
governments. 
Reports. 
Records. 
-' -
" 
complaint filed with the Office unless the individual has 
S"' 
received such training as may be required under subpara-
graph (G)(iv) and has been approved by the long-term care 
ombudsman as qualified to investigate such complaints.", 
(e) MINIMUM EXPENDITURE FOR OMBUDSMAN SERVICES.—Section 
307(a)(21) of the Older Americans Act of 1965 (42 U.S.C. 3027(a)(21)) 
is amended to read as follows: 
"(21) The State plan shall provide that the State agency, from 
funds allotted under section 304(a) for part B and for paragraph 
(12) (relating to the State long-term care ombudsman) shall 
expend to carry out paragraph (12), for each fiscal year in which 
f
f the allotment for part B for the State is not less than the 
' 
allotment for fiscal year 1987 for part B for such State, an 
amount which is not less than the amount expended from funds 
received under this Act by such State in fiscal year 1987 to 
'^*' carry out paragraph (12) as in effect before the effective date of 
the Older Americans Act Amendments of 1987. This paragraph 
shall not apply to American Samoa, Guam, the Virgin Islands, 
the Trust Territory of the Pacific Islands, and the Common-
wealth of the Northern Mariana Islands.". 
SEC. 130. FLEXIBILITY OF SERVICES; LEGAL ASSISTANCE. 
(a) AREA PLANS.—(1) Section 306(a)(2) of the Older Americans Act 
of 1965 (42 U.S.C. 3026(a)(2)) is amended by inserting ", as required 
under section 307(a)(22)," after "adequate proportion". 
(2) Section 30603)(2) of the Older Americans Act of 1965 (42 U.S.C. 
3026(b)(2)) is amended by adding at the end the following: 
"(C) Whenever the State agency proposes to grant a waiver to an 
area agency under this subsection, the State agency shall publish 
the intention to grant such a waiver together with the justification 
for the waiver at least 30 days prior to the effective date of the 
decision to grant the waiver. An individual or a service provider 
from the area with respect to which the proposed waiver applies is 
entitled to request a hearing before the State agency on the request 
to grant such waiver. If, within the 30-day period described in the 
first sentence of this subparagraph, an individual or service provider 
requests a hearing under this subparagraph, the State agency shall 
afford such individual or provider an opportunity for a hearing. 
"(D) If the State agency waives the requirement described in 
clause (2) of subsection (a), the State agency shall provide to the 
Commissioner— 
"(i) a report regarding such waiver that details the dem-
onstration made by the area agency on aging to obtain such 
waiver; 
"(ii) a copy of the record of the public hearing conducted 
pursuant to subparagraph (A); and 
IS 
"(iii) a copy of the record of any public hearing conducted 
pursuant to subparagraph (C).". 
(h) MINIMUM EXPENDITURE OF FUNDS.—Section 307(a) of the Older 
Americans Act of 1965 (42 U.S.C. 3027(a)) is amended by adding at 
the end the following: 
"(22) The plan shall specify a minimum percentage of the 
funds received by each area agency for part B that will be 
expended, in the absence of the waiver granted under section 
v6 306(b)(1), by such area agency to provide each of the categories 
¥1 of services specified in section 306(a)(2).". 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 939 
SEC. 131. DOCUMENTATION REGARDING MINORITY PARTICIPATION. 
(a) AREA PLANS.—Section 306(a)(5)(A) of the Older Americans Act 
of 1965 (42 U.S.C. 3026(a)(5)(A)) is amended— 
(1) by inserting "(i)" after "(5)(A)", and 
(2) in subparagraph (A)(i), as so redesignated— 
(A) by striking "and" at the end, and 
(B) by inserting after clause (i) the following: 
"(ii) provide assurances that the area agency will include in 
each agreement made with a provider of any service under this 
title, a requirement that such provider will— 
"(I) specify how the provider intends to satisfy the service 
needs of low-income minority individuals in the area served 
by the provider; and 
"(II) attempt to provide services to low-income minority 
*
' 
* 
individuals in at least the same proportion as the popu-
lation of low-income minority older individuals bears to the 
population of older individuals of the area served by such 
" 
provider; and 
"(iii) with respect to the fiscal year preceding the fiscal year 
for which such plan is prepared— 
"(I) identify the number of low-income minority older 
individuals in the planning and service area; and 
"(II) describe the methods used to satisfy the service 
needs of such minority older individuals; and". 
(b) STATE PLAN.—Section 307(a) of the Older Americans Act of 
1965 (42 U.S.C. 3027(a)), as amended by section 130(c), is amended by 
adding at the end the following: 
"(23) The plan shall, with respect to the fiscal year preceding 
the fiscal year for which such plan is prepared— 
"(A) identify the number of low-income minority older 
individuals in the State; and 
"(B) describe the methods used to satisfy the service 
needs of such minority older individuals.". 
SEC. 132. TARGETING OF SERVICES. 
(a) ORGANIZATION.—(1) Section 305(a)(1)(E) of the Older Americans 
Act of 1965 (42 U.S.C. 3025(a)(1)(E)) is amended— 
(A) by striking "the distribution of older individuals who have 
low incomes residing in such areas", and 
(B) by inserting after "legal services," the following: "the 
' * distribution of older individuals who have greatest economic 
need (with particular attention to low-income minority individ-
uals) residing in such areas, the distribution of older individuals 
' who have greatest social need (with particular attention to low-
income minority individuals) residing in such areas,". 
(2) Section 305(a)(2) of the Older Americans Act of 1965 (42 U.S.C. 
3025(a)(2)) is amended— 
(A) in subparagraph (D) by striking "and" at the end, 
(B) in subparagraph (E) by striking the period at the end and 
inserting "; and", and 
(C) by inserting after subparagraph (E) the following: 
(F) assure the use of outreach efforts that will identify 
individuals eligible for assistance under this Act, with spe-
-::rn: 
^ial emphasis on older individuals with the greatest 
economic or social needs (with particular attention to low-
income minority individuals) and inform such individuals of 
' *
^ 
the availability of such assistance.". 
101 STAT. 940 
PUBLIC LAW 100-175—NOV. 29, 1987 
(b) AREA PLANS.—Section 306(a) of the Older Americans Act of 
1965 (42 U.S.C. 3026(a)) is amended— 
(1) in paragraph (1) by inserting after "residing in such area" 
the following: ", the number of older individuals who have 
greatest economic need (with particular attention to low-income 
minority individuals) residing in such area, the number of older 
individuals who have greatest social need (with particular 
attention to low-income minority individuals) residing in such 
J 
area,", 
(2) in paragraph (5)(B) by inserting after "rural elderly," the 
^ 
following: "older individuals who have greatest economic need 
I 
(with particular attention to low-income minority individuals), 
older individuals who have greatest social need (with particular 
attention to low-income minority individuals),", and 
(3) in paragraph (6)(A) by inserting before the semicolon at the 
(- 
end the following: "and an annual evaluation of the effective-
L 
nessof outreach conducted under paragraph (5)(B)". 
(c) STATE PLAN.—Section 307(a) of the Older Americans Act of 
1965 (42 U.S.C. 3027(a)), as amended by sections 130(c) and 131(b), is 
amended— 
(1) in paragraph (8) by inserting before the semicolon the 
following: ", including an evaluation of the effectiveness of the 
State agency in reaching older individuals with the greatest 
economic or social needs, with particular attention to low-
^ 
income minority individuals", and 
c 
' (2) by adding at the end the following: 
"(24) The plan shall provide assurances that the State agency 
will require outreach efforts that will— 
"(A) identify older individuals who are eligible for assist-
i
f
^ ,
^ 
ance under this title, with special emphasis on older 
individuals with greatest economic need (with particular 
3>iv-» 
attention to low-income minority individuals), older individ-
uals with greatest social need (with particular attention to 
low-income minority individuals), and older individuals who 
reside in rural areas; and 
"(B) inform such individuals of the availability of such 
assistance.". 
SEC. 133. COORDINATION RELATING TO MENTAL HEALTH SERVICES. 
Section 306(a)(6) of the Older Americans Act of 1965 (42 U.S.C. 
3026(a)(6)), as amended by section 127, is amended— 
(1) in subparagraph (K) by striking "and", and 
^ 
(2) in subparagraph (L) by striking the period at the end and 
inserting "; and", and 
i
, £ 
(3) by adding at the end the following: 
"(M) coordinate any mental health services provided with 
funds expended by the area agency on aging for part B with 
, , r I 
the mental health services provided by community health 
centers and by other public agencies and nonprofit private 
organizations.". 
Indians. 
SEC. 134. SERVICES TO OLDER NATIVE AMERICANS. 
(a) ORGANIZATION.—(1) Section 305(a)(1)(E) of the Older Americans 
Act of 1965 (42 U.S.C. 3025(a)(lXE)), as amended by section 132(aXl), 
is amended by inserting "the distribution of older Indians residing 
in such areas," after "such areas," the second place it appears. 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 941 
(2) Section 306(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 
3026(a)(1)), as amended by section 132(b)(1), is amended by inserting 
", and the number of older Indians residing in such area," before 
"and" the last place it appears in the parenthetical. 
(b) AREA PLANS.—Section 306(a)(6) of the Older Americans Act of 
1965 (42 U.S.C. 3026(a)(6)), as amended by sections 127 and 133, is 
amended— 
(1) by striking "and" at the end of subparagraph (L), 
(2) by striking the period at the end of subparagraph (M) and 
inserting "; and", and 
(3) by adding at the end the following: 
"(N) if there is a significant population of older Indians in 
the planning and service area of the area agency, the area 
agency shall conduct outreach activities to identify older 
Indians in such area and shall inform such older Indians of 
^ 
the availability of assistance under this Act.". 
(c) EDUCATION AND TRAINING.—(1) Section 402 of the Act (42 
U.S.C. 3030bb) is amended by adding at the end the following: 
"(c) The Commissioner shall ensure that grants and contracts 
under this title are equitably awarded to agencies, organizations, 
and institutions representing minorities.". 
(2) Section 410(5) of the Older Americans Act of 1965 (42 U.S.C. 
3030jj(5)) is amended by inserting "(including centers of gerontology 
to improve, enhance, and expand minority personnel and training 
programs)" after "gerontology". 
(3) Section 411(a) of the Older Americans Act of 1965 (42 U.S.C. 
3031(a)) is amended by adding at the end the following: 
"(4) To provide in-service training opportunities and courses 
of instruction on aging to Indian tribes through public and 
nonprofit Indian aging organizations.". 
(4) The matter in parentheses in the first sentence of section 
412(a) of the Older Americans Act of 1965 (42 U.S.C. 3032(a)) is 
amended— 
(A) by striking "and" and inserting a comma, and 
(B) by inserting "and minority populations" after "services". 
(5) Section 423(a) of the Older Americans Act of 1965 (42 U.S.C. 
3035b(a)) is amended by adding at the end the following: 
"(4) The Commissioner shall ensure that grants and contracts 
under this section are equitably awarded to agencies, organizations, 
and institutions representing minorities.". 
(6) Section 425(a) of the Older Americans Act of 1965 (42 U.S.C. 
3035d(a)) is amended— 
(A) by striking "(1)" and "(2)" and inserting "(A)" and "(B)", 
respectively, 
0 
(B) by inserting "(1)" after "(a)", and 
(C) by adding at the end the following: 
"(2) The Commissioner shall carry out, directly or through grants 
or contracts, special training programs and technical assistance 
designed to improve services to minorities.". 
(d) TASK FORCE.—(1) The Commissioner on Aging shall establish a 
permanent interagency task force that is representative of depart-
ments and agencies of the Federal Government with an interest in 
older Indians and their welfare, and is designed to make rec-
ommendations with respect to facilitating the coordination of serv-
ices and the improvement of services to older Indians. 
(2) The task force shall be chaired by the Associate Commissioner 
on American Indian, Alaskan Native, and Native Hawaiian Aging 
Grants. 
Contracts. 
Grants. 
Contracts. 
Grants. 
Contracts. 
42 u s e 3057b 
note. 
101 STAT. 942 
PUBLIC LAW 100-175—NOV. 29, 1987 
Reports. 
Contracts. 
42 use 3057b 
note. 
Grants. 
and shall submit its findings and recommendations to the Commis-
sioner at 6-month intervals beginning after the date of the enact-
ment of this Act. Such findings and recommendations shall be 
included in the annual report required by section 207(a) of the Older 
Americans Act of 1965 to be submitted by the Commissioner. 
(e) SPECIAL REPORT ON SERVICES FOR OLDER INDIANS.—(1) The 
Commissioner on Aging shall enter into a contract with a public 
agency or nonprofit private organization to conduct a thorough 
study of the availability and quality of services under the Older 
Americans Act of 1965 to older Indians. The study shall include— 
(A) an analysis of how many Indians now participate in 
programs under titles III and VI of such Act as compared to how 
many older Indians are eligible to participate in such programs, 
(B) a description of how grants under titles III and VI of such 
Act are made to Indian tribes and how services are made 
H available to older Indians, and 
(C) a determination of what services are currently provided 
through title VI of such Act to older Indians and how well the 
Administration on Aging assures that supportive services under 
title VI of such Act to Indians are commensurate with support-
ive services under title III of such Act with special consideration 
to information and referral services, legal services, transpor-
tation services, and the ombudsman services. 
(2) Not later than December 31, 1988, the Commissioner on Aging 
shall prepare and submit to the Congress a report on the study 
required by this subsection, together with such recommendations, 
including recommendations for legislation, as the Commissioner 
considers to be appropriate. 
SEC. 135. OUTREACH 
REGARDING 
TUITION-FREE 
POST-SECONDARY 
EDUCATION. 
Section 306(a)(6) of the Older Americans Act of 1965 (42 U.S.C. 
3026(a)(6)), as amended by sections 127,133, and 1340t)), is amended— 
(1) in subparagraph (M) by striking "and" at the end, 
•,, 
(2) in subparagraph (N) by striking the period at the end and 
inserting "; and", and 
(3) by adding at the end the following: 
"(0)(i) compile available information on institutions of 
higher education in the planning and service area 
if i 
regarding— 
"(I) the courses of study offered to older individuals 
, 
; 
by such institutions; and 
"(II) the policies of such institutions with respect to 
the enrollment of older individuals with little or no 
payment of tuition, on a space available basis, or on 
another special basis; 
and include in such compilation such related supple-
mentary information as may be necessary; and 
"(ii) based on the results of such compilation, make a 
summary of such information available to older individuals 
at multipurpose senior centers, congregate nutrition sites, 
and other appropriate places.". 
SEC. 136. SERVICES TO INDIVIDUALS WITH DISABILITIES. 
(a) DEFINITIONS.—(1) Section 102 of the Older Americans Act of 
1965 (42 U.S.C. 3002) is amended by adding at the end the following: 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 943 
"(8) The term 'disability' means (except when such term is 
used in the phrase 'severe disabihty', 'developmental disabil-
ities', 'physical or mental disability', 'physical and mental 
disabilities', or 'physical disabilities') a disability attributable to 
mental or physical impairment, or a combination of mental and 
physical impairments, that results in substantial functional 
limitations in 1 or more of the following areas of major life 
activity: (A) self-care, (B) receptive and expressive language, (C) 
learning, (D) mobility, (E) self-direction, (F) capacity for 
independent living, (G) economic self-sufficiency, (H) cognitive 
functioning, and (I) emotional adjustment. 
"(9) The term 'severe disability' means a severe, chronic 
disability attributable to mental or physical impairment, or a 
combination of mental and physical impairments, that— 
"(A) is likely to continue indefinitely; and 
"(B) results in substantial functional limitation in 3 or 
t^ 
more of the major life activities specified in subparagraphs 
(A) through (G) of paragraph (8).". 
(2) Section 302(11) of the Older Americans Act of 1965 (42 U.S.C. 
3022(11)) is amended by inserting "(including mental health)" after 
"health". 
(b) AREA PLANS.—Section 306(a)(5)(B) of the Older Americans Act 
of 1965 (42 U.S.C. 3026(a)(5)(B)), as amended by section 132(b)(2), is 
amended by inserting "and older individuals with severe disabil-
ities," after "individuals)," the second place it appears. 
