Older Americans Act Amendments of 2013 - Reauthorizes the Older Americans Act of 1965 (OAA) and funding for its programs for FY2014-FY2018.
Revises OAA to include lesbian, gay, bisexual, and transgendered (LGBT) individuals, HIV-positive individuals, individuals with Alzheimer's disease, veterans, and Holocaust survivors, among others, within the status of greatest social need caused by noneconomic factors.
Requires the Director of the Office of Long-Term Care Ombudsman Programs (in the Administration on Aging [AOA] of the Department of Health and Human Services [HHS]) to collect, analyze, and report on best practices related to screening for elder abuse.
Requires the Assistant Secretary for Aging of the AOA to assist states with the development of the Home Care Consumer Bill of Rights and Plan for Enforcement (required by this Act).
Requires the AOA to work with the Health Resources and Services Administration (HRSA) and the Secretary of Labor to identify and address personnel shortages in the field of aging.
Establishes an Advisory Committee to Assess, Coordinate, and Improve Legal Assistance Activities to study the legal services activities assistance system for older individuals.
Requires the Secretary of Labor, through the Bureau of Labor Statistics (BLS), to revise, improve, and report to Congress on the Experimental Price Index for the Elderly (CPI-E).
Amends OAA to express the sense of the Senate that the amount appropriated under OAA for FY2014 and each subsequent year should be at least $2.675 billion (reflecting a 12% increase over FY2010 levels).
Authorizes states to enter into cooperative arrangements with Federally Qualified Health Centers for services for the elderly.
Reauthorizes appropriations for FY2014-FY2018 for supportive services, congregate nutrition services, home-delivered nutrition services, disease prevention and health promotion services, and family caregiver support.
Requires area agencies on aging (AAAs) to develop area plans that provide for modernization of multipurpose senior centers, including a plan to use the skills and services of older adults in paid and unpaid work at such centers.
Requires AAA area plans also to: (1) include evidence-based behavioral health services, chronic self-care management programs, and falls prevention programs; (2) describe efforts to increase public awareness of elder abuse, neglect, and exploitation; and (3) describe outreach efforts to veterans and coordination of services under OAA with those provided by the Department of Veterans Affairs (VA).
Requires a state plan, among other things, to: (1) assure an adequately funded State Long-Term Care Ombudsman programprovided with adequate funding; and (2) provide legal assistance through an integrated legal assistance delivery system; and (3) describe efforts for outreach to veterans eligible for OAA services under the Act.
Increases from 185% to 200% of the poverty line the self-declared income level of individuals who may be solicited for voluntary contributions for certain services they receive.
Includes among supportive services covered by grants to states evidence-based chronic condition self-care management, evidence-based falls prevention programs, screening for elder abuse and neglect, and falls prevention screening.
Requires the meals provided under a state nutrition project to be adjusted and appropriately funded, to the maximum extent practicable, to meet any special health-related or other dietary needs of program participants, including needs based on religious, cultural, or ethnic requirements.
Declares that older adults should receive the clinical preventive services covered under title XVIII (Medicare) of the Social Security Act.
Revises caregiver and care recipient requirements for the National Family Caregiver Support Program. Authorizes the Assistant Secretary to make grants to states to assess the needs of family caregivers for targeted support services. Requires the services of AAAs or AAA contractors to include Ombudsman efforts to support family and caregiver councils in long-term care facilities, as well as facilitate and support the State Long-Term Care Ombudsman program.
Directs the Assistant Secretary to award grants to carry out or establish: (1) projects to support and promote modern multipurpose senior center models which yield multiservice, multigenerational centers for older individuals, their families, and others to gain needed skills, resources, and connections for continuum of care and quality of life; and (2) a demonstration program on care coordination and service delivery redesign for older individuals with chronic illness or at risk of institutional placement.
Directs the HHS Secretary to award competitive grants to or contract with eligible entities to fund the employment costs of professionals who will: (1) coordinate with the provision of medically recommended dental care to eligible individuals by volunteer dentists; and (2) verify the medical, dental, and financial needs of individuals who may be eligible for free medically recommended dental care.
Directs the Secretary to award a grant to or enter into a cooperative agreement with a public or private nonprofit entity to establish a National Resource Center on Family Caregiving.
Revises the purposes of the Older American Community Service Employment Program to further the goal of economic security, grow local economies, and improve the quality of life of local communities.
Directs the Assistant Secretary and the Secretary of Labor to study the feasibility of transferring the Senior Community Service Employment Program to the AOA from the Department of Labor.
Reauthorizes funding for grants for Native Americans for FY2014-FY2018.
Requires the Assistant Secretary to ensure that education and public awareness activities under OAA title XI (Allotments for Vulnerable Elder Rights Protection Activities) are fully integrated with OAA programs.
Authorizes appropriations for the State Home Care Ombudsman Program, and authorizes the Assistant Secretary to award competitive grants to states for such programs.
Requires a state to have a Home Care Consumer Bill of Rights and a Plan for Enforcement.
Requires the state Home Care Consumer Bill of Rights to address a home care consumer's right to: (1) basic safety; (2) information access; (3) choice, participation, and self-determination; and (4) redress of grievances.
Revises requirements for: (1) state long-term care ombudsman programs; (2) prevention of elder abuse, neglect, and exploitation; and (3) state legal assistance development.
Amends OAA to require state agencies to carry out a Home Care Ombudsman Program within the Office of the State Long-Term Care Ombudsman.
Amends the Public Health Service Act to include geriatrics and gerontology as primary health services.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1028 Introduced in Senate (IS)]
113th CONGRESS
1st Session
S. 1028
To reauthorize and improve the Older Americans Act of 1965, and for
other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 23, 2013
Mr. Sanders (for himself, Ms. Klobuchar, Ms. Warren, Ms. Baldwin, Mrs.
