Strengthening Services for America's Seniors Act - Amends the Older Americans Act of 1965 to authorize the Assistant Secretary for Aging in the Department of Health and Human Services (HHS) to make grants to states to establish a program to assess the needs of family caregivers for targeted support services.
Allows Aging and Disability Resource Centers to carry out an assessment program with respect to informal caregivers and care recipients.
Establishes an Advisory Committee to Assess, Coordinate, and Improve Legal Assistance Activities for older Americans.
Makes it a duty of the Administration on Aging to reserve and provide specified amounts for FY2012 and subsequent fiscal years for the funding of the National Ombudsman Resource Center (NORC).
Authorizes the use of such amounts to enable NORC to: (1) collaborate and participate with the Centers for Medicare and Medicaid Services (CMS) in providing training for state survey agencies with an agreement in effect under the Medicare program; or (2) work with the CMS Administrator, in the case of states without such an agency, to improve the investigative processes used by the center to address complaints by residents of long-term care facilities.
Requires the state to ensure that representatives of the Office of the State Long-Term Care Ombudsman shall have access to review all records concerning a resident.
Declares a State Long-Term Care Ombudsman, and any representative of the Office, a "health oversight agency," so that release of residents' individually identified health information to the Ombudsman or a representative is not precluded (by the Health Insurance Portability and Accountability Act of 1996 [HIPAA]) in certain cases.
Imposes confidentiality requirements upon the Ombudsman and each representative of the Office with respect to communications with individuals seeking assistance under this Act.
[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 1819 Introduced in Senate (IS)]
112th CONGRESS
1st Session
S. 1819
To amend the Older Americans Act of 1965 to improve programs and
services.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 8, 2011
Mr. Kohl (for himself and Ms. Mikulski) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Older Americans Act of 1965 to improve programs and
services.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Strengthening Services for America's
Seniors Act''.
SEC. 2. STANDARDIZED ASSESSMENT OF NEEDS OF FAMILY CAREGIVERS.
(a) In General.--Section 373 (42 U.S.C. 3030s-1) is amended--
(1) by redesignating subsections (b) through (g) as
subsections (c) through (h), respectively;
(2) in subsection (d), as so redesignated, by striking
``subsection (b)'' and inserting ``subsection (c)'';
(3) in subsection (e), as so redesignated, by striking
``subsection (b)'' and inserting ``subsection (c)''; and
(4) by inserting after subsection (a) the following:
``(b) Assessment Program of Needs of Family Caregivers.--
``(1) In general.--The Assistant Secretary may make grants
to States to establish a program, in accordance with the
program requirements described in paragraph (5), to assess the
needs of family caregivers for targeted support services
described in paragraph (5)(C).
``(2) Application by states.--Each State seeking a grant
under this subsection shall submit an application to the
Assistant Secretary at such time, in such manner, and
containing such information and assurances as the Assistant
Secretary determines appropriate.
``(3) Grant amount.--The amount of a grant to a State under
this subsection shall be determined according to such
methodology as the Assistant Secretary determines appropriate.
``(4) Program administration.--A State receiving a grant
under this subsection may enter into an agreement with area
agencies on aging in the State, or an Aging and Disability
Resource Center in the State, to administer the program, using
such grant funds.
``(5) Program requirements.--
``(A) Standardized assessment.--Assessments under a
program established under paragraph (1)--
``(i) shall be conducted by social workers,
care managers, nurses, or other appropriate
professionals; and
``(ii)(I) shall be conducted with a
standardized instrument to identify family
caregiver needs; and
``(II) in a State in which an area agency
on aging or an Aging and Disability Resource
Center is using such an instrument on the date
of enactment of the Strengthening Services for
America's Seniors Act, may continue to be
conducted with that instrument.
``(B) Questionnaire.--
``(i) In general.--Subject to clause (ii),
assessments under a program established as
described in paragraph (1) shall include asking
the family caregiver relevant questions in
order to determine whether the family caregiver
would benefit from any targeted support
services described in subparagraph (C).