(c) STATE PLANS.—(1) Section 307(a)(13)(I) of the Older Americans 
Act of 1965 (42 U.S.C. 3027(a)(13)(I)) is amended by inserting before 
the semicolon at the end the following: ", and to individuals with 
disabilities who reside at home with and accompany older individ-
uals who are eligible under this Act". 
(2) Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)), as amended by sections 130(c), 131(b), and 132(c), is amended 
by adding at the end the following: 
"(25) The plan shall provide, with respect to the needs of older 
individuals with severe disabilities, assurances that the State 
will coordinate planning, identification, assessment of needs, 
and service for older individuals with disabilities with particu-
lar attention to individuals with severe disabilities with the 
State agencies with primary responsibility for individuals with 
disabilities, including severe disabilities, and develop collabo-
rative programs, where appropriate, to meet the needs of older 
individuals with disabilities.". 
(d) SUPPORTIVE SERVICES.—(1) Section 321(a)(1) of the Older Ameri-
cans Act of 1965 (42 U.S.C. 3030d(a)(l)) is amended by inserting after 
"health" the following: "(including mental health)". 
(2) Section 321(a)(4)(B) of the Older Americans Act of 1965 (42 
U.S.C. 3030d(a)(4)(B)) is amended by striking "suffering from phys-
ical disabilities" and inserting "who have physical disabilities". 
SEC. 137. CONFIDENTIALITY OF INFORMATION RELATING TO LEGAL 
ASSISTANCE PROVIDED. 
(a) AREA AGENCY ON AGING.—Section 306 of the Older Americans 
Act of 1965 (42 U.S.C. 3026) is amended by adding at the end the 
following: 
"(d) An area agency on aging may not require any provider of 
legal assistance under this title to reveal any information that is 
protected by the attorney-client privilege.". 
101 STAT. 944 
PUBLIC LAW 100-175—NOV. 29, 1987 
(b) STATE AND STATE AGENCY.—Section 307 of the Older Ameri-
cans Act of 1965 (42 U.S.C. 3027) is amended by adding at the end 
the following: 
"(g) Neither a State, nor a State agency, may require any provider 
of legal assistance under this title to reveal any information that is 
protected by the attorney-client privilege.". 
SEC. 138. COORDINATION OF COMMUNITY-BASED SERVICES. 
Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)), as amended by sections 130(c), 131(b), 132(c), and 136(c)(3), is 
amended by adding at the end the following: 
"(26) The plan shall provide assurances that area agencies on 
aging will conduct efforts to facilitate the coordination of 
community-based, long-term care services, pursuant to section 
306(a)(6)(I), for older individuals who— 
"(A) reside at home and are at risk of institutionalization 
because of limitations on their ability to function independ-
ently; 
"(B) are patients in hospitals and are at risk of prolonged 
institutionalization; or 
"(C) are patients in long-term care facilities, but who can 
" 
return to their homes if community-based services are pro-
vided to them.". 
SEC. 139. PAYMENTS. 
Section 309(c) of the Older Americans Act of 1965 (42 U.S.C. 
3029(c)) is amended— 
(1) by inserting "average annual" after "less than its", and 
(2) by striking "preceding fiscal year" and inserting "period of 
3 fiscal years preceding such year'. 
SEC. 140. IN-HOME SERVICES FOR FRAIL OLDER INDIVIDUALS. 
(a) AUTHORIZATION OF APPROPRIATIONS.—Section 303 of the Older 
Americans Act of 1965 (42 U.S.C. 3023) is amended by adding at the 
end the following: 
"(d) There are authorized to be appropriated $25,000,000 for fiscal 
year 1988, $26,250,000 for fiscal year 1989, $27,563,000 for fiscal year 
1990, and $28,941,000 for fiscal year 1991 for the purpose of making 
grants under part D of this title (relating to in-home services).'. 
(b) AREA PLANS.—Section 306(a) of the Older Americans Act of 
1965 (42 U.S.C. 3026(a)) is amended— 
(1) in paragraph (6) by striking the period at the end and 
inserting "; and", and 
(2) by adding at the end the following: 
"(7) provide assurances that any amount received under part 
D will be expended in accordance with such part.". 
(c) STATE PLANS.—(1) Section 307(a)(10) of the Older Americans 
Act of 1965 (42 U.S.C. 3027(a)(10)) is amended by striking "including 
nutrition services," and inserting "nutrition services, or in-home 
services (as defined in section 342(1))". 
(2) Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)), as amended by sections 130(c), 131(b), 132(c), 136(c)(3), and 
138 is amended by adding at the end the following: 
"(27) The plan shall provide assurances of consultation and 
• ' 
coordination in planning and provision of in-home services 
under section 341 with State and local agencies and private 
nonprofit organizations which administer and provide services 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 945 
relating to health, social services, rehabilitation, and mental 
health services.", 
(d) PROGRAM.—Title III of the Older Americans Act of 1965 (42 
U.S.C. 3021 et seq.) is amended by adding at the end the following: 
"PART D — I N - H O M E SERVICES FOR FRAIL OLDER INDIVIDUALS 
"PROGRAM AUTHORIZED 
"SEC. 341. (a) The Commissioner shall carry out a program for 
Grants. 
making grants to States under State plans approved under section 
'^^ USC 3030h. 
307 to provide in-home services to frail older individuals, including 
in-home supportive services for older individuals who are victims of 
Alzheimer's disease and related disorders with neurological and 
organic brain dysfunction, and to the families of such victims. 
"(b) In carrying out the provisions of this part, each area agency 
shall coordinate with other community agencies and voluntary 
organizations 
providing 
counseling 
and 
training 
for 
family 
caregivers and support service personnel in management of care, 
functional and needs assessment services, assistance with locating, 
arranging for, and coordinating services, case management, and 
counseling prior to admission to nursing home to prevent premature 
institutionalization. 
"DEFINITIONS 
> "SEC. 342. For purposes of this part— 
42 use 3030i. 
"(1) the term 'in-home services' includes— 
"(A) homemaker and home health aides; 
• 
"(B) visiting and telephone reassurance; 
vi t 
"(C) chore maintenance; 
"(D) in-home respite care for families, and adult day care 
as a respite service for families; and 
: 
"(E) minor modification of homes that is necessary to 
facilitate the ability of older individuals to remain at home 
and that is not available under other programs, except that 
2i 
not more than $150 per client may be expended under this 
'•'•'- 
part for such modification; and 
"(2) the term 'frail' means having a physical or mental 
disability, including having Alzheimer's disease or a related 
disorder with neurological or organic brain dysfunction, that 
restricts the ability of an individual to perform normal daily 
tasks or which threatens the capacity of an individual to live 
independently. 
"STATE CRITERIA 
"SEC. 343. The State agency shall develop eligibility criteria for 
42 usc 3030j. 
providing in-home services to frail older individuals which shall 
take into account— 
"(Dage; 
"(2) greatest economic need; 
"(3) noneconomic factors contributing to the frail condition; 
and 
"(4) noneconomic and nonhealth factors contributing to the 
tv 
need for such services. 
101 STAT. 946 
PUBLIC LAW 100-175—NOV. 29, 1987 
, . 
MAINTENANCE OF EFFORT 
. ^ » 
42 use 3030k. 
"SEC. 344. Funds made available under this part shall be in 
addition to, and may not be used to supplant, any funds that are or 
would otherwise be expended under any Federal, State, or local law 
by a State or unit of general purpose local government (including 
area agencies on aging which have in their planning and services 
areas existing services which primarily serve older individuals who 
are victims of Alzheimer's disease and related disorders with neuro-
logical and organic brain dysfunction, and the families of such 
, " ';t ' 
victims).". 
SEC. 141. ASSISTANCE FOR SPECIAL NEEDS. 
(a) AUTHORIZATION OF APPROPRIATIONS.—Section 303 of the Older 
Americans Act of 1965 (42 U.S.C. 3023), as amended by section 
140(a), is amended by adding at the end the following: 
"(e) Subject to subsection (h), there are authorized to be appro-
priated $25,000,000 for fiscal year 1988, $25,000,000 for fiscal year 
1989, and such sums as may be necessary for each of the fiscal years 
1990 and 1991 to carry out part E (relating to special needs).". 
(b) AREA PLANS.—Section 306(a) of the Older Americans Act of 
1965 (42 U.S.C. 3026(a)), as amended bv section 140(b), is amended— 
(1) in paragraph (6) by striking and" at the end, 
(2) in paragraph (7) by striking the period at the end and 
inserting "; and", and 
(3) by inserting after paragraph (7) the following: 
. 
' 
"(8) provide assurances that any amount received under part 
E will be expended in accordance with such part;". 
(c) STATE PLANS.—Section 307(a) of the Older Americans Act of 
1965 (42 U.S.C. 3027(a)), as amended by sections 130(c), 131(b), 132(c), 
136(c)(3), 138, and 140(c)(2), is amended by adding at the end the 
following: 
"(28) The plan shall provide assurances that if the State 
receives funds appropriated under section 303(e), the State 
agency and area agencies on aging will expend such funds to 
carry out part E.". 
(d) GRANTS FOR SPECIAL NEEDS.—Title III of the Older Americans 
Act of 1965 (42 U.S.C. 3021-3030g), as amended by section 140(d), is 
amended by adding at the end the following: 
"PART E—ADDITIONAL ASSISTANCE FOR SPECIAL NEEDS OF OLDER 
INDIVIDUALS 
PROGRAM AUTHORIZED 
Grants. 
"SEC. 351. The Commissioner shall carry out a program for 
42 use 3030/. 
making grants to States under State plans approved under section 
307 to provide services, consistent with the purpose of this title, 
designed to satisfy special needs of older individuals. Such services 
include— 
"(1) transportation associated with services provided under 
this title; 
/'' 
"(2) outreach regarding such services; 
"(3) targeting such services to older individuals with greatest 
economic need or greatest social need; 
"(4) services under the ombudsman program established 
under section 307(a)(12); and 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 947 
"(5) any other service under this title— 
"(A) for which the State demonstrates to satisfaction of 
* 
the Commissioner that there is unmet need; and 
"(B) which is appropriate to improve the quality of life of 
older individuals, particularly those with greatest economic 
need and those with greatest social need.". 
SEC. 142. STATE PLAN INFORMATION REGARDING SERVICES TO OLDER 
INDIVIDUALS RESIDING IN RURAL AREAS. 
Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)), as amended by sections 130(c), 131(b), 132(c), 136(c)(3), 138, 
140(c)(2), and 141(c), is amended by adding at the end the following: 
"(29) The plan shall, with respect to the fiscal year preceding 
the fiscal year for which such plan is prepared, describe the 
methods used to satisfy the service needs of older individuals 
who reside in rural areas.". 
SEC. 143. HEALTH EDUCATION AND PROMOTION FOR OLDER INDIVID-
UALS. 
(a) AUTHORIZATION OF APPROPRIATIONS.—Section 303 of the Older 
Americans Act of 1965 (42 U.S.C. 3023), as amended by sections 
140(a) and 141(a), is amended by adding at the end the following: 
"(f) Subject to subsection (h), there are authorized to be appro-
priated $5,000,000 for fiscal year 1988 and such sums as may be 
necessary for each of the fiscal years 1989, 1990, and 1991 for the 
purpose of making grants under part F of this title (relating to 
periodic preventive health, health education, and promotion 
services).". 
(b) AREA PLANS.—Section 306(a) of the Older Americans Act of 
1965 (42 U.S.C. 3026(a)), as amended by sections 140(b) and 141(b), is 
amended— 
(1) in paragraph (7) by striking "and" at the end, 
(2) in paragraph (8) by striking the period at the end and 
inserting "; and", and 
(3) by adding at the end the following: 
"(9) provide assurances that any amount received under part 
F will be expended in accordance with such part.". 
(c) PROGRAM.—Title III of the Older Americans Act of 1965 (42 
U.S.C. 3021 et seq.), as amended by sections 140(d) and 141(d), is 
amended by adding at the end the following: 
"PART F—PREVENTIVE HEALTH SERVICES 
"PROGRAM AUTHORIZED 
"SEC. 361. (a) The Commissioner shall carry out a program for Grants. 
making grants to States under State plans approved under section 
^^ use 3030m. 
307 for periodic preventive health services to be provided at senior 
centers or alternative sites as appropriate. 
"(b) Preventive health services under this part may not include 
services eligible for reimbursement under Medicare. 
"(c) The Commissioner shall, to the extent possible, assure that 
services provided by other community organizations and agencies 
are used to carry out the provisions of this part. 
101 STAT. 948 
PUBLIC LAW 100-175—NOV. 29, 1987 
DISTRIBUTION TO AREA AGENCIES 
v fii^i c 
State and local 
"SEC. 362. The State agency shall give priority, in carrying out 
f 
overnments. 
this part, to areas of the State— 
42 use 3030n. 
u^^^ ^iji^.j^ ^^.^ medically underserved; and 
"(2) in which there are a large number of older individuals 
who have the greatest economic need for such services. 
"DEFINITIONS 
42 use 3030o. 
"SEC. 363. For the purpose of this part and section 307 the term 
'preventive health services' means— 
"(1) routine health screening, which may include hyper-
tension, glaucoma, cholesterol, cancer, vision and hearing 
screening; 
"(2) group exercise programs; 
"(3) home injury control services, including screening of high-
risk home environments and educational programs on injury 
protection in the home environment; 
"(4) nutritional counseling and educational services; 
"(5) screening for the prevention of depression, coordination 
of community mental health services, educational activities, 
and referral to psychiatric and psychological services; 
"(6) educational programs on the benefits and limitations of 
Medicare and various supplemental insurance coverage, includ-
ing individual policy screening and health insurance-needs 
counseling; and 
"(7) counseling regarding foUowup health services based on 
any of the services provided for above.". 
SEC. 144. PREVENTION OF ABUSE OF OLDER INDIVIDUALS. 
(a) DEFINITIONS.—Section 302 of the Older Americans Act of 1965 
(42 U.S.C. 3022), as amended by section 136(a), is amended by adding 
at the end the following: 
"(15) The term 'abuse' means the willful— 
"(A) infliction of injury, unreasonable confinement, 
„? 
intimidation, or cruel punishment with resulting physical 
harm or pain or mental anguish; or 
>••, 
"(B) deprivation by a caretaker of goods or services which 
are necessary to avoid physical harm, mental anguish, or 
mental illness. 
"(16) The term 'elder abuse' means abuse of an older 
individual. 
"(17) The term 'caretaker' means an individual who has the 
responsibility for the care of an older individual, either volun-
tarily, by contract, receipt of payment for care, as a result 
, i^ 
of family relationship, or by order of a court of competent 
. 'i'^ • 
' 
jurisdiction. 
"(18) The term 'exploitation' means the illegal or improper 
act or process of a caretaker using the resources of an older 
individual for monetary or personal benefit, profit, or gain. 
"(19) The term 'neglect' means the failure to provide for 
oneself the goods or services which are necessary to avoid 
physical harm, mental anguish, or mental illness or the failure 
of a caretaker to provide such goods or services. 
"(20) The term 'physical harm' means bodily pain, injury, 
impairment, or disease.". 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 949 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 303 of the Older 
Americans Act of 1965 (42 U.S.C. 3023), as amended by sections 
140(a), 141(a), and 143(a), is amended by adding at the end the 
following: 
"(g) Subject to subsection (h), there are authorized to be appro-
priated $5,000,000 for fiscal year 1988 and such sums as may be 
necessary for each of the fiscal years 1989, 1990, and 1991, to carry 
out part G (relating to abuse, neglect, and exploitation of older 
individuals).". 
(c) AREA PLANS.—Section 306(a) of the Older Americans Act of 
1965 (42 U.S.C. 3026(a)), as amended by sections 140(b), 141(b), and 
143(b), is amended— 
(1) in paragraph (8) by striking "and" at the end, 
(2) in paragraph (9) by striking the period at the end and 
inserting "; and", and 
(3) by adding at end the following: 
"(10) provide assurances that any amount received under part 
G will be expended in accordance with such part.". 
(d) STATE PLAN.—(1) Section 307(a)(16) of the Older Americans Act 
of 1965 (42 U.S.C. 3027(a)(16)) is amended by striking "provide" the 
second place it appears and inserting ", if funds are not appro-
priated under section 303(g) for a fiscal year, provide that for such 
fiscal year". 