Boxer, Mr. Merkley, Mr. Blumenthal, Mr. Franken, Mr. Schatz, Mr.
Johnson of South Dakota, Mr. Cardin, Mrs. Gillibrand, Mr. Leahy, Mr.
Casey, and Mr. Nelson) introduced the following bill; which was read
twice and referred to the Committee on Health, Education, Labor, and
Pensions
_______________________________________________________________________
A BILL
To reauthorize and improve the Older Americans Act of 1965, 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.
(a) Short Title.--This Act may be cited as the ``Older Americans
Act Amendments of 2013''.
(b) Table of Contents.--
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
TITLE I--DECLARATION OF OBJECTIVES; DEFINITIONS
Sec. 101. Declaration of objectives.
Sec. 102. Definitions.
TITLE II--ADMINISTRATION ON AGING
Sec. 201. Establishment of Administration on Aging.
Sec. 202. Functions of Assistant Secretary.
Sec. 203. Federal agency consultation.
Sec. 204. Evaluation.
Sec. 205. Reports.
Sec. 206. Conforming amendments.
Sec. 207. Authorization of appropriations.
Sec. 208. Advisory Committee to Assess, Coordinate, and Improve Legal
Assistance Activities.
Sec. 209. Consumer Price Index.
Sec. 210. Sense of the Senate regarding appropriation levels.
TITLE III--GRANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING
Sec. 301. Purpose; administration.
Sec. 302. Definition.
Sec. 303. Authorization of appropriations.
Sec. 304. Allotments.
Sec. 305. Organization.
Sec. 306. Area plans.
Sec. 307. State plans.
Sec. 308. Planning, coordination, evaluation, and administration of
State plans.
Sec. 309. Nutrition services incentive program.
Sec. 310. Consumer contributions.
Sec. 311. Supportive services and senior centers program.
Sec. 312. Nutrition services.
Sec. 313. Disease prevention and health promotion services.
Sec. 314. National family caregiver support program.
TITLE IV--ACTIVITIES FOR HEALTH, INDEPENDENCE, AND LONGEVITY
Sec. 401. Grant programs.
Sec. 402. Community innovations for aging in place.
Sec. 403. Multipurpose senior center modernization, training, and
support.
Sec. 404. Demonstration program on care coordination and service
delivery.
Sec. 405. Grants or contracts to facilitate low-income access to dental
care.
Sec. 406. National Resource Center on Family Caregiving.
Sec. 407. Conforming amendment.
TITLE V--COMMUNITY SERVICE SENIOR OPPORTUNITIES
Sec. 501. Older American Community Service Employment Program.
Sec. 502. Interagency cooperation.
Sec. 503. Authorization of appropriations.
Sec. 504. Study on feasibility of transfer of program.
TITLE VI--GRANTS FOR NATIVE AMERICANS
Sec. 601. Technical amendment.
Sec. 602. Conforming amendment.
Sec. 603. Reauthorization of funding for grants for Native Americans.
TITLE VII--VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES
Sec. 701. Establishment.
Sec. 702. Authorization of appropriations.
Sec. 703. Grants.
Sec. 704. Eligibility.
Sec. 705. Additional State plan requirements.
Sec. 706. Definitions.
Sec. 707. State Long-Term Care Ombudsman program.
Sec. 708. Prevention of elder abuse, neglect, and exploitation.
Sec. 709. State legal assistance development.
Sec. 710. State Home Care Ombudsman Programs.
TITLE VIII--GERIATRICS AND GERONTOLOGY
Sec. 801. Primary health services.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Older adults are the fastest growing segment of the
Nation's population.
(2) Every day, 10,000 Baby Boomers turn 65.
(3) One in 5 of those individuals age 65 and older survives
on an average of $7,500 a year.
(4) Federal funding to support older adults and their
caregivers has not kept pace with inflation.
(5) Only 7 percent of individuals who are food insecure get
a home-delivered meal.
(6) For every reported incident of elder abuse, neglect,
exploitation, or self-neglect, approximately 25 go unreported.
(7) By making significant improvements through the Older
Americans Act Amendments of 2013, it is possible to improve the
lives of millions of older adults, and ensure that they receive
the supports and services that they need to stay healthy and
active in their homes and communities.
TITLE I--DECLARATION OF OBJECTIVES; DEFINITIONS
SEC. 101. DECLARATION OF OBJECTIVES.
Section 101 of the Older Americans Act of 1965 (42 U.S.C. 3001) is
amended--
(1) by striking paragraph (1) and inserting the following:
``(1) An adequate income and economic security in later
life in accordance with the American standard of living.'';
(2) in paragraph (4), by inserting ``care coordination
and'' after ``including'';
(3) by striking paragraphs (9) and (10) and inserting the
following:
``(9) Immediate benefit from proven research knowledge
which can sustain and improve health, happiness, and economic
security.
``(10) Freedom, independence, economic security, and the
free exercise of individual initiative for older individuals in
planning and managing their own lives, full participation in
the planning and operation of community-based services and
programs provided for their benefit, and protection against
abuse, neglect, and exploitation.''; and
(4) by adding at the end the following:
``(11) Acquiring high-quality services in a manner that is
culturally and linguistically responsive to older individuals
and family caregivers.''.
SEC. 102. DEFINITIONS.
(a) In General.--Section 102 of the Older Americans Act of 1965 (42
U.S.C. 3002) is amended--
(1) by amending paragraph (1) to read as follows:
``(1) The term `abuse' means the knowing infliction of
physical or psychological harm or the knowing