``(ii) Completion on a voluntary basis.--
The answering of questions under clause (i) by
a family caregiver shall be on a voluntary
basis.
``(iii) Addressing diverse caregiver needs
and preferences.--The questionnaire under this
subparagraph shall be designed in a manner that
accounts for, and aims to ascertain, the
varying needs and preferences of family
caregivers, based on the range of their
capabilities, caregiving experience, and other
relevant personal characteristics and
circumstances.
``(C) Targeted support services described.--The
following targeted support services are described in
this subparagraph:
``(i) Information and assistance (including
brochures and online resources for researching
a disease or disability or for learning and
managing a regular caregiving role, new
technologies that can assist family caregivers,
and practical assistance for locating
services).
``(ii) Individual counseling (including
advice and consultation sessions to bolster
emotional support for the family caregiver to
make well-informed decisions about how to cope
with caregiver strain).
``(iii) Support groups, including groups
which provide help for family caregivers to--
``(I) locate a support group either
locally or online to share experiences
and reduce isolation;
``(II) make well-informed
caregiving decisions; and
``(III) reduce isolation.
``(iv) Education and training (including
workshops and other resources available with
information about stress management, self-care
to maintain good physical and mental health,
understanding and communicating with
individuals with dementia, medication
management, normal aging processes, change in
disease and disability, the role of assistive
technologies, and other relevant topics).
``(v) Respite care and emergency back-up
services (including short-term in-home care
services that gives the family caregiver a
break from providing such care).
``(vi) Chore services (such as house
cleaning) to assist the individual receiving
care.
``(vii) Personal care (including outside
help) to assist the individual receiving care.
``(viii) Legal and financial planning and
consultation (including advice and counseling
regarding long-term care planning, estate
planning, powers of attorney, community
property laws, tax advice, employment leave
advice, advance directives, and end-of-life
care).
``(ix) Transportation (including
transportation to medical appointments) to
assist the individual receiving care.
``(x) Other targeted support services, as
determined appropriate by the State agency and
approved by the Assistant Secretary.
``(D) Referrals.--In the case where a questionnaire
completed by a family caregiver under subparagraph (B)
indicates that the family caregiver would benefit from
1 or more of the targeted support services described in
subparagraph (C), the agency administering the program
shall provide referrals to the family caregiver for
State, local, and private-sector caregiver programs and
other resources that provide such targeted support
services to such caregivers.
``(E) Targeting and timing of assessments.--
Assessments under the program established under
paragraph (1) may be conducted--
``(i) when an individual who is being
assisted by a family caregiver transitions from
one care setting to another;
``(ii) upon referral from a social worker,
care manager, nurse, physician, or other
appropriate professional; or
``(iii) according to circumstances
determined by the State and approved by the
Assistant Secretary.
``(F) Coordination with other assessment.--
Assessments under the program established under
paragraph (1) may be conducted separately or as part
of, or in conjunction with, eligibility or other
routine assessments of an individual who is being (or
is going to be) assisted by a family caregiver.
``(G) Followup services.--As the Assistant
Secretary determines appropriate, a State with a
program described in paragraph (1) shall conduct
followup activities with caregivers who have
participated in an assessment to determine the status
of the caregiver and whether services were provided.
``(H) Reporting requirement.--Each State with a
program described in paragraph (1) shall periodically
submit to the Assistant Secretary a report containing
information on the number of caregivers assessed under
the program, information on the number of referrals
made for targeted support services under the program
(disaggregated by type of service), demographic
information on caregivers assessed under the program,
and other information required by the Assistant
Secretary.''.
(b) Standardized Assessment of Needs of Informal Caregivers.--
Section 202 (42 U.S.C. 3012) is amended--
(1) in subsection (b)(8)--
(A) in subparagraph (D), by striking ``and'';
(B) in subparagraph (E), inserting ``and'' after
the semicolon at the end; and
(C) by adding at the end the following:
``(F) which may carry out the informal caregiver
assessment program described in subsection (g);''; and
(2) by adding at the end the following:
``(g) Standardized Assessment of Needs of Informal Caregivers.--
``(1) In general.--Aging and Disability Resource Centers
implemented under subsection (b)(8) may carry out an assessment
program with respect to informal caregivers and care
recipients. Such assessment program shall be modeled on the
family caregiver assessment program established under section
373(b).