(2) Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)), as amended by sections 130(c), 131(b), 132(c), 136(c)(3), 138, 
140(cX2), 141(c), and 142, is amended by adding at the end the 
following: 
"(30) The plan shall provide assurances that if the State 
receives funds appropriated under section 303(g), the State 
agency and area s^^encies on aging will expend such funds to 
carry out part G.". 
(e) ABUSE, NEGLECT, AND EXPLOITATION OF OLDER INDIVIDUALS.— 
Title III of the Older Americans Act of 1965 (42 U.S.C. 3021 et seq.), 
as amended by sections 140(d), 141(d), and 143(c), is amended by 
adding at the end the following: 
"PART G—PREVENTION OF ABUSE, NEGLECT, AND EXPLOITATION OF 
OLDER INDIVIDUALS 
PROGRAM AUTHORIZED 
"SEC. 371. The Commissioner shall carry out a program for Grants. 
making grants to States under State plans approved under section 
42 use 3030p. 
307 to carry out a program with respect to the prevention of abuse, 
neglect, and exploitation of older individuals. The program shall— 
"(1) be consistent with relevant State law and coordinated 
with State adult protective service activities and other State 
and local elder abuse prevention and protection; 
"(2) provide for— 
"(A) public education and outreach services to identify 
Education. 
and prevent abuse, neglect, and exploitation of older 
individuals; 
* 
"(B) receipt of reports of such abuse, neglect, and Reports. 
exploitation; 
"(C) active participation of older individuals participating 
'^ 
'- 
in programs under this Act through outreach, conferences, 
and referral of such individuals to other social service 
91' 
101 STAT. 950 
PUBLIC LAW 100-175—NOV. 29, 1987 
agencies or sources of assistance if appropriate and with the 
p 
consent of the older individuals to be referred; and 
"(D) the referral of complaints and other reports of abuse, 
neglect, or exploitation of older individuals to law enforce-
ment agencies, public protective service agencies, licensing 
and certification agencies, ombudsman programs, or protec-
tion and advocacy system if appropriate; 
"(3) not permit involuntary or coerced participation in such 
program by alleged victims, abusers, or their households; and 
"(4) require that all information gathered in the course of 
receiving such a complaint or report, and making such a refer-
ral, shall remain confidential unless— 
"(A) all parties to such complaint or report consent in 
yii > ?., 
writing to the release of such information; or 
"(B) the release of such information is to a law enforce-
ment agency, public protective service agency, licensing or 
; S
I
'
S • '^' certification agency, ombudsman program, or protection or 
^ 
advocacy system.". 
SEC. 145. LIMITATION ON CERTAIN AUTHORITY TO MAKE APPROPRIA-
TIONS. 
42 use 3023. 
Section 303 of the Older Americans Act of 1965 (42 U.S.C. 2023), as 
amended by sections 140(a), 141(a), 143(a), and 144(b), is amended by 
adding at the end the following: 
"(h) No funds may be appropriated under subsection (a)(2), (a)(3), 
(e), (f), or (g) for a fiscal year unless the aggregate amount appro-
priated for such fiscal year to carry out this title (other than sections 
306(a)(6)(P), 307(a)(12), and 311, and parts E, F, and G), title IV (other 
than sections 427 and 428), title V, and title VI exceeds 105 percent 
of the aggregate amount appropriated for the preceding fiscal year 
to carry out such titles.". 
SEC. 146. ASSISTIVE TECHNOLOGY INFORMATION. 
(a) DEFINITIONS.—Section 102 of the Older Americans Act of 1965 
(42 U.S.C. 3002) is amended by adding at the end the following: 
"(8) The term 'assistive technology' means technology, 
engineering methodologies, or scientific principles appropriate 
to meet the needs of, and address the barriers confronted by, 
older individuals with functional limitations. 
"(9) The term 'information and referral' includes information 
^•.'f I 
' relating to assistive technology.", 
c 
''<''• > 
O
t
>
) CuENT ASSESSMENT THROUGH CASE MANAGEMENT.—Section 
321(a) of the Older Americans Act of 1965 (42 U.S.C. 3030d(a)) is 
amended by adding at the end the following: "For purposes of 
paragraph (5), the term 'client assessment through case manage-
ment' includes providing information relating to assistive tech-
nology,". 
(C) MULTIDISCIPUNARY CENTERS OF GERONTOLOGY.—Section 412(a) 
}..:. 
: 
of the Older Americans Act of 1965 (42 U.S.C. 3032(a)) is amended— 
(1) in paragraph (5) by striking "and" at the end, 
(2) in paragraph (6) by striking the period at the end and 
- • * ^ inserting "; and", and 
(3) by adding at the end the following: 
"(7) if appropriate, provide information relating to assistive 
technology.". 
, 
,,,,. .. 
v , 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 951 
PART C—DEMONSTRATION GRANTS 
SEC. 151. DEMONSTRATION PROJECTS; PURPOSE. 
Section 401(1) of the Older Americans Act of 1965 (42 U.S.C. 
3030aa(l)) is amended by inserting before the semicolon the follow-
ing: ", with special emphasis on minority individuals, low-income 
individuals, frail individuals, and individuals with disabilities", 
SEC. 152. DEMONSTRATION PROJECTS. 
Section 422 of the Older Americans Act of 1965 (42 U.S.C. 3035a) is 
amended— 
(1) in subsection (a)— 
(A) by inserting "(1)" after "(a)", and 
(B) by adding at the end the following: 
"(2) The Commissioner may, after consultation with the State 
agency in the State involved, make grants to or enter into contracts 
with public or private institutions of higher education having grad-
uate programs with capability in public health, the medical sciences, 
psychology, pharmacology, nursing, social work, health education, 
nutrition, or gerontology, for the purpose of designing and develop-
ing prototype health education and promotion programs for the use 
of State and area agencies on aging in implementing preventive 
health service programs.", and 
(2) in subsection Ot)) by striking "this section" and inserting 
"subsection (aXD". 
SEC. 153. VOLUNTEER OPPORTUNITIES. 
Section 422(b) of the Older Americans Act of 1965 (42 U.S.C. 
3035a) is amended— 
(1) in paragraph (7) by striking "and" at the end, 
(2) in paragraph (8) by striking the period at the end and 
inserting "; and", and 
(3) by adding at the end the following: 
"(9) provide expanded, innovative volunteer opportunities to 
older individuals which are designed to fulfill unmet commu-
T nity needs, while at the same time avoiding duplication of 
existing volunteer programs, which may include— 
"(A) projects furnishing intergenerational services by 
... f 
older individuals addressing the needs of children, such 
as— 
"(i) tutorial services in elementary and special 
schools; 
'. ' 
"(ii) after school programs for latch key children; 
"(iii) voluntary services for day care center programs; 
'h 
ai»d 
"(B) volunteer service credit projects operated in conjunc-
tion with ACTION, permitting elderly volunteers to earn 
credits for services furnished, which may later be redeemed 
for similar volunteer services.". 
SEC. 154. SPECIAL PROJECTS IN COMPREHENSIVE LONG-TERM CARE. 
Section 423(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 
3035b(aXl)), as amended by section 134(c)(5), is amended by striking 
"may" and inserting "shall". 
Minorities. 
Disadvantaged 
persons. 
Handicapped 
persons. 
State and local 
governments. 
Contracts. 
Schools and 
colleges. 
Health and 
medical care. 
Children and 
youth. 
101 STAT. 952 
PUBLIC LAW 100-175—NOV. 29, 1987 
State and local 
SEC. 155. OUTREACH TO SSI. MEDICAID, AND FOOD STAMP RECIPIENTS. 
ffOVGrnmGnts 
(a) 
OUTREACH 
AND APPLICATION 
ASSISTANCE 
FUNCTIONS 
OF 
ADMINISTRATION ON AGING.—Section 202(a) of the Older Americans 
Act of 1965 (42 U.S.C. 3012(a)), as amended by section 103(a), is 
. 
amended— 
(1) in paragraph (18) by striking "and" at the end, 
(2) in paragraph (19) by striking the period and inserting 
"; and", and 
(3) by adding at the end the following: 
-
» 
, 
. 4 
,j, 
"(20) obtain from— 
"(A) the Department of Agriculture information explain-
ing the requirements for eligibility to receive benefits under 
the Food Stamp Act of 1977; and 
"(B) the Social Security Administration 
information 
, 
, 
, ^. 
explaining the requirements for eligibility to receive 
supplemental security income benefits under title XVI of 
the Social Security Act (or assistance under a State plan 
program under title XVI of that Act); 
and distribute such information, in written form, to State agen-
cies, for redistribution to area agencies on aging, to carry out 
outreach activities and application assistance under section 
307(a)(31).". 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 303(a) of the 
Older Americans Act of 1965 (42 U.S.C. 3023(a)), as amended by 
sections 122(a) and 129(c), is amended— 
(1) in paragraph (1) by inserting "for purposes other than 
outreach activities and application assistance under section 
307(a)(31)" before the period at the end, and 
(2) by adding at the end the following: 
"(3) Subject to subsection (h), there are authorized to be appro-
priated $10,000,000 for fiscal year 1989, $10,000,000 for fiscal year 
1990, and such sums as may be necessary for fiscal year 1991 to 
carry out section 306(a)(6)(P). Amounts appropriated under this 
subsection shall remain available until expended.". 
(c) ALLOTMENT, STATE MIMINUM.—(1)(A) The first sentence of 
section 304(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 
3024(a)(1)) is amended by striking "paragraph (2)" and inserting 
"paragraphs (2) and (3)". 
;. ;• 
(B) The last sentence of section 304(a)(1) of the Older Americans 
Act of 1965 (42 U.S.C. 3024(a)(1)) is amended by striking "purpose o f 
and inserting "purposes of paragraph (3) and". 
(2) Section 304(a) of the Older Americans Act of 1965 (42 U.S.C. 
3024(a)) is amended— 
(A) by redesignating paragraph (3) as paragraph (4), and 
(B) by inserting after paragraph (2) the following: 
"(3) No State shall be allotted, from the amount appropriated 
pursuant to section 303(a)(3), less than $50,000 for any fiscal year.". 
(d) ADMINISTRATIVE EXPENSES.—Subparagraphs (B) and (C) of sec-
tion 304(dXl) of the Older Americans Act of 1965 (42 U.S.C. 
3024(dXl)) are each amended by inserting "(excluding any amount 
attributable to funds appropriated under section 303(aX3))" after 
"amount". 
(e) OUTREACH AND APPLICATION ASSISTANCE.— 
(1) AREA PLANS.—Section 306(aX6) of the Older Americans Act 
of 1965 (42 U.S.C. 3026(aX6)), as amended by sections 127, 133, 
1340t)), and 135, is amended— 
"^gW^i. 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 953 
(A) in subparagraph (N) by striking "and" at the end, 
-.-H 
(B) in subparagraph (O) by striking the period at the end 
and inserting "; and , and 
i t • 
(C) by adding at the end the following: 
"(P) with funds and information received under section 
307(a)(31) from the State agency— 
"(i) carry out activities to identify older individuals 
~ 
with greatest economic need who may be eligible to 
receive, but are not receiving, supplemental security 
income benefits under title XVI of the Social Security 
Act (or assistance under a State plan program under 
-Hjo '; 
title XVI of that Act), medical assistance under title 
XIX of the Social Security Act, and benefits under the 
rv., .-v 
Food Stamp Act of 1977; 
"(ii) conduct outreach activities to inform older 
individuals of the requirements for eligibility to receive 
such assistance and such benefits; and 
"(iii) assist older individuals to apply for such assist-
'ji:^ii 
£mce and such benefits;". 
(2) STATE PLANS.—Section 307(a) of the Older Americans Act 
r of 1965 (42 U.S.C. 3027(a)), as amended by sections 130(c), 
: 
131(b), 132(c), 136(c)(3), 138, 140(c)(2), 141(c), 142, and 144(d), is 
f
c amended— 
(A) in paragraph (20)(A) by striking "section 306(a)(2)(A)" 
and inserting "sections 306(a)(2)(A) and 306(a)(6)(P)", and 
(B) by adding at the end the following: 
"(31) The plan shall provide that the State agency— 
"(A) from funds allotted for fiscal year 1989 under section 
304(a) for part B that are attributable to the amount appro-
priated under section 303(a)(3), will make funds available to 
eligible area agencies on aging to carry out section 
,^ . 
306(a)(6)(P) and, in distributing such funds among eligible 
r. 
area agencies, will give priority to area agencies on aging 
based on— 
"(i) the number of older individuals with greatest 
economic need (as defined in section 302(20)) residing in 
their respective planning and service areas; and 
"(ii) the inadequacy in such areas of outreach activi-
ties and application assistance of the type specified in 
•fSifl H
n 
section 306(a)(6)(P); 
"(B) will require, as a condition of eligibility to receive 
c )fi: V funds under this paragraph, an area agency on aging to 
submit an application that— 
"(i) describes the activities for which such funds are 
sought; 
"(ii) provides for an evaluation of such activities by 
the area agency; and 
"(iii) includes assurances that the area agency will 
prepare and submit to the State agency a report of the 
* f'l 
activities conducted with funds provided under this 
paragraph and the evaluation of such activities; 
"(C) will distribute to area agencies on aging— 
Public 
"(i) the eligibility information received under section information. 
202(aX20) from the Administration; and 
"(ii) information, in written form, explaining the 
requirements for eligibility to receive medical assist-
i>- 
ance under title XIX of the Social Security Act; and 
101 STAT. 954 
PUBLIC LAW 100-175—NOV. 29, 1987 
Reports. 
42 use 3026 
note. 
Public 
information. 
42 use 3026 
note. 
< • 
"(D) will submit to the Commissioner a report on the 
-
* 
evaluations required to be submitted 
under 
section 
307(a)(31)(B).". 
(f) REPORT.—Section 207 of the Older Americans Act of 1965 (42 
U.S.C. 3018) is amended by adding at the end the following: 
"(c) The Commissioner shall, as part of the annual report submit-
ted under subsection (a), prepare and submit a report on the evalua-
tions required to be submitted under section 307(a)(31)(D), together 
with such recommendations as the Commissioner deems appro-
priate. In carrying out this subsection, the Commissioner shall 
consider— 
"(1) the number of older individuals reached through out-
reach activities supported under section 306(a)(6)(P); 
"(2) the dollar amount of the assistance and benefits received 
by older individuals as a result of such activities; 
"(3) the cost of such activities in terms of the number of 
individuals reached and the dollar amount described in para-
graph (2); and 
"(4) the effect of such activities on supportive services and 
nutrition services furnished under title III of this Act.". 
(g) IMPLEMENTATION INFORMATION.—Not later than September 1, 
1988, the Commissioner on Aging shall— 
(1) analyze and compile information on successful and 
unsuccessful activities carried out to conduct outreach of the 
type described in section 306(a)(6)(P) of the Older Americans Act 
of 1965, as added by subsection (e), and 
(2) distribute such information to the State agencies on aging 
for dissemination to interested area agencies on aging to assist 
such area agencies in designing outreach activities to be carried 
out under section 306(a)(6)(P) of such Act. 
(h) EVALUATION GUIDELINES.—The Commissioner on Aging shall 
issue guidelines to be followed by State agencies on aging and area 
agencies on aging in conducting evaluations of outreach activities 
carried out under section 306(a)(6)(P), of the Older Americans Act of 
1965, as added by subsection (e). Such guidelines shall be designed to 
ensure that such evaluations are based on uniform criteria that 
provide a basis for the valid comparison of such outreach activities 
conducted by the various area agencies. 
SEC. 156. DEMONSTRATION GRANTS FOR 
INDIVIDUALS WITH DIS-
ABILITIES. 
(a) TRAINING.—Section 411(c) of the Older Americans Act of 1965 
(42 U.S.C. 3031(c)) is amended— 
(1) by striking "custodial and skilled care for older individuals 
who suffer from" and inserting "services to individuals with 
disabilities and to individuals with", and 
(2) by striking "other neurological and organic brain disorders 
of the Alzheimer's type" and inserting "and related disorders 
with neurological and organic brain dysfunction". 
(b) MuLTiDisciPLiNARY CENTERS.—Section 412(a) of the Older 
Americans Act of 1965 (42 U.S.C. 3032(a)) is amended by inserting 
"disabilities 
(including 
severe 
disabilities)," 
before 
"income 
maintenance". 