``(2) Definitions.--For purposes of an informal caregiver
assessment carried out in accordance with paragraph (1), the
following definitions shall apply:
``(A) Care recipient.--The term `care recipient'
means--
``(i) an older individual;
``(ii) an individual with a disability; or
``(iii) an individual with a special need.
``(B) Individual with a special need.--The term
`individual with a special need' means an individual
who requires care or supervision to--
``(i) meet the individual's basic needs;
``(ii) prevent physical self-injury or
injury to others; or
``(iii) avoid placement in an institutional
facility.
``(C) Informal caregiver.--
``(i) In general.--Subject to clause (ii),
the term `informal caregiver' means an adult
family member, or another individual, who is an
informal provider of in-home and community care
to a care recipient.
``(ii) Alternate definition.--A State that
has a State law with an alternate definition of
the term `informal caregiver' for purposes of a
program described in paragraph (1) may use that
definition (with respect to caregivers for care
recipients) for purposes of provisions of this
Act that relate to that program, if such
alternative definition is broader than the
definition in clause (i), and subject to
approval by the Assistant Secretary.''.
(c) Conforming Amendment.--Section 631(b) (42 U.S.C. 3057k-11(b))
is amended by striking ``subsections (c), (d), and (e)'' and inserting
``subsections (d), (e), and (f)''.
SEC. 3. ADVISORY COMMITTEE TO ASSESS, COORDINATE, AND IMPROVE LEGAL
ASSISTANCE ACTIVITIES.
(a) In General.--Title II of the Older Americans Act of 1965 is
amended--
(1) in section 215(j) (42 U.S.C. 3020e-1(j)), by striking
``section 216'' and inserting ``section 217'';
(2) by redesignating section 216 (42 U.S.C. 3020f) as
section 217; and
(3) by inserting after section 215 (42 U.S.C. 3020e-1) the
following:
``SEC. 216. ADVISORY COMMITTEE TO ASSESS, COORDINATE, AND IMPROVE LEGAL
ASSISTANCE ACTIVITIES.
``(a) Establishment.--There is established an Advisory Committee to
Assess, Coordinate, and Improve Legal Assistance Activities (referred
to in this section as the `Committee').
``(b) Membership.--
``(1) Composition.--The Committee shall be composed of 9
members--
``(A) with expertise with existing State legal
assistance development programs carried out under
section 731 and providers of State legal assistance
under subtitle B of title III and title IV; and
``(B) of whom--
``(i) 6 individuals shall be appointed by
the Assistant Secretary--
``(I) 1 of whom shall be a consumer
advocate;
``(II) 1 of whom shall be a
professional advocate from a State
agency or State Legal Services
Developer; and
``(III) 4 of whom shall be
representatives from collaborating
organizations under the National Legal
Resource Center of the Administration;
and
``(ii) 3 individuals shall be appointed by
the Comptroller General of the United States.
``(2) Date.--The appointments of the members of the
Committee shall be made not later than 9 months after the date
of enactment of the Strengthening Services for America's
Seniors Act.
``(3) Period of appointment; vacancies.--Members shall be
appointed for the life of the Committee. Any vacancy in the
Committee shall not affect its powers, but shall be filled in
the same manner as the original appointment.
``(4) Chairperson and vice chairperson.--The Committee
shall select a Chairperson and Vice Chairperson from among its
members.
``(c) Initial Meeting.--The Committee shall hold its first meeting
not later than 9 months after the date of enactment of the
Strengthening Services for America's Seniors Act.
``(d) Duties of the Committee.--
``(1) Definition.--In this subsection, the term `assistance
activities' includes--
``(A) legal assistance made available to older
individuals in social or economic need under this Act;
``(B) activities of the National Legal Resource
Center carried out under section 420(a);
``(C) State legal assistance developer activities
carried out under section 731; and
``(D) any other directly related activity or
program as determined appropriate by the Assistant
Secretary.
``(2) Study.--
``(A) In general.--The Committee shall design,
implement, and analyze results of a study of--
``(i) the extent to which State leadership
is provided through the State legal assistance
developer in States to enhance the coordination
and effectiveness of legal assistance
activities across the State;
``(ii) the extent to which--
``(I) there is data collection and
reporting of information by legal
assistance providers in States;
``(II) there is uniform statewide
reporting among States; and
``(III) the value and impact of
services provided is being captured at
the State or local level; and
``(iii) the mechanisms to organize and
promote legal assistance development and
services to best meet the needs of older
individuals with greatest social and economic
need.
``(B) Considerations.--In carrying out subparagraph
(A)(i), particular attention shall be given to--
``(i) State leadership on targeting limited
legal resources to older individuals in
greatest social and economic need; and
``(ii) State leadership on establishing
priority legal issue areas in accordance with
section 307(a)(11)(E).
``(3) Recommendations.--After completion and analysis of
study results under paragraph (2), the Committee shall develop
recommendations for the establishment of guidelines for--
``(A) enhancing the leadership capacity of the
State legal assistance developers to carry out
statewide coordinated legal assistance service
delivery, with particular focus on enhancing leadership
capacity to--
``(i) target limited legal resources to
older individuals in greatest social and
economic need; and
``(ii) establish priority legal issue areas
in accord with priorities set forth in section
307(a)(11)(E);
``(B) developing a uniform national data collection
system to be implemented in all States on legal
assistance development and services; and
``(C) identifying mechanisms for organizing and
promoting legal assistance activities to provide the
highest quality, impact, and effectiveness to older
individuals with the greatest social and economic need.
``(4) Report.--Not later than 1 years after the date of the
establishment of the Committee, the Committee shall submit to
the President, Congress, and the Assistant Secretary a report
that contains a detailed statement of the findings and
conclusions of the Committee, together with the recommendations
described in paragraph (3).
``(e) Duties of the Assistant Secretary.--Not later than 180 days
after receiving the report described in subsection (d)(4), the
Assistant Secretary shall issue regulations or guidance, taking into
consideration the recommendations described in subsection (d)(3).
``(f) Powers.--
``(1) Information from federal agencies.--The Committee may
secure directly from any Federal department or agency such
information as the Committee considers necessary to carry out
the provisions of this section. Upon request of the Committee,
the head of such department or agency shall furnish such
information to the Committee.
``(2) Postal services.--The Committee may use the United
States mails in the same manner and under the same conditions
as other departments and agencies of the Federal Government.
``(g) Personnel and Administration.--
``(1) Travel expenses.--The members of the Committee shall
not receive compensation for the performance of services for
the Committee, but shall be allowed travel expenses, including
per diem in lieu of subsistence, at rates authorized for
employees of agencies under subchapter I of chapter 57 of title
5, United States Code, while away from their homes or regular
places of business in the performance of services for the
Committee. Notwithstanding section 1342 of title 31, United
States Code, the Secretary may accept the voluntary and
uncompensated services of members of the Committee.
``(2) Detail of government employees.--Any Federal
Government employee may be detailed to the Committee without
reimbursement, and such detail shall be without interruption or
loss of civil service status or privilege.
``(3) Administrative and support services.--The Assistant
Secretary shall provide administrative and support services to
the Committee.
``(4) Procurement of temporary and intermittent services.--
The Chairman of the Committee may procure temporary and
intermittent services under section 3109(b) of title 5, United
States Code, at rates for individuals that do not exceed the
daily equivalent of the annual rate of basic pay prescribed for
level V of the Executive Schedule under section 5316 of such
title.
``(h) Exemption From Termination Requirements.--Section 14 of the
Federal Advisory Committee Act shall not apply to the Committee.''.