(c) DEMONSTRATION GRANTS.—Section 422(b)(2) of the Older Ameri-
cans Act of 1965 (42 U.S.C. 3035aa))(2)) is amended— 
(1) in subparagraph (C) by striking "and" at the end, 
(2) in subparagraph (D) by inserting "and" at the end, and 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 955 
'<• 
(3) by adding at the end the following: 
"(E) the identification and provision of services to older 
individuals with severe disabilities;". 
(d) LONG-TERM CARE SPECIAL PROJECTS.—Section 423(a)(3) of 
the 
Older Americans Act of 1965 (42 U.S.C. 3035b(a)(3)) is amended by 
inserting after "geriatric health maintenance organizations;" the 
following: "services to older individuals with severe disabilities 
residing in nursing homes;". 
(e) ADDITIONAL SPECIAL PROJECTS.—(1) Part B of title IV of the 
Older Americans Act of 1965 (42 U.S.C. 3034 et seq.) is amended by 
adding at the end the following: 
"OMBUDSMAN AND ADVOCACY DEMONSTRATION PROJECTS 
State and local 
governments. 
42 u s e 3035f. 
"SEC. 427. (a) The Commissioner is authorized to make grants to 
not less than three nor more than ten States to demonstrate and 
evaluate cooperative projects between the State long-term care 
ombudsman program and the State protection and advocacy systems 
for developmental disabilities and mental illness, established 
under part A of the Developmental Disabilities Assistance and Bill 
of Rights Act (42 U.S.C. 6001 et seq.) and under the Protection and 
Advocacy for Mentally 111 Individuals Act of 1986 (Public Law 99-
319). 
"(b) The Commissioner on Aging shall prepare and submit to the Reports. 
Congress a report of the study and evaluation required by subsection 
(a). Such report shall contain such recommendations as the Commis-
sioner on Aging deems appropriate.". 
(2) Section 431(a) of the Older Americans Act of 1965 (42 U.S.C. 
3037(a)) is amended— 
(A) by inserting "(other than section 427)" after "title", 
(B) by inserting "(1)" after "(a)", and 
(C) by adding at the end the following: 
"(2) Subject to subsection (b), there is authorized to be appro-
priated $1,000,000 for fiscal year 1989 to carry out the provisions of 
section 427. The funds appropriated pursuant to this paragraph 
shall remain available for expenditure for fiscal year 1990.". 
SEC. 157. CONSUMER PROTECTION DEMONSTRATION PROJECTS 
FOR 
SERVICES PROVIDED IN THE HOME. 
(a) DEMONSTRATION PROJECTS AUTHORIZED.—Part B of title IV of 
the Older Americans Act of 1965 (42 U.S.C. 3034 et seq.), as amended 
by section 156(e)(1), is amended by adding at the end the following: 
"CONSUMER PROTECTION DEMONSTRATION PROJECTS FOR SERVICES 
PROVIDED IN THE HOME 
Appropriation 
authorizations. 
"SEC. 428. (a)(1) The Commissioner is authorized to make grants to 
not fewer than 6 nor more than 10 States to demonstrate and 
evaluate the effectiveness of consumer protection projects for serv-
ices (other than medical services) provided to older individuals in 
the home that are furnished or assisted with public funds. 
"(2) Grants made under this section shall be used to test different 
approaches to protecting older individuals with regard to services in 
the home. Such projects may provide consumer protection through 
State and local ombudsmen, legal assistance agencies, and other 
community service agencies. 
"(b) No grant may be made under this section unless an applica-
tion is made to the Commissioner at such time, in such manner, and 
State and local 
governments. 
42 u s e 3035g. 
101 STAT. 956 
PUBLIC LAW 100-175—NOV. 29, 1987 
containing such information as the Commissioner may reasonably 
require. Each such application shall— 
"(1) describe activities for which assistance is sought; 
"(2) provide for an evaluation of the activities for which 
assistance is sought; and 
"(3) provide assurances that the applicant will prepare and 
A submit a report to the Commissioner on the activities conducted 
with assistance under this section and the evaluation of such 
activities. 
"(c) In approving applications under this section, the Commis-
sioner shall assure equitable geographic distribution of assistance. 
Reports. 
"(d) The Commissioner shall, as part of the annual report 
submitted under section 207, prepare and submit a report on the 
evaluations submitted under this section, together with such rec-
ommendations as the Commissioner deems appropriate. In carrying 
out this section, the Commissioner shall include in the report— 
"(1) a description of the demonstration projects assisted under 
this section; 
"(2) an evaluation of the effectiveness of each such project; 
and 
"(3) recommendations of the Commissioner with respect to 
the desirability and feasibility of carrying out on a nationwide 
basis a consumer protection program for services in the home. 
^' 
'5 
"(e) Consumer protection projects carried out under this section— 
"(1) may include, but are not limited to, consumer education, 
the use of consumer hotlines, receipt and resolution of 
consumer complaints, and advocacy; and 
"(2) may not address medical services.", 
(b) AUTHORIZATION OF APPROPRIATIONS.—Section 431(aXl) of 
the 
Older Americans Act of 1965 (42 U.S.C 3037(a)(1)), as amended by 
section 156(e)(2), is amended— 
(1) by striking "section 427" in the parenthetical and insert-
yfji 
' 
ing "sections 427 and 428", and 
(2) by adding at the end the following: 
"(3) Subject to subsection (b), there is authorized to be appro-
priated $2,000,000 for each of the fiscal years 1989 and 1990 to carry 
out the provisions of section 428.". 
SEC. 158. AUTHORIZATION 
OF 
APPROPRIATIONS 
FOR 
TRAINING, 
RESEARCH, AND DISCRETIONARY PROJECTS AND PROGRAMS. 
Paragraph (1) of section 431(a) of the Older Americans Act of 1965 
(42 U.S.C. 3037(a)(1)), as amended by sections 156(eX2) and 157(b), is 
amended to read as follows: 
"(1) There are authorized to be appropriated to carry out the 
provisions of this title (other than sections 427 and 428) $32,970,000 
for the fiscal year 1988, $34,619,000 for the fiscal year 1989, 
$36,349,000 for the fiscal year 1990, and $38,167,000 for the fiscal 
year 1991. 
SEC. 159. LIMITATION ON CERTAIN AUTHORITY TO MAKE APPROPRIA-
TIONS. 
Section 431 of the Older Americans Act of 1965 (42 U.S.C. 3037) is 
amended— 
(1) by redesignating subsection Qy) as subsection (c), and 
(2) by inserting after subsection (a) the following: 
"(b) No funds may be appropriated under paragraph (2) or (3) of 
subsection (a) for a fiscal year unless the aggregate amount appro-
:<f>Jii 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 957 
priated for such fiscal year to carry out this title (other than sections 
427 and 428), title III (other than sections 306(a)(6)(P), 307(a)(12), and 
311, and parts E, F, and G), title V, and title VI exceeds 105 percent 
of the aggregate amount appropriated for the preceding fiscal year 
to carry out such titles.". 
PART D—COMMUNITY SERVICE EMPLOYMENT 
SEC. 161. ADMINISTRATIVE COSTS OF EMPLOYMENT PROJECTS. 
Section 502(c)(3) of the Older Americans Act of 1965 (42 U.S.C. 
3056(c)(3)) is amended to read as follows: 
"(3) Of the amount for any project to be paid by the Secretary 
under this subsection, not more than 13,5 percent for fiscal year 
1987 and each fiscal year thereafter shall be available for paying the 
costs of administration for such project, except that— 
"(A) whenever the Secretary determines that it is necessary 
to carry out the project assisted under this title, based on 
information submitted by the public or private nonprofit agency 
or organization with which the Secretary has an agreement 
under subsection 0^), the Secretary may increase the amount 
available for paying the cost of administration to an amount not 
more than 15 percent of the cost of such project; and 
"(B) whenever the public or private nonprofit agency or 
organization with which the Secretary has an agreement under 
subsection (b) demonstrates to the Secretary that— 
"(i) major 
administrative cost increases are being 
incurred in necessary program components, including li-
ability insurance, payments for workers' compensation, 
costs associated with achieving unsubsidized placement 
' ' ' 
goals, and other operation requirements imposed by the 
Secretary; 
:\>f' 
"(ii) the number of employment positions in the project or 
the number of minority eligible individuals participating in 
~ • 
the project will decline if the amount available for paying 
the cost of administration is not increased; or 
f 
"(iii) the size of the project is so small that the amount of 
administrative expenses incurred to carry out the project 
necessarily exceed 13.5 percent of the amount for such 
project; 
the Secretary shall increase the amount available for the fiscal 
year for paying the cost of administration to an amount not 
more than 15 percent of the cost of such project.". 
SEC. 162. COMMUNITY 
SERVICE 
EMPLOYMENT 
SPECIAL 
NEEDS 
ASSURANCE. 
(a) PROGRAM ASSURANCE.—Section 502(b)(l)(M) of the Older 
Americans Act of 1965 (42 U.S.C. 3056(b)(l)(M)) is amended to read 
as follows: 
"(M) will assure, that to the extent feasible, such project will 
serve the needs of minority, limited English-speaking, and 
Indian eligible individuals in proportion to their numbers in the 
State and take into consideration their rates of poverty and 
unemployment;". 
(b) RESERVATION OF FUNDS.—Section 506(a)(1)(A) of the Older 
Americans Act of 1965 (42 U.S.C 3056d(a)(l)(A)) is amended by 
inserting after the first sentence the following: "Beginning with the 
first fiscal year in which the amount appropriated to carry out this 
Minorities. 
Indians. 
Grants. 
Contracts. 
Indians. 
101 STAT. 958 
PUBLIC LAW 100-175—NOV. 29, 1987 
title exceeds the amount appropriated for fiscal year 1987 to carry 
out this title, the Secretary shall next reserve such sums as may be 
necessary for national grants or contracts with public or nonprofit 
national Indian aging organizations with the ability to provide 
employment services to older Indians and with national public or 
nonprofit Pacific Island and Asian American aging organizations 
with the ability to provide employment services to older Pacific 
Island and Asian Americans.". 
SEC. 163. INFORMATION ON AGE DISCRIMINATION PROHIBITIONS. 
Section 503(b) of the Older Americans Act of 1965 (42 U.S.C. 
3056a(b)) is amended— 
(1) by inserting "(1)" after "(b)", and 
-; 
^
^ j 
(2) by adding at the end the following: 
Grants. 
"(2) The Secretary shall distribute to grantees under this title, for 
distribution to program enroUees, and at no cost to grantees oi 
enroUees, informational materials developed and supplied by the 
Equal Employment Opportunity Commission and other appropriate 
Federal agencies which the Secretary determines are designed to 
help enroUees identify age discrimination and understand their 
rights under the Age Discrimination in Employment Act of 1967.". 
SEC. 164. DEFINITIONS. 
(a) COMMUNITY SERVICES.—Section 507(3) of the Older Americans 
Act of 1965 (42 U.S.C. 3056e(3)) is amended by inserting "(particu-
larly literacy tutoring)" after "educational services". 
(b) PACIFIC ISLAND AND ASIAN AMERICANS.—Section 507 of the 
Older Americans Act of 1965 (42 U.S.C. 3056e) is amended— 
(1) in paragraph (3) by striking "and" at the end, 
,,5 
(2) in paragraph (4) by striking the period at the end, and 
(3) by adding at the end the following: 
"(5) the term 'Pacific Island and Asian Americans' means 
Americans having origins in any of the original peoples of the 
Far East, Southeast Asia, the Indian Subcontinent, or the 
Pacific Islands.". 
SEC. 165. AUTHORIZATION OF APPROPRIATIONS FOR COMMUNITY SERV-
ICE EMPLOYMENT FOR OLDER AMERICANS. 
Section 508(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 
3056f(a)(l)) is amended to read as follows: 
"(1) $386,715,000 for the fiscal year 1988, $406,051,000 for the 
fiscal year 1989, $426,353,000 for the fiscal year 1990, and 
$447,671,000 for the fiscal year 1991.". 
SEC. 166. EMPLOYMENT ASSISTANCE AND OTHER PROGRAMS. 
Title V of the Older Americans Act of 1965 (42 U.S.C. 3056-30560 
is amended by adding at the end the following: 
"EMPLOYMENT ASSISTANCE AND FEDERAL HOUSING AND FOOD STAMP 
' s./r 
PROGRAMS 
42 use 3056g. 
"SEC. 509. Funds received by eligible individuals from projects 
carried out under the program established in this title shall not be 
considered to be income of such individuals for purposes of deter-
mining the eligibility of such individuals, or of any other persons, to 
participate in any housing program for which Federal funds may be 
available or for any income determination under the Food Stamp 
Act of 1977.". 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 959 
PART E—NATIVE AMERICAN PROGRAMS 
SEC. 171. NATIVE AMERICAN PROGRAMS. 
^ 
Title VI of the Older Americans Act of 1965 (42 U.S.C. 3057-3057g) 
is amended to read as follows: 
"TITLE VI—GRANTS FOR NATIVE AMERICANS 
"STATEMENT OF PURPOSE 
"SEC. 601. It is the purpose of this title to promote the delivery of 42 USC 3057. 
supportive services, including nutrition services to American 
Indians, Alaskan Natives, and Native Hawaiians that are com-
parable to services provided under title III. 
"SENSE OF CONGRESS 
"SEC. 602. It is the sense of the Congress that older Indians, older 42 use 3057a. 
Alaskan Natives, and older Native Hawaiians are a vital resource 
-r, .; 
entitled to all benefits and services available and that such services 
and benefits should be provided in a manner that preserves and 
restores their respective dignity, self-respect, and cultural identities. 
. 
- 
"PART A—INDIAN PROGRAM 
FINDINGS 
"SEC. 611. (a) The Congress finds that the older Indians of the 42 USC 3057b. 
United States— 
"(1) are a rapidly increasing population; 
"(2) suffer from high unemployment; 
"(3) live in poverty at a rate estimated to be as high as 61 
percent; 
"(4) have a life expectancy between 3 and 4 years less than 
the general population; 
"(5) lack sufficient nursing homes, other long-term care facili-
ties, and other health care facilities; 
"(6) lack sufficient Indian area agencies on aging; 
"(7) frequently live in substandard and over-crowded housing; 
"(8) receive less than adequate health care; 
"(9) are served under this title at a rate of less than 19 
percent of the total national Indian elderly population living on 
"- 
Indian reservations; and 
"(10) are served under title III at a rate of less than 1 percent 
of the total participants under that title. 
ELIGIBIUTY 
"SEC, 612. (a) A tribal organization of an Indian tribe is eligible for 
assistance under this part only if— 
"(1) the tribal organization represents at least 50 individuals 
who are 60 years of age or older; and 
"(2) the tribal organization demonstrates the ability to deliver 
supportive services, including nutritional services. 
"(b) For the purposes of this part the terms 'Indian tribe' and 
'tribal organization have the same meaning as in section 4 of the 
Indian Self-Determination and Education Assistance Act (25 U.S.C. 
450b). 
42 USC 3057c. 
101 STAT. 960 
PUBLIC LAW 100-175—NOV. 29, 1987 
GRANTS AUTHORIZED 
42 use 3057d. 
"SEC. 613. The Commissioner may make grants to eligible tribal 
organizations to pay all of the costs for delivery of supportive 
services and nutrition services for older Indians. 
APPUCATIONS 
v. 
42 use 3057e. 
"SEC. 614. (a) No grant may be made under this part unless the 
eligible tribal organization submits an application to the Commis-
, 
;,;j^,, 
sioner which meets such criteria as the Commissioner may by 
regulation prescribe. Each such application shall— 
"(1) provide that the eligible tribal organization will evaluate 
the need for supportive and nutrition services among older 
Indians to be represented by the tribal organization; 
"(2) provide for the use of such methods of administration as 
are necessary for the proper and efficient administration of the 
program to be assisted; 
Reports. 
"(3) provide that the tribal organization will make such 
reports in such form and containing such information, as the 
Commissioner may reasonably require, and comply with such 
S' 
requirements as the Commissioner may impose to assure the 
correctness of such reports; 
"(4) provide for periodic evaluation of activities and projects 
carried out under the application; 
"(5) establish objectives consistent with the purposes of this 
-, 
. ., 
,, : part toward which activities under the application will be 
directed, identify obstacles to the attainment of such objectives, 
and indicate the manner in which the tribal organization pro-
poses to overcome such obstacles; 
rj; 
"(6) provide for establishing and maintaining information and 
referral services to assure that older Indians to be served by the 
^^, . assistance made available under this part will have reasonably 
convenient access to such services; 
,|., 
"(7) provide a preference for Indians aged 60 and older for full 
or part-time staff positions wherever feasible; 
Contracts. 
"(8) provide assurances that either directly or by way of grant 
^, or contract with appropriate entities nutrition services will be 
delivered to older Indians represented by the tribal organization 
i r 
substantially in compliance with the provisions of part C of title 
III, except that in any case in which the need for nutritional 
services for older Indians represented by the tribal organization 
.^, is already met from other sources, the tribal organization may 
use the funds otherwise required to be expended under this 
clause for supportive services; 
"(9) contain assurances that the provisions of sections 
307(a)(14)(A) (i) and (iii), 307(a)(14XB), and 307(aX14)(C) will be 
) ' 
'•^•'- 
complied with whenever the application contains provisions for 
the acquisition, alteration, or renovation of facilities to serve as 
- 
multipurpose senior centers; 
"(10) provide that any legal or ombudsman services made 
available to older Indians represented by the tribal organization 
will be substantially in compliance with the provisions of title 
III relating to the furnishing of similar services; and 
"(11) provide satisfactory assurance that fiscal control and 
fund accounting procedures will be adopted as may be necessary 
to assure proper disbursement of, and accounting for. Federal 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 961 
funds paid under this part to the tribal organization, including 
any funds paid by the tribal organization to a recipient of a 
. 
, 
grant or contract. 
"(b) For the purpose of any application submitted under this part, 
the tribal organization may develop its own population statistics, 
with certification from the Bureau of Indian Affairs, in order to 
establish eligibility. 
"(c) The Commission shall approve any application which com-
plies with the provisions of subsection (a). 
' - * 
"(d) Whenever the Commissioner determines not to approve an 
application submitted under subsection (a) the Commission shall— 
"(1) state objections in writing to the tribal organization 
within 60 days after such decision; 
"(2) provide to the extent practicable technical assistance to 
the tribal organization to overcome such stated objections; and 
"(3) provide the tribal organization with a hearing, under 
such rules and regulations as the Commissioner may prescribe. 
"(e) Whenever the Commissioner approves an application of a 
tribal organization under this part, funds shall be awarded for not 
less than 12 months. 
"SURPLUS EDUCATIONAL FACIUTIES 
"SEC. 615. (a) Notwithstanding any other provision of law, the 
42 use 3057f. 
Secretary of the Interior through the Bureau of Indian Affairs shall 
make available surplus Indian educational facilities to tribal 
organizations, and nonprofit organizations with tribal approval, for 
use as multipurpose senior centers. Such centers may be altered so 
as to provide extended care facilities, community center facilities, 
nutrition services, child care services, and other supportive services. 
"(b) Each eligible tribal organization desiring to take advantage of 
such surplus facilities shall submit an application to the Secretary 
of the Interior at such time and in such manner, and containing or 
accompanied by such information, as the Secretary of the Interior 
determines to be necessary to carry out the provisions of this 
section. 
"PART B—NATIVE HAWAIIAN PROGRAM 
FINDINGS 
"SEC. 621. The Congress finds the older Native Hawaiians— 
"(1) have a life expectancy 10 years less than any other ethnic 
group in the State of Hawaii; 
"(2) rank lowest on 9 of 11 standard health indicies for all 
ethnic groups in Hawaii; 
"(3) are often unaware of social services and do not know how 
to go about seeking such assistance; and 
"(4) live in poverty at a rate of 34 percent. 
42 use 3057g. 
ELIGIBILITY 
"SEC. 622. A public or nonprofit private organization having the 
capacity to provide services under this part for Native Hawaiians is 
eligible for assistance under this part only if— 
"(1) the organization will serve at least 50 individuals who 
have attained 60 years of age or older; and 
"(2) the organization demonstrates the ability to deliver 
supportive services, including nutrition services. 
42 use 3057h. 
101 STAT. 962 
PUBLIC LAW 100-175—NOV. 29, 1987 
^ 
« 
v.; 
.^^ 
. 
GRANTS AUTHORIZED 
^ 
/ 
42 use 30571. 
"SEC. 623. The Commissioner may make grants to public and 
nonprofit private organizations to pay all of the costs for the deliv-
ery of supportive services and nutrition services to older Native 
Hawaiians. 
;K,,;>^ .jfiv 
.-...j . 
"APPLICATION 
42 use 3057J. 
"SEC. 624. (a) No grant may be made under this part unless the 
public or nonprofit private organization submits an application to 
the Commissioner which meets such criteria as the Commissioner 
may by regulation prescribe. Each such application shall— 
"(1) provide that the organization will evaluate the need for 
supportive and nutrition services among older Native Hawai-
ians to be represented by the organization; 
"(2) provide for the use of such methods of administration as 
are necessary for the proper and efficient administration of the 
program to be assisted; 
"(3) provide assurances that the organization will coordinate 
its activities with the State agency on aging; 
Reports. 
"(4) provide that the organization will make such reports in 
such form and containing such information as the Com-
missioner may reasonably require, and comply with such re-
quirements as the Commissioner may impose to ensure the 
correctness of such reports; 
"(5) provide for periodic evaluation of activities and projects 
carried out under the application; 
"(6) establish objectives, consistent with the purpose of this 
title, toward which activities described in the application will be 
directed, identify obstacles to the attainment of such objectives, 
and indicate the manner in which the organization proposes to 
overcome such obstacles; 
"(7) provide for establishing and maintaining information and 
"' 
referral services to assure that older Native Hawaiians to be 
served by the assistance made available under this part will 
have reasonably convenient access to such services; 
"(8) provide a preference for Native Hawaiians 60 years of age 
and older for full or part-time staff positions wherever feasible; 
"(9) provide that any legal or ombudsman services made 
., 
available to older Native Hawaiians represented by the non-
profit private organization will be substantially in compliance 
^-. 
with the provisions of title III relating to the furnishing and 
similar services; and 
,tff; 
"(10) provide satisfactory assurances that the fiscal control 
and fund accounting procedures will be adopted as may be 
necessary to assure proper disbursement of, and accounting for. 
Federal funds paid under this part to the nonprofit private 
organization, including any funds paid by the organization to a 
^
^ 
, 
recipient of a grant or contract. 
' 
' ' 
"Oo) The Commissioner shall approve any application which com-
plies with the provisions of subsection (a). 
"(c) Whenever the Commissioner determines not to approve an 
application submitted under subsection (a) the Commissioner shall— 
"(1) state objections in writing to the nonprofit private 
organization within 60 days after such decision; 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 963 
"(2) provide to the extent practicable technical assistance to 
the nonprofit private organization to overcome such stated 
objections; and 
"(3) provide the organization with a hearing under such rules 
and regulations as the Commissioner may prescribe. 
"(d) Whenever the Commissioner approves an application of a 
nonprofit private or public organization under this part funds shall 
be awarded for not less than 12 months. 
DEFINITION 
"SEC. 625. For the purpose of this part, the term 'Native Hawai-
ian' means any individual any of whose ancestors were natives of 
the area which consists of the Hawaiian Islands prior to 1778. 
42 u s e 3057k. 
'PART C—GENERAL PROVISIONS 
ADMINISTRATION 
"SEC. 631. In establishing regulations for the purpose of part A the 42 USC 3057/. 
Commissioner shall consult with the Secretary of the Interior. 
PAYMENTS 
"SEC. 632. Payments may be made under this title (after necessary 
adjustments, in the case of grants, on account of previously made 
overpayments or underpayments) in advance or by way of re-
imbursement in such installments and on such conditions, as the 
Commissioner may determine. 
42 USC 3057m. 
AUTHORIZATION OF APPROPRIATIONS 
"SEC. 633. (a) Subject to subsection (b), there are authorized to be 
appropriated to carry out this title (other than section 615)— 
"(1) $13,400,000 for fiscal year 1988, of which $12,100,000 shall 
be available to carry out part A and $1,300,000 shall be avail-
able to carry out part B; 
"(2) $16,265,000 for fiscal year 1989, of which $14,900,000 shall 
be available to carry out part A and $1,365,000 shall be avail-
C able to carry out part B; 
"(3) $19,133,000 for fiscal year 1990, of which $17,700,000 shall 
be available to carry out part A and $1,433,000 shall be avail-
f 
able to carry out part B; and 
"(4) $22,105,000 for fiscal year 1991, of which $20,600,000 shall 
be available to carry out part A and $1,505,000 shall be avail-
able to carry out part B.". 
"Ot>)(l) If the amount appropriated under subsection (a) for a fiscal 
year does not exceed the amount appropriated to carry out this title 
(as in effect before the effective date of the Older Americans Act 
Amendments of 1987) in fiscal year 1987, then the amount appro-
priated under subsection (a) for such fiscal year shall be available 
only to carry out part A. 
"(2) If the amount appropriated under subsection (a) for a fiscal 
year exceeds the amount appropriated to carry out this title (as in 
effect before the effective date of the Older Americans Act Amend-
ments of 1987) in fiscal year 1987, then— 
"(A) $250,000 of such excess shall be made available to carry 
out part B; and 
42 USC 3057n. 
91-194 O - 90 - 32 : QL.3 Part 1 
101 STAT. 964 
PUBLIC LAW 100-175—NOV. 29, 1987 
:
>
5 
"(B) one-half of the remaining amount of such excess shall be 
made available to carry out part B; 
except that the aggregate amount made available to carry out part 
B may not exceed the amount required (without regard to this 
paragraph) by subsection (a) to be made available to carry out part 
B.". 
PART F—MISCELLANEOUS AND TECHNICAL AMENDMENTS 
SEC. 181. REPEAL OF OLDER AMERICANS PERSONAL HEALTH EDU-
CATION AND TRAINING PROGRAM. 
' 
--''^ 
Title VII of the Older Americans Act of 1965 (42 U.S.C. 3058-
3058d) is repealed. 
SEC. 182. TECHNICAL AMENDMENTS. 
(a) Section 102(1) of the Older Americans Act of 1965 (42 U.S.C. 
3002(1)) is amended by striking "other than for purposes of title V" 
and inserting "except that for purposes of title V such term means 
the Secretary of Labor". 
: u c;.' i; 
(i,)(i) Section 102 of the Older Americans Act of 1965 (42 U.S.C. 
3002) is amended— 
(A) in paragraph (3)— 
(i) by striking "includes" and inserting "means any of the 
, .,. . ,, , 
^ 
several States,", and 
.5, 
(ii) by striking "Puerto Rico" and inserting "the Common-
wealth of Puerto Rico", and 
(B) by adding at the end the following: 
"(8) The term 'Trust Territory of the Pacific Islands' includes 
the Federated States of Micronesia, the Republic of the Mar-
shall Islands, and the Republic of Palau.". 
(2) Section 302 of the Older Americans Act of 1965 (42 U.S.C. 3022), 
(trc.: ' -; i • as amended by sections 136(a) and 144(a), is amended— 
(A) by striking paragraph (6), and 
i'i 
(B) by redesignating paragraphs (7) through (20) as para-
graphs (6) through (19), respectively. 
(3) Section 506(aX4)(A) of the Older Americans Act of 1965 (42 
U.S.C. 3056d(a)(4)(A)) is amended by striking "Puerto Rico" and 
inserting "the Commonwealth of Puerto Rico". 
(4) Section 507 of the Older Americans Act of 1965 (42 U.S.C. 
3056e), as amended by section 164(b), is amended— 
(A) by striking paragraph (1), and 
(B) by redesignating paragraphs (2), (3), (4), and (5) as para-
graphs (1), (2), (3), and (4), respectively. 
(c) Section 201(a) of the Older Americans Act of 1965 (42 U.S.C. 
3011(a)) is amended by striking "his functions" and inserting "the 
functions of the C!ommissioner". 
(d) Section 204(d)(3) of the Older Americans Act of 1965 (42 U.S.C. 
3015(d)(3)) is amended by inserting "to" after "Secretary,". 
(eXl) Section 302 of the Older Americans Act of 1965 (42 U.S.C. 
3022), as amended by subsection (b)(2) and sections 136(a) and 144(a), 
is amended by adding at the end the following: 
"(20) The term 'greatest economic need' means the need 
"
^ 
resulting from an income level at or below the poverty levels 
" 
established by the Office of Management and Budget. 
"(21) The term 'greatest social need' means the need caused 
'^' 
by noneconomic factors which include physical and mental 
disabilities, language barriers, and cultural, social, or geo-
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 965 
graphical isolation including that caused by racial or ethnic 
status which restricts an individual's ability to perform normal 
daily tasks or which threatens such individual's capacity to live 
independently.". 
(2) Section 305(d) of the Older Americans Act of 1965 (42 U.S.C. 
3025(d)) is amended— 
(A) by striking "(d)(1)" and inserting "(d)", and 
(B) by striking paragraph (2). 
(3) Section 306(a) of the Older Americans Act of 1965 (42 U.S.C. 
3026(a)) is amended by striking the last sentence. 
(f) Section 304(d)(1) of the Older Americans Act of 1965 (42 U.S.C. 
3024(d)(1)) is amended in the matter preceding subparagraph (A) by 
inserting a comma after "section 308(b)". 
(g) Section 305(a)(1)(E) of the Older Americans Act of 1965 (42 
U.S.C. 3025(a)(1)(E)) is amended by striking "legal services" and 
inserting "legal assistance", 
(h) Section 305(a)(2)(C) of the Older Americans Act of 1965 (42 
U.S.C. 3025(a)(2)(C)) is amended by inserting "in accordance with 
subsection (d)" before the semicolon at the end. 
(i) Section 306(a)(6)(G) of the Act (42 U.S.C. 3026(a)(6)(G)), as 
amended by section 137(b), is amended by striking "and" at the end. 
0) Section 306(a)(2)(B) of the Older Americans Act of 1965 (42 
U.S.C. 3026(aX2)(B)) is amended by striking "other neurological and 
organic brain disorders of the Alzheimer's type" and inserting 
"related disorders with neurological and organic brain dysfunction'. 
(k) Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)) is amended— 
(1) by striking "Each such plan shall—" and inserting "Each 
such plan shall comply with all of the following requirements:", 
(2) in paragraph (1)— 
-«* 
(A) by inserting "The plan shall" after "(1)", and 
(B) by striking the semicolon at the end and inserting a 
period, 
(3) in paragraph (2)— 
a la .., 
(A) by inserting "The plan shall" after "(2)", and 
(B) by striking the semicolon at the end and inserting a 
period, 
(4) in paragraph (3)— 
» c 
(A) in subparagraph (A) by inserting "The plan shall" 
after "(3)(A)", and 
(B) in subparagraph (B)— 
(i) by inserting "The plan shall" after "(B)", and 
i. I.'* •. 
(ii) by striking the semicolon at the end and inserting 
a period, 
(5) in paragraph (4)— 
(A) by inserting "The plan shall" after "(4)", and 
K 1^ 
(B) by striking the semicolon at the end and inserting a 
period, 
(6) in paragraph (5)— 
(A) by inserting "The plan shall" after "(5)", and 
(B) by striking the semicolon at the end and inserting a 
period, 
(7) in paragraph (6)— 
(A) by inserting "The plan shall" after "(6)", and 
(B) by striking the semicolon at the end and inserting a 
period, 
(8) in paragraph (7)— 
101 STAT. 966 
PUBLIC LAW 100-175—NOV. 29, 1987 
(A) by inserting "The plan shall" after "(7)", and 
(B) by striking the semicolon at the end and inserting a 
period, 
^-=-.:'- 
••J:-' 
(9) in paragraph (8)— 
(A) by inserting "The plan shall" after "(8)", and 
(B) by striking the semicolon at the end and inserting a 
period, 
(10) in paragraph (9)— 
(A) by inserting "The plan shall" after "(9)", and 
(B) by striking the semicolon at the end and inserting a 
period, 
' •
' 
(11) in paragraph (10)— 
(A) by inserting "The plan shall" after "(10)", and 
' 
: 
(B) by striking the semicolon at the end and inserting a 
i-ith 
period, 
(12) in paragraph (11)— 
(A) by inserting "The plan shall" after "(11)", and 
'- 
(B) by striking the semicolon at the end and inserting a 
period, 
^ 
(13) in paragraph (13)— 
,. 
(A) by inserting "The plan shall" after "(13)", and 
(B) in subparagraph (I) by striking the semicolon at the 
end and inserting a period, 
(14) in paragraph (14)— 
(A) by inserting "The plan shall" after "(14)", and 
(B) in subparagraph (E) by striking the semicolon at the 
end and inserting a period, 
(15) in paragraph (15)— 
(A) by inserting "The plan shall" after "(15)", and 
(B) in subparagraph (D) by striking the semicolon and 
inserting a period, 
;,i ^ 
(16) in paragraph (16)— 
(A) by inserting "The plan shall" after "(16)", and 
(B) in subparagraph (C) by striking the semicolon at the 
end and inserting a period, 
(17) in paragraph (17)— 
(A) by inserting "The plan shall" after "(17)", and 
I A , 
(B) by striking the semicolon at the end and inserting a 
period, 
(18) in paragraph (18)— 
b 
(A) by inserting "The plan shall" after "(18)", and 
(B) by striking the semicolon at the end and inserting a 
period, 
(19) in paragraph (19)— 
(A) by inserting "The plan shall" after "(19)", and 
(B) by striking the semicolon at the end and inserting a 
period, and 
(20) in paragraph (20)— 
(A) by inserting "The plan shall" after "(20)", and 
E J 
(B) in subparagraph (B)(ii) by striking "; and" at the end 
and inserting a period. 
(1) Section 308(b) of the Older Americans Act of 1965 (42 U.S.C. 
3028(b)) is amended— 
(1) by striking "(b)(1)(A)" and inserting "ObXD", 
(2) in paragraph (1)— 
(A) by striking "(i)" and inserting "(A)", and 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 967 
(B) by striking "(ii)" the second place it appears and 
inserting "(B)", 
(3) in paragraph (2)— 
(A) by striking "(2)(A)" and inserting "(2)", 
(B) by striking "(i)" and inserting "(A)", and 
(C) by striking "(ii)" the second place it appears and 
inserting "(B)", 
(4) in paragraph (3)(C) by striking "he" and inserting "the 
Commissioner", 
(5) in subparagraphs (A) and (B) of paragraph (5) by striking 
' "appropriated" each place it appears and inserting "allotted", 
and 
(6) in paragraph (5)(B) beginning with the dash strike out all 
through the period and insert: "not more than 30 percent of the 
funds allotted for any fiscal year.". 
(m) Section 321(a)(10) of the Older Americans Act of 1965 (42 
U.S.C. 3030d(a)(10)) is amended by inserting "for" after "advocate". 
(n) Section 337 of the Older Americans Act of 1965 (42 U.S.C. 
3030g) is amended by striking "Association of Area Agencies on 
Aging" and inserting "National Association of Area Agencies on 
Aging". 
(o) Section 422(b)(1) of the Older Americans Act of 1965 (42 U.S.C. 
3035a(b)(l)) is amended by striking "Alzheimers' disease and other 
organic and neurological brain disorders of the Alzheimers' type" 
and inserting "Alzheimer's disease and related disorders with 
neurological and organic brain dysfunction", 
(p) Section 507(1) of the Older Americans Act of 1965 (42 U.S.C. 
3056e(2)), as amended by subsection Ot))(4), is amended by striking 
"the Bureau of Labor Statistics" and inserting "the Office of 
Management and Budget". 
PART G—CONSUMER PRICE INDEX FOR OLDER AMERICANS 
SEC. 191. INDEX AUTHORIZED. 
29 USC 2 note. 
The Secretary of Labor shall, through the Bureau of Labor Statis-
tics, develop, from existing data sources, a reweighted index of 
consumer prices which reflects the expenditures for consumption by 
Americans 62 years of age and older. The Secretary shall furnish to 
the Congress the index within 180 days after the date of enactment 
of this Act. The Secretary shall include with the index furnished a 
report which explains the characteristics of the reweighted index, 
the research necessary to develop and measure accurately the rate 
of inflation affecting such Americans, and provides estimates of 
time and cost required for additional activities necessary to carry 
out the objectives of this section. 
TITLE 11—1991 WHITE HOUSE 
CONFERENCE ON AGING 
SEC. 201. WHITE HOUSE CONFERENCE AUTHORIZED. 
42 USC 3001 
(a) FINDINGS.—The Congress finds that— 
(1) the number of individuals 55 years of age or older was 
approximately 51,400,000 in 1986, and will, by the year 2040, be 
approximately 101,700,000, 
101 STAT. 968 
PUBLIC LAW 100-175—NOV. 29, 1987 
(2) more than 1 of every 6 persons 55 years of age or older will 
be hospitalized during the next year, 
(3) persons 55 years of age or older have a higher average out-
of-pocket medical cost burden than younger persons; approxi-
mately 17 percent of individuals age 55 to 64 experience out-of-
b 
pocket costs in excess of 20 percent of their family income and 
the average per capita out-of-pocket cost of persons 65 years of 
y 
age or older is expected to equal 18.5 percent of income by 1991, 
(4) there is a great need to ensure access and the quality of 
•jj 
affordable health care to all older individuals, 
* 
(5) the need for a comprehensive and responsive long-term 
care delivery system is great, 
11 
(6) the availability and cost of suitable housing, together with 
ft, 
suitable services needed for independent or semi-independent 
living, still cause concern to older individuals, 
gi 
(7) the ability to lead an independent or semi-independent life 
is contingent, in many cases, upon the availability of a 
comprehensive and effective social service system for older 
4 
individuals, 
n 
(8) the availability and access to opportunities for continued 
productivity and employment is of great importance to middle-
aged and older individuals who want or need to work, 
T. 
(9) the fulfillment, dignity, and satisfaction of retirees still 
depend on the continuing development of a consistent national 
retirement policy, 
(10) there is a continuing need to maintain and preserve the 
national policy with respect to increasing, coordinating, and 
;; 
expediting biomedical and other appropriate research directed 
"ti. 
at determining the causes and effects of the aging process, 
(11) false stereotypes about aging and the process of aging 
continue to be prevalent throughout the United States and 
policies should be nurtured to overcome such stereotypes, and 
(12) the talents and experience of older individuals represent 
?io - 5 -a j >i 
a valuable community resource which should be developed and 
more widely shared within the local community. 
j (b) POLICY.—It is the policy of the Congress that— 
(1) the Federal Government should work jointly with the 
J
* 
States and their citizens to develop recommendations and plans 
;,' 
for action to meet the challenges and needs of older individuals, 
r 
consistent with the objectives of this section, and 
(2) in developing programs for the aging pursuant to this 
Ij 
section emphasis should be directed toward individual, private, 
\^- 
and public initiatives and resources intended to enhance the 
economic security and self-sufficiency of elder Americans. 
42 use 3001 
SEC. 202. AUTHORIZATION OF THE CONFERENCE. 
"° ^' 
(a) AUTHORITY TO CALL CONFERENCE.—The President may call a 
White House Conference on Aging in 1991 in order to develop 
recommendations for additional research and action in the field of 
aging which will further the policy set forth in subsection (b). 
(b) PLANNING AND DIRECTION.—The Conference shall be planned 
'\ 
and conducted under the direction of the Secretary in cooperation 
with the Commissioner on Aging and the Director of the National 
Institute on Aging, and the heads of such other Federal departments 
and agencies as are appropriate. Such assistance may include the 
assignment of personnel. 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 969 
(c) PURPOSE OF THE CONFERENCE.—The purpose of the Conference 
shall be— 
(1) to increase the public awareness of the essential contribu-
tions of older individuals to society, 
(2) to identify the problems of the older individuals, 
;.;; 
(3) to develop recommendations for the coordination of Fed-
eral policy with State and local needs and the implementation 
of such recommendations, 
(4) to examine the well-being of older individuals, 
(5) to develop such specific and comprehensive recommenda-
tions for executive and legislative action as may be appropriate 
for maintaining and improving the well-being of older individ-
uals, and 
(6) to review the status of recommendations adopted at pre-
vious White House Conferences on Aging. 
(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, 
and 
local 
r,.j.,,,.^. governments, 
(B) professional and lay people 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. 
SEC. 203. CONFERENCE ADMINISTRATION. 
42 USC 3001 
(a) ADMINISTRATION.—In administering this section, the Secretary 
shall— 
(1) request the cooperation and assistance of the heads of such 
other Federal departments and agencies as may be appropriate 
in the carrying out of this section, 
(2) furnish all reasonable assistance, including 
financial 
assistance, to State agencies on the aging and to area agencies 
on the aging, and to other appropriate organizations, to enable 
them to organize and conduct conferences in conjunction with 
the Conference, 
(3) prepare and 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 consist-
ent with the provisions of subsection (a), 
(4) prepare and make available background materials for the 
use of delegates to the Conference which 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 provi-
sions 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 classifica-
tion and General Schedule pay rates. 
(b) DUTIES.—The Secretary shall, in carr3dng out the Secretary's 
responsibilities and functions under this section, assure that— 
(1) the conferences under subsection (a)(2) will— 
101 STAT. 970 
PUBLIC LAW 100-175—NOV. 29, 1987 
Federal 
Register, 
publication. 
Federal 
Register, 
publication. 
Grants. 
Contracts. 
42 use 3001 
note. 
(A) include a conference on older Indians to identify 
conditions that adversely affect older Indians, to propose 
< solutions to ameliorate such conditions, and to provide for 
the exchange of information relating to the delivery of 
services to older Indians, and 
(B) be so conducted as to assure broad participation of 
older individuals, 
(2) the proposed agenda for the Conference under subsection 
(a)(3) is published in the Federal Register not less than 180 days 
before the beginning of the Conference and the proposed agenda 
is open for public comment for a period of not less than 60 days, 
(3) the final agenda for the Conference under subsection (a)(3), 
taking into consideration the comments received under para-
^« 1 graph (2), is published in the Federal Register and transmitted 
to the chief executive officers of the States not later than 30 
days after the close of the public comment period provided for 
'•^f under paragraph (2), 
(4) the personnel engaged under subsection (a)(5) shall be 
10- fairly balanced in terms of points of views represented and shall 
be appointed without regard to political affiliation or previous 
:^i- partisan activities, 
(5) the recommendations of the Conference are not inappro-
priately influenced by any appointing authority or by any 
special interest, but will instead be the result of the independ-
Qj, ent judgment of the Conference, and 
(6) 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 ad-
vance 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. 
SEC. 204. CONFERENCE COMMITTEES. 
(a) ADVISORY COMMITTEE.—The Secretary shall establish an ad-
visory committee to the Conference which shall include representa-
tion from the Federal Council on Aging and other public agencies 
and private nonprofit organizations as appropriate. 
(b) OTHER COMMITTEES.—The Secretary may establish such other 
committees, including technical committees, as may be necessary to 
assist in the planning, conducting, and reviewing of the Conference. 
(c) COMPOSITION OF COMMITTEES.—Each such committee shall be 
composed of professionals and public members, and shall include 
individuals from low-income families and from minority groups. A 
majority of the public members of each such committee shall be 55 
years of age or older. 
(d) COMPENSATION.—Appointed members of any such committee 
(other than any officers or employees of the Federal Government), 
while attending conferences or meetings of the committee or other-
wise serving at the request of the Secretary, shall be entitled to 
receive compensation at a rate to be fixed by the Secretary, but not 
to exceed the daily prescribed rate for GS-18 under section 5332 of 
title 5, United States Code (including travel time). While away from 
their homes or regular places of business, such members may be 
allowed travel expenses, including per diem in lieu of subsistence, as 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 971 
authorized under section 5703 of such title for persons employed 
intermittently in Federal Government service. 
SEC. 205. REPORT OF THE CONFERENCE. 
State and local 
(a) PROPOSED REPORT.—A proposed report of the Conference, 
42 use 3001 
which shall include a statement of comprehensive coherent national 
note, 
policy on aging together with recommendations for the implementa-
tion of the policy, shall be published and submitted to the chief 
executive officers of the States not later than 60 days following the 
date on which the Conference is adjourned. The findings and rec-
ommendations included in the published proposed report shall be 
immediately available to the public. 
(h) RESPONSE TO PROPOSED REPORT.—The chief executive officers of 
the States, after reviewing and soliciting recommendations and 
comments on the report of the Conference, shall submit to the 
Secretary, not later than 180 days after receiving the report, their 
views and findings on the recommendations of the Conference. 
(c) FINAL REPORT.—The Secretary shall, after reviewing the views 
" '-
and recommendations of the chief executive officers of the States, 
' 
prepare a final report of the Conference, which shall include a 
compilation of the actions of the chief executive officers of the States 
and take into consideration the views and findings of such officers. 
(d) RECOMMENDATIONS OF SECRETARY.—The Secretary shall, within 
90 days after submission of the views of the chief executive officers 
of the States, publish and transmit to the President and to the 
Congress recommendations for the administrative action and the 
legislation necessary to implement the recommendations contained 
within the report. 
SEC. 206. DEFINITIONS. 
42 USC 3001 
For the purposes of this title— 
(1) the term "area agency on aging" means the agency des-
ignated under section 305(a)(2)(A) of the Act, 
(2) the term "State agency on aging" means the State agency 
designated under section 305(a)(1) of the Act, 
(3) the term "Secretary" means the Secretary of Health and 
Human Services, 
(4) the term "Conference" means the White House Conference 
on Aging authorized in subsection (b), and 
(5) the term "State" means any of the several States, the 
District of Columbia, the Commonwealth of Puerto Rico, Guam, 
American Samoa, the Virgin Islands, the Trust Territory of the 
Pacific Islands, or the Commonwealth of the Northern Mariana 
Islands. 
SEC. 207. AUTHORIZATION OF APPROPRIATIONS. 
42 USC 3001 
(a) AUTHORIZATION.—There are authorized to be appropriated 
such sums as may be necessary, for each of the fiscal years 1989, 
1990, and 1991, to carry out this title. Sums appropriated under this 
paragraph shall remain available until the expiration of the 1-year 
period beginning on the date the Conference is adjourned. New 
spending authority or authority to enter into contracts as provided 
in this section shall be effective only to the extent and in such 
amounts as are provided in advance in appropriations Acts. 
(b) RETURN OF UNEXPENDED FUNDS.—Any funds remaining upon 
the expiration of such 1-year period shall be returned to the Treas-
ury of the United States and credited as miscellaneous receipts. 
101 STAT. 972 
PUBLIC LAW 100-175—NOV. 29, 1987 
TITLE III—ALZHEIMER'S DISEASE 
RESEARCH 
42USC285e-2 
SEC. 301. REQUIREMENT FOR CLINICAL TRIALS. 
(a) IN GENERAL.—The Director of the National Institute on Aging 
shall provide for the conduct of clinical trials on the efficacy of the 
use of such promising therapeutic agents as have been or may be 
discovered and recommended for further scientific analysis by the 
National Institute on Aging and the Food and Drug Administration 
to treat individuals with Alzheimer's disease, to retard the progres-
sion of symptoms of Alzheimer's disease, or to improve the function-
ing of individuals with such disease. 
(b) RULE OF CONSTRUCTION.—Nothing in this title shall be con-
strued to affect adversely any research being conducted as of the 
date of the enactment of this Act. 
42USC285e-2 
SEC. 302. AUTHORIZATION OF APPROPRIATIONS. 
^°^' 
For the purpose of carrying out section 301, there is authorized to 
be appropriated $2,000,000 for fiscal year 1988. 
, TITLE IV—NATIONAL SCHOOL LUNCH 
ACT AMENDMENT 
SEC. 401. PARTICIPATION OF OLDER PERSONS AND CHRONICALLY IM-
PAIRED DISABLED PERSONS IN CHILD CARE FOOD PROGRAM. 
Section 17 of the National School Lunch Act (42 U.S.C. 1766) is 
i ^ 
i '? 'i 
amended by adding at the end the following: 
^' 
"(pXD For purposes of this section, adult day care centers shall be 
considered eligible institutions for reimbursement for meals or 
supplements served to persons 60 years of age or older or to chron-
ically impaired disabled persons, including victims of Alzheimer's 
disease and related disorders with neurological and organic brain 
dysfunction. Reimbursement provided to such institutions for such 
purposes shall improve the quality of meals or level of services 
provided or increase participation in the program. 
"(2) For purposes of this subsection— 
"(A) the term'adult day care center'means any public agency 
.( 
or private nonprofit organization, or any proprietary title XIX 
5 
or title XX center, which— 
"(i) is licensed or approved by Federal, State, or local 
authorities to provide adult day care services to chronically 
impaired disabled adults or persons 60 years of age or older 
* * 
in a group setting outside their homes on a less than 24-
(„ 
hour basis; and 
. ' ' 
"(ii) provides for such care and services directly or under 
arrangements made by the agency or organization whereby 
i:'- 
the agency or organization maintains professional manage-
ment responsibility for all such services; and 
i 
"(B) the term 'proprietary title XIX or title XX center' means 
f 
any private, for-profit center providing adult day care services 
for which it receives compensation from amounts granted to the 
f 
States under title XIX or XX of the Social Security Act and 
which title XIX or title XX beneficiaries were not less than 25 
percent of enrolled eligible participants in a calendar month 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 973 
preceding initial application or annual reapplication for pro-
gram participation. 
"(3)(A) The Secretary of Agriculture, in consultation with the 
Commissioner on Aging, may establish separate guidelines for re-
imbursement of institutions described in this subsection. 
"(B) The guidelines shall contain provisions designed to assure 
that reimbursement under this subsection shall not duplicate re-
imbursement under part C of title III of the Older Americans Act of 
1965, for the same meal served.". 
TITLE V—NATIVE AMERICAN PROGRAMS 
SEC. 501. SHORT TITLE. 
This title may be cited as the "Native American Programs Act 
Amendments of 1987". 
SEC. 502. REVIEW OF APPLICATIONS FOR ASSISTANCE. 
The Native American Programs Act of 1974 (42 U.S.C. 2991-
2992d) is amended— 
(1) in the first sentence of section 803(a) by inserting ", on a 
single year or multiyear basis," after "financial assistance", 
(2) by redesignating sections 813 and 814 as sections 815 and 
816, respectively, 
(3) by redesignating sections 806 through 812, as sections 807 
through 813, respectively, and 
(4) by inserting after section 805 the following: 
Native 
American 
Programs Act 
Amendments of 
1987. 
42 u s e 2991 
note. 
42 u s e 2991b. 
42 u s e 2992c, 
2992d. 
42 use 
2991e-2992b. 
PANEL REVIEW OF APPUCATIONS FOR ASSISTANCE 
"SEC. 806. (a)(1) The Secretary shall establish a formal panel 42 USe 299ld-l. 
review process for purposes of— 
"(A) evaluating applications for financial assistance under 
sections 803 and 805; and 
V 
"(B) determining the relative merits of the projects for which 
such assistance is requested. 
"(2) To implement the process established under paragraph (1), 
the Secretary shall appoint members of review panels from among 
individuals who are not officers or employees of the Administration 
for Native Americans. In making appointments to such panels, the 
Secretary shall give preference to American Indians, Native Hawai-
ians, and Alaskan Natives. 
"(b) Each review panel appointed under subsection (a)(2) that 
reviews any application for financial assistance shall— 
"(1) determine the merit of each project described in such 
application; 
"(2) rank such application with respect to all other applica-
tions it reviews for the fiscal year involved, according to the 
relative merit of all of the projects that are described in such 
application and for which financial assistance is requested; and 
> 
"(3) submit to the Secretary a list that identifies all applica-
tions reviewed by such panel and arranges such applications 
according to rank determined under paragraph (2). 
"(c) Upon the request of the chairman of the Select Committee on 
Indian Affairs of the Senate or of the chairman of the Committee on 
Education and Labor of the House of Representatives made with 
respect to any application for financial assistance under section 803 
101 STAT. 974 
PUBLIC LAW 100-175—NOV. 29, 1987 
or 805, the Secretary shall transmit to the chairman written 
notice— 
"(1) identifying such application; 
"(2) containing a copy of the list submitted to the Secretary 
under subsection G))(3) in which such application is ranked; 
"(3) specifying which other applications ranked in such list 
have been approved by the Secretary under sections 803 and 
805; and 
"(4) if the Secretary has not approved each application supe-
rior in merit, as indicated on such list, to the application with 
. . 
respect to which such notice is transmitted, containing a state-
\ . 
ment of the reasons relied upon by the Secretary for— 
"(A) approving the application with respect to which such 
iv 
'' 
notice is transmitted; and 
..'"•r 
u 
"(B) failing to approve each pending application that is 
^, . 
superior in merit, as indicated on such list, to the applica-
tion described in subparagraph (A).". 
SEC. 503. PROCEDURAL REQUIREMENTS. 
(a) RULEMAKING.—The Native American Programs Act of 1974 (42 
} 
U.S.C. 2991-2992d) is amended by inserting after section 813, as so 
redesignated by section 502, the following: 
"ADDITIONAL REQUIREMENTS APPUCABLE TO RULEMAKING 
Loans. 
"SEC. 814. (a) Notwithstanding subsection (a) of section 553 of title 
Grants. 
5, United States Code, and except as otherwise provided in this 
42 USC^*2992b-i 
section, such section 553 shall apply with respect to the establish-
ment and general operation of any program that provides loans, 
grants, benefits, or contracts authorized by this title. 
"03)(1) Subparagraph (A) of the last sentence of section 553(b) of 
title 5, United States Code, shall not apply with respect to any 
interpretative rule or general statement of policy— 
"(A) proposed under this title; or 
' " 
"(B) applicable exclusively to any program, project, or activity 
authorized by, or carried out under, this title. 
"(2) Subparagraph (B) of the last sentence of section 553(b) of title 
5, United States Code, shall not apply with respect to any rule (other 
than an interpretative rule or a general statement of policy)— 
"(A) proposed under this title; or 
"(B) applicable exclusively to any program, project, or activity 
authorized by, or carried out under, this title. 
"(3) The first 2 sentences of section 5530)) of title 5, United States 
Code, shall apply with respect to any rule (other than an interpreta-
tive rule, a general statement of policy, or a rule of agency organiza-
tion, procedure, or practice) that is— 
"(A) proposed under this title; or 
"(B) applicable exclusively to any program, project, or activity 
authorized by, or carried out under, this title; 
unless the Secretary for good cause finds (and incorporates the 
finding and a brief statement of the reasons therefor in such rule) 
that notice and public procedure thereon are contrary to the public 
interest or would impair the effective administration of any pro-
gram, project, or activity with respect to which such rule is issued. 
"(c) Notwithstanding section 553(d) of title 5, United States Code, 
no rule (including an interpretative rule) or general statement of 
policy that— 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 975 
"(1) is issued to carry out this title; or 
"(2) applies exclusively to any program, project, or activity 
authorized by, or carried out under, this title; 
may take effect until 30 days after the publication required under 
the first 2 sentences of section 5530?) of title 5, United States Code. 
"(d) Each rule (including an interpretative rule) and each general 
statement of policy to which this section applies shall contain after 
each of its sections, paragraphs, or similar textual units a citation to 
the particular provision of statutory or other law that is the legal 
authority for such section, paragraph, or unit. 
"(e) Except as provided in subsection (c), if as a result of the 
enactment of any law affecting the administration of this title it is 
necessary or appropriate for the Secretary to issue any rule (includ-
ing any interpretative rule) or a general statement of policy, the 
Secretary shall issue such rule or such general statement of policy 
not later than 180 days after the date of the enactment of such law. 
"(f) Whenever an agency publishes in the Federal Register a rule 
(including an interpretative rule) or a general statement of policy to 
which subsection (c) applies, such agency shall transmit a copy of 
such rule or such general statement of policy to the Speaker of the 
House of Representatives and the President pro tempore of the 
-
Senate.". 
(b) DEFINITION OF RULE.—Section 815 of the Native American 
Programs Act of 1974 (42 U.S.C. 2992c), as so redesignated by section 
502, is amended— 
(1) in paragraph (3) by striking "and" at the end thereof, 
(2) by redesignating paragraph (4) as paragraph (5), and 
(3) by inserting after paragraph (3) the following: 
"(4) the term 'rule' has the meaning given it in section 551(4) 
of title 5, United States Code, as amended from time to time; 
and". 
SEC. 504. INCLUSION OF OTHER NATIVE AMERICAN PACIFIC ISLANDERS. 
(a) FINANCIAL ASSISTANCE.—Section 803(a) of the Native American 
Programs Act of 1974 (42 U.S.C. 2991b(a)) is amended by inserting 
after the first sentence the following: "The Secretary is authorized, 
subject to the availability of funds appropriated under the authority 
of section 816(c), to provide financial assistance to public and non-
profit private agencies serving other Native American Pacific 
Islanders (including American Samoan Natives) for projects pertain-
ing to the purposes of this Act.". 
(b) CONFORMING AMENDMENTS.—(1) Section 802 of the Native 
American Programs Act of 1974 (42 U.S.C. 2991a) is amended by 
inserting ", other Native American Pacific Islanders (including 
American Samoan Natives)," after "Hawaiian Natives". 
(2) Section 806(a)(2) of the Native American Programs Act, as 42 USC 299ld-l. 
added by section 502(4) of this Act, is amended by inserting "other 
Native American Pacific Islanders (including American Samoan 
Natives)," after "Hawaiian Natives,". 
(3) Section 808 of the Native American Programs Act of 1974 (42 
U.S.C. 29910, as so redesignated bv section 502, is amended by 
inserting "or Territory" after "State' each place it appears. 
SEC. 505. AUTHORIZATION OF APPROPRIATIONS. 
Section 816 of the Native American Programs Act of 1974 (42 
U.S.C. 2992d), as so redesignated by section 502 of this Act, is 
amended— 
101 STAT. 976 
PUBLIC LAW 100-175—NOV. 29, 1987 
(1) in subsection (a) by striking "1979 through 1986" and 
" "" inserting "1988,1989,1990, and 1991", and 
(2) by adding at the end the following: 
"(c)(1) Except as provided in paragraph (2), there are authorized to 
be appropriated $500,000 for each of the fiscal years 1988,1989,1990, 
and 1991 for the purpose of providing financial assistance to other 
Native American Pacific Islanders (including American Samoan 
Natives) under section 803(a). 
"(2) No funds may be appropriated under paragraph (1) for a fiscal 
year unless the amount appropriated under subsection (a) for such 
fiscal year exceeds 105 percent of the amount appropriated under 
subsection (a) for the preceding fiscal year.". 
SEC. 506. REVOLVING LOAN FUND FOR NATIVE HAWAIIANS. 
(a) ESTABLISHMENT OF FUND AND AUTHORITY FOR GRANTS.—The 
Native American Programs Act of 1974 (42 U.S.C. 2991 et seq.) is 
amended by inserting after section 803 the following: 
"LOAN FUND; DEMONSTRATION PROJECT 
42 use 299ib-L 
"SEC. 803A. (a)(1) In order to provide funding that is not available 
from private sources, the Secretary shall award grants to one agency 
of the State of Hawaii, or to one community-based Native Hawaiian 
organization whose purpose is the economic and social self-suffi-
ciency of Native Hawaiians, which shall use such grants to establish 
and carry out, in the State of Hawaii, a 5-year demonstration project 
involving the establishment of a revolving loan fund— 
"(A) from which such agency or Native Hawaiian organiza-
tion shall make loans to Native Hawaiian organizations and to 
individual Native Hawaiians for the purpose of promoting eco-
nomic development in the State of Hawaii; and 
. >
v 
"(B) into which all payments, interest, charges, and other 
amounts collected from loans made under subparagraph (A) 
shall be deposited notwithstanding any other provision of law. 
"(2) The agreement under which a grant is awarded under para-
graph (1) shall contain provisions which set forth the administrative 
costs of the grantee that are to be paid out of the funds provided 
under the grant. 
"(hXD The agency or organization to which a grant is awarded 
under subsection (a)(1) may make loans to a borrower under subsec-
tion (a)(1)(A) only if the agency or organization determines that— 
"(A) the borrower is unable to obtain financing from other 
sources on reasonable terms and conditions; and 
"(B) there is a reasonable prospect that the borrower will 
repay the loan. 
" • <
, 
O;:. ii 
"(2) Loans made under subsection (a)(1)(A) shall be— 
"(A) for a term that does not exceed 5 years; and 
"(B) at a rate of interest that is 2 percentage points below the 
average market yield on the most recent public offering of 
United States Treasury bills occurring before the date on which 
the loan is made. 
"(3) The agency or organization to which a grant is awarded under 
subsection (a)(1) may require any borrower of a loan made under 
subsection (a)(1)(A) to provide such collateral as the agency or 
organization determines to be necessary to secure the loan. 
"(4) Prior to making loans under subsection (a)(1)(A), the agency or 
organization to which a grant is awarded under subsection (a)(1) 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 977 
shall establish written procedures and definitions pertaining to 
defaults and collections of payments under the loans which shall be 
subject to the review and approval of the Secretary. Such agency or 
organization shall provide to each applicant for a loan under subsec-
tion (a)(1)(A), at the time application for the loan is made, a written 
copy of such procedures and definitions. 
"(5) The agency or organization to which a grant is awarded under 
subsection (a)(1) may not lend to itself any of the funds awarded 
under the grant. 
"(6) No loan may be made from the revolving fund that is required 
to be established under subsection (a) after the close of the 5-year 
period beginning on the date of enactment of the Native American 
Programs Act Amendments of 1987. 
"(c)(1) The agency or organization to which a grant is awarded 
under subsection (a)(1) shall provide the Secretary at regular inter-
vals written notice of each loan made under subsection (a)(1)(A) that 
is in default and the status of such loan. 
"(2)(A) After making reasonable efforts to collect all amounts 
payable under a loan made under subsection (a)(1)(A) that is in 
default, the agency or organization to which a grant is awarded 
under subsection (a)(1) shall notify the Secretary that such loan is 
uncoUectable or collectable only at an unreasonable cost. Such 
notice shall include recommendations for future action to be taken 
by the agency or organization. 
^n .: 
"(B) Upon receiving such notice, the Secretary shall instruct the 
agency or organization— 
"(i) to continue with its collection activities; 
"(ii) to cancel, adjust, compromise, or reduce the amount of 
such loan; or 
"(iii) to modify any term or condition of such loan, including 
te 
any term or condition relating to the rate of interest or the time 
of payment of any installment of principal or interest, or por-
tion thereof, that is payable under such loan. 
"(C) The agency or organization shall carry out all instructions 
received under subparagraph (B) from the Secretary. 
"(d)(1) The agency or organization to which a grant is awarded 
under subsection (a)(1) shall, out of funds available in the revolving 
loan fund established under such subsection— 
"(A) pay expenses incurred by the agency or organization in 
administering the revolving loan fund; and 
"(B) provide competent management and technical assistance 
to borrowers of loans made under subsection (a)(1)(A) to assist 
the borrowers to achieve the purposes of such loans. 
"(2) The Secretary shall provide to the agency or organization to 
which a grant is made under subsection (a)(1) such management and 
technical assistance as the agency or organization may request in 
order to carry out the provisions of this section. 
"(e) Not later than 120 days after the date of enactment of the Regulations. 
Native American Programs Act Amendments of 1987, the Secretary, 
in consultation with appropriate agencies of the State of Hawaii and 
community-based Native Hawaiian organizations, shall prescribe 
regulations which set forth the procedures and criteria to be used— 
"(1) in making loans under subsection (a)(1)(A); and 
"(2) in canceling, adjusting, compromising, and reducing 
under subsection (c) the outstanding amounts of such loans. 
101 STAT. 978 
PUBLIC LAW 100-175—NOV. 29, 1987 
Appropriation 
authorizations. 
Reports. 
42 u s e 2991a. 
42 u s e 2991b. 
The Secretary may prescribe such other regulations as may be 
necessary to carry out the purposes of this section, including regula-
tions involving reporting and auditing. 
"(f)(1) There is authorized to be appropriated for fiscal years 1988, 
1989, and 1990 the aggregate amount $3,000,000 for all such fiscal 
years for the purpose of carrying out the provisions of this section. 
Any amount appropriated under this paragraph shall remain avail-
able for expenditure without fiscal year limitation. 
"(2) The revolving loan fund that is required to be established 
under subsection (aXD shall be maintained as a separate account. 
Any portion of the revolving loan fund that is not required for 
expenditure shall be invested in obligations of the United States or 
in obligations guaranteed or insured by the United States. 
"(3)(A) All monies that are in the revolving loan fund at the close 
of the 5-year period beginning on the date of enactment of the 
Native American Programs Act Amendments of 1987 and that are 
not otherwise needed (as determined by the Secretary) to carry out 
the provisions of this section shall be deposited in the Treasury of 
the United States as miscellaneous receipts. 
"(B) All monies deposited in the revolving loan fund after the 
close of such period pursuant to subsection (a)(1)(B) shall be depos-
ited into the Treasury of the United States as miscellaneous 
receipts. 
"(g)(1) The Secretary, in consultation with the agency or organiza-
tion to which a grant is awarded under subsection (a)(1), shall 
submit to the Congress— 
"(A) an interim report not later than 2 years after the date of 
enactment of the Native American Programs Act Amendments 
of 1987; and 
"(B) a final report not later than 4 years after the date of 
enactment of the Native American Programs Act Amendments 
of 1987; 
regarding the administration of this section. 
"(2) Each such report shall include the views and recommenda-
tions of the Secretary regarding— 
"(A) the effectiveness of the demonstration project; 
"(B) whether the demonstration project should be expanded to 
other groups eligible for assistance under this title; and 
"(C) whether the duration of the demonstration project should 
be extended. 
O
t
>
) CONFORMING AMENDMENTS.—Subsections (a) and (b) of section 
816 of the Native American Programs Act of 1974 (42 U.S.C. 2992d), 
as so redesignated by section 502, are each amended by inserting 
"(other than section 803A)" after "title". 
(c) TECHNICAL AMENDMENTS.—The Native American Programs 
Act of 1974 (42 U.S.C. 2991 et seq.) is amended— 
(1) in section 802 by striking "Hawaiian Natives" and insert-
ing "Native Hawaiians", and 
(2) in the first sentence of section 803 by striking "Hawaiian 
Natives" and inserting "Native Hawaiians". 
',>] 
-'.^i.^v 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 979 
TITLE VI—HEALTH CARE SERVICES IN 
THE HOME 
SEC. 601. SHORT TITLE. 
This title may be cited as the "Health Care Services in the Home 
Act of 1987". 
SEC. 602. E^TABLISHMENT OF GRANT PROGRAMS FOR DEMONSTRATION 
PROJECTS. 
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is 
amended by adding at the end the following: 
"PART K—HEALTH CARE SERVICES IN THE HOME 
"Subpart I—Grants for Demonstration Projects 
"SEC. 395. ESTABLISHMENT OF PROGRAM. 
"(a) IN GENERAL.—The Secretary, acting through the Adminis-
trator of the Health Resources and Services Administration, shall 
make not less than 3, and not more than 5, grants to States for the 
purpose of assisting grantees in carrying out demonstration 
projects— 
"(1) to identify low-income individuals who can avoid institu-
tionalization or prolonged hospitalization if skilled medical serv-
ices or related health services (or both) are provided in the 
homes of the individuals; 
"(2) to pay the costs of the provision of such services in the 
homes of such individuals; and 
"(3) to coordinate the provision by public and private entities 
of such services, and other long-term care services, in the homes 
of such individuals. 
"(b) REQUIREMENT WITH RESPECT TO AGE OF RECIPIENTS OF SERV-
ICES.—The Secretary may not make a grant under subsection (a) to a 
State unless the State agrees to ensure that not less than 25 percent 
of individuals receiving services pursuant to subsection (a) are 
individuals who are not less than 65 years of age. 
"(c) RELATIONSHIP TO ITEMS AND SERVICES UNDER OTHER PRO-
GRAMS.—A State may not make payments from a grant under 
subsection (a) for any item or service to the extent that payment has 
been made, or can reasonably be expected to be made, with respect 
to such item or service— 
"(1) under any State compensation program, under an insur-
ance policy, or under any Federal or State health benefits 
program; or 
"(2) by an entity that provides health services on a prepaid 
basis. 
"SEC. 396. LIMITATION ON DURATION OF GRANT AND REQUIREMENT OF 
MATCHING FUNDS. 
"(a) LIMITATION ON DURATION OF GRANT.—The period during 
which payments are made to a State from a grant under section 
395(a) may not exceed 3 years. Such payments shall be subject to 
annual evaluation by the Secretary. 
"(b) REQUIREMENT OF MATCHING FUNDS.— 
Health Care 
Services in the 
Home Act of 
1987. 
State and local 
governments. 
42 u s e 201 note. 
42 u s e 280c. 
Disadvantaged 
persons. 
42 u s e 280C-1. 
101 STAT. 980 
PUBLIC L A W 100-175—NOV. 29, 1987 
. 
<
« ,. 
"(1)(A) For the first year of payments to a State from a grant 
•3. ' 
under section 395(a), the Secretary may not make such pay-
ments in an amount exceeding 75 percent of the costs of services 
;, 
to be provided by the State pursuant to such section. 
"(B) For the second year of such payments to a State, the 
Secretary may not make such payments in an amount exceed-
ing 65 percent of the costs of such services. 
"(C) For the third year of such payments to a State, the 
Secretary may not make such payments in an amount exceed-
ing 55 percent of the costs of such services. 
"(2) The Secretary may not make a grant under section 395(a) 
to a State unless the State agrees to make available, directly or 
through donations from public or private entities, non-Federal 
contributions toward the costs of services to be provided pursu-
ant to such section in an amount equal to— 
"(A) for the first year of payments to the State from the 
grant, not less than $25 (in cash or in kind under subsection 
(c)) for each $75 of Federal funds provided in the grant; 
"(B) for the second year of such payments to the State, 
'•' 
• 
- ' 
not less than $35 (in cash or in kind under subsection (c)) for 
• '"•"'•'' 
each $65 of such Federal funds; and 
"(C) for the third year of such pajnments to the State, not 
less than $45 (in cash or in kind under subsection (c)) for 
each $55 of such Federal funds. 
"(c) DETERMINATION OF AMOUNT OP NON-FEDERAL CONTRIBU-
TION.—Non-Federal contributions required in subsection (b) may be 
in cash or in kind, fairly evaluated, including plant, equipment, or 
services. Amounts provided by the Federal Government, or services 
assisted or subsidized to any significant extent by the Federal 
Government, may not be included in determining the amount of 
such non-Federal contributions. 
42 use 280C-2. 
"SEC. 397. GENERAL PROVISIONS. 
"(a) LIMITATION ON ADMINISTRATIVE EXPENSES.—The Secretary 
may not make a grant under section 395(a) to a State unless the 
State agrees that not more than 10 percent of the grant will be 
expended for administrative expenses with respect to the grant. 
"(b) DESCRIPTION OF INTENDED USE OF GRANT.—The Secretary may 
not make a grant under section 395(a) to a State unless— 
"(1) the State submits to the Secretary a description of the 
purposes for which the State intends to expend the grant; and 
"(2) such description provides information relating to the 
programs and activities to be supported and services to be 
provided, including— 
"(A) the number of individuals who will receive services 
pursuant to section 395(a) and the average costs of provid-
i
*
^
- :
• 
ing such services to each such individual; and 
"(B) a description of the manner in which such programs 
\.f 
and activities will be coordinated with any similar pro-
grams and activities of public and private entities. 
"(c) REQUIREMENT OF APPUCATION.—The Secretary may not make 
a grant under section 395(a) to a State unless the State h£is submit-
ted to the Secretary an application for the grant. The application 
shall— 
"(1) contain the description of intended expenditures required 
in subsection (b); 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 981 
•
? 
"(2) with respect to carrying out the purpose for which the 
grant is to be made, provide assurances of compliance satisfac-
tory to the Secretary; and 
"(3) otherwise be in such form, be made in such manner, and 
contain such information and agreements as the Secretary 
determines to be necessary to carry out this subpart. 
"(d) EVALUATIONS AND REPORT BY SECRETARY.—The Secretary 
shall— 
"(1) provide for an evaluation of each demonstration project 
for which a grant is made under section 395(a); and 
"(2) not later than 6 months after the completion of such 
evaluations, submit to the Congress a report describing the 
findings made as a result of the evaluations. 
"(e) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of 
carrying out this subpart, there is authorized to be appropriated 
$5,000,000 for each of the fiscal years 1988 through 1990. 
"Subpart II—Grants for Demonstrations Projects With Respect to 
Alzheimer's Disease 
"SEC. 398. ESTABLISHMENT OF PROGRAM. 
42 USC 280c-3. 
"(a) IN GENERAL.—The Secretary shall make not less than 3, and 
not more than 5, grants to States for the purpose of assisting 
grantees in carrying out demonstration projects for planning, 
establishing, and operating programs— 
-i 
"(1) to coordinate the development and operation by public 
and private organizations of diagnostic, treatment, 
care 
management, respite care, legal counseling, and education serv-
ices provided within the State to individuals with Alzheimer's 
disease or related disorders and to the families and care pro-
viders of such individuals; 
^
^ 
"(2) to provide home health care, personal care, day care, 
companion services, short-term care in health facilities, and 
other respite care to individuals with Alzheimer's disease or 
related disorders; and 
"(3) to provide to health care providers, to individuals with Public 
Alzheimer's disease or related disorders, to the families of such information. 
individuals, to organizations established for such individuals 
and such families, and to the general public, information with 
respect to— 
"(A) diagnostic services, treatment services, and related 
services available to such individuals and to the families of 
such individuals; 
"(B) sources of assistance in obtaining such services, 
including assistance under entitlement programs; and 
^ 
"(C) the legal rights of such individuals and such families. 
"(b) REQUIREMENT WITH RESPECT TO CERTAIN EXPENDITURES.—The 
Secretary may not make a grant under subsection (a) to a State 
unless the State agrees to expend not less than 50 percent of the 
grant for the provision of services described in subsection (a)(2). 
"(c) RELATIONSHIP TO ITEMS AND SERVICES UNDER OTHER PRO-
GRAMS.—A State may not make payments from a grant under 
subsection (a) for any item or service to the extent that payment has 
been made, or can reasonably be expected to be made, with respect 
to such item or service— 
101 STAT. 982 
PUBLIC LAW 100-175—NOV. 29, 1987 
"(1) under any State compensation program, under an insur-
ance policy, or under any Federal or State health benefits 
program; or 
"(2) by an entity that provides health services on a prepaid 
basis. 
42 u s e 280C-4. 
"SEC. 399. LIMITATION ON DURATION OF GRANT AND REQUIREMENT OF 
MATCHING FUNDS. 
"(a) LIMITATION ON DURATION OF GRANT.—The period during 
which payments are made to a State from a grant under section 
398(a) may not exceed 3 years. Such payments shall be subject to 
annual evaluation by the Secretary. 
"(b) REQUIREMENT OF MATCHING FUNDS.— 
"(1)(A) For the first year of payments to a State from a grant 
under section 398(a), the Secretary may not make such pay-
ments in an amount exceeding 75 percent of the costs of services 
to be provided by the State pursuant to such section. 
"(B) For the second year of such payments to a State, the 
" Secretary may not make such payments in an amount exceed-
ing 65 percent of the costs of such services. 
'(C) For the third year of such payments to a State, the 
' 
Secretary may not make such payments in an amount exceed-
ing 55 percent of the costs of such services. 
"(2) The Secretary may not make a grant under section 398(a) 
to a State unless the State agrees to make available, directly or 
through donations from public or private entities, non-Federal 
contributions toward the costs of services to be provided pursu-
ant to such section in an amount equal to— 
"(A) for the first year of payments to the State from the 
grant, not less than $25 (in cash or in kind under subsection 
(c)) for each $75 of Federal funds provided in the grant; 
"(B) for the second year of such payments to the State, 
not less than $35 (in cash or in kind under subsection (c)) for 
each $65 of such Federal funds; and 
"(C) for the third year of such pa5mients to the State, not 
less than $45 (in cash or in kind under subsection (c)) for 
each $55 of such Federal funds. 
"(c) DETERMINATION OF AMOUNT OF NON-FEDERAL CONTRIBU-
TION.—Non-Federal contributions required in subsection (b) may be 
in cash or in kind, fairly evaluated, including plant, equipment, or 
services. Amounts provided by the Federal Government, or services 
assisted or subsidized to any significant extent by the Federal 
Government, may not be included in determining the amount of 
such non-Federal contributions. 
42USC280C-5. 
"SEC. 399A. GENERAL PROVISIONS. 
"(a) LIMITATION ON ADMINISTRATIVE EXPENSES.—The Secretary 
may not make a grant under section 398(a) to a State unless the 
State agrees that not more than 10 percent of the grant will be 
expended for administrative expenses with respect to the grant. 
"(b) DESCRIPTION OF INTENDED USE OF GRANT.—The Secretary may 
not make a grant under section 398(a) to a State unless— 
"(1) the State submits to the Secretary a description of the 
purposes for which the State intends to expend the grant; and 
"(2) such description provides information relating to the 
programs and activities to be supported and services to be 
provided, including— 
: : 
r 
* 
PUBLIC LAW 100-175—NOV. 29, 1987 
101 STAT. 983 
"(A) the number of individuals who will receive services 
pursuant to section 398(a) and the average costs of provid-
ing such services to each such individual; and 
"(B) a description of the manner in which such programs 
and activities will be coordinated with any similar pro-
grams and activities of public and private entities. 
"(c) REQUIREMENT OF APPLICATION.—The Secretary may not make 
a grant under section 398(a) to a State unless the State has submit-
ted to the Secretary an application for the grant. The application 
shall— 
"(1) contain the description of intended expenditures required 
in subsection (b); 
"(2) with respect to carrying out the purpose for which the 
grant is to be made, provide assurances of compliance satisfac-
tory to the Secretary; and 
"(3) otherwise be in such form, be made in such manner, and 
contain such information and agreements as the Secretary 
determines to be necessary to carry out this subpart. 
"(d) EVALUATIONS AND REPORT BY SECRETARY.—The Secretary 
shall— 
"(1) provide for an evaluation of each demonstration project 
for which a grant is made under section 398(a); and 
"(2) not later than 6 months after the completion of such 
evaluations, submit to the Congress a report describing the 
findings made as a result of the evaluations. 
"(e) AUTHORIZATIONS OF APPROPRIATIONS.—For the purpose of 
carrying out this subpart, there is authorized to be appropriated 
$5,000,000 for each of the fiscal years 1988 through 1990.". 
TITLE VII—GENERAL PROVISIONS 
SEC. 701. EFFECTIVE DATES; APPLICATION OF AMENDMENTS. 
42 USC 3001 
(a) GENERAL EFFECTIVE DATE.—Except as provided in subsections 
(b) and (c), this Act and the amendments made by this Act shall take 
effect on October 1,1987. 
(b) APPLICATION OF AMENDMENTS.—The amendments made by 
title I of this Act shall not apply with respect to— 
(1) any area plan submitted under section 306(a) of the Older 
Americans Act of 1965, or 
101 STAT. 984 
PUBLIC LAW 100-175—NOV. 29, 1987 
(2) any State plan submitted under section 307(a) of such Act, 
and approved for any fiscal year beginning before the date of the 
enactment of this Act. 
(c) EFFECTIVE DATE OF SECTION 506.—The amendments made by 
section 506 of this Act shall take effect upon the expiration of the 90-
day period beginning on the date of the enactment of this Act. 
Approved November 29, 1987. 
LEGISLATIVE HISTORY—H.R. 1451 (S. 887): 
HOUSE REPORTS: No. 100-97 (Comm. on Education and Labor) and No. 100-427 
(Comm. of Conference). 
SENATE REPORTS: No. 100-136 (Comm. on Labor and Human Resources) and No. 
100-140 (Select Comm. on Indian Affairs), both accompanying 
S. 887. 
CONGRESSIONAL RECORD, Vol. 133 (1987): 
May 27, 28, considered and passed House: 
Aug. 6, considered and passed Senate, amended, in lieu of S. 887. 
Nov. 5, 12, Senate agreed to conference report. 
Nov. 17, House agreed to conference report. 
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 23 (1987): 
Nov. 30, Presidential statement.