(b) Authorization of Appropriations.--Section 217 of the Older
Americans Act of 1965, as redesignated by subsection (a), is amended by
adding at the end the following:
``(d) Advisory Committee To Assess, Coordinate, and Improve Legal
Assistance Activities.--There is authorized to be appropriated to carry
out section 216, $300,000 for fiscal year 2012.''.
SEC. 4. IMPROVING THE STATE LONG-TERM CARE OMBUDSMAN PROGRAMS.
(a) National Ombudsman Resource Center.--Section 202(a)(18)(B) of
the Older Americans Act of 1965 (42 U.S.C. 3012(a)(18)(B)) is amended
by striking ``make available'' and all that follows and inserting
``reserve and provide, for the funding of the National Ombudsman
Resource Center (which may include enabling the center to collaborate
and participate with the Centers for Medicare & Medicaid Services in
providing training for State survey agencies with an agreement in
effect under section 1864 of the Social Security Act (42 U.S.C. 1395aa)
or, in the case of States without such an agency, work with the
Administrator for the Centers for Medicare & Medicaid Services to
improve the investigative processes used by the center to address
complaints by residents of long-term care facilities)--
``(i) for fiscal year 2012, not less than
$2,000,000; and
``(ii) for each subsequent fiscal year, not
less than the sum of--
``(I) $100,000; and
``(II) the amount made available
under this subparagraph for the fiscal
year preceding the year for which the
sum is determined;''.
(b) Functions of Program.--
(1) Private and unimpeded access to ombudsman services.--
Section 712(b)(1)(A) of the Older Americans Act of 1965 (42
U.S.C. 3058g(b)(1)(A)) is amended by striking ``access'' and
inserting ``private and unimpeded access''.
(2) Ombudsman development of resident and family
councils.--Section 712(a)(3)(H)(iii) of such Act (42 U.S.C.
3058g(a)(3)(H)(iii)) is amended by striking ``provide technical
support for'' and inserting ``actively encourage and assist
in''.
(3) Local entity development of resident and family
councils.--Section 712(a)(5)(B)(vi) of such Act (42 U.S.C.
3058g(a)(5)(B)(vi)) is amended by striking ``support'' and
inserting ``actively encourage and assist in''.
(c) Ombudsman Authority With Respect to HIPAA.--Section 712(b) of
the Older Americans Act of 1965 (42 U.S.C. 3058g(b)) is amended--
(1) in paragraph (1)(B)(i) by striking ``the medical and
social records of a'' and inserting ``all records concerning
a''; and
(2) by adding at the end the following:
``(3) For purposes of section 264(c) of the Health Insurance
Portability and Accountability Act of 1996 (including regulations
issued under that section) (42 U.S.C. 1320d-2 note), the Ombudsman and
a representative of the Office shall be considered a `health oversight
agency,' so that release of residents' individually identifiable health
information to the Ombudsman or representative is not precluded in
cases in which the requirements of clause (i) or (ii) of paragraph
(1)(B) are otherwise met.''.
(d) Disclosure and Confidentiality.--Section 712(d) of the Older
Americans Act of 1965 (42 U.S.C. 3058g(d)) is amended--
(1) in paragraph (1), by striking ``files'' and inserting
``information''; and
(2) in paragraph (2)--
(A) in the paragraph heading, by striking
``Identity of complainant or resident'' and inserting
``Procedures'';
(B) in subparagraph (A)--
(i) by striking ``files or records'' the
first place it appears and inserting
``information (including files or records)'';
and
(ii) by striking ``disclose'' and all that
follows and inserting ``disclose such
information);'';
(C) in subparagraph (B)--
(i) in the matter preceding clause (i), by
striking ``files or records'' and inserting
``information''; and
(ii) in clause (iii), by striking the
period and inserting ``; and''; and
(D) by adding at the end the following:
``(C) require that the Ombudsman and each
representative of the Office hold in strict confidence
all communications with individuals seeking assistance
under this Act, and take all reasonable steps to
safeguard the confidentiality of information provided
to the Ombudsman or a representative of the Office
under this title by a complainant or resident.''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S7189-7191)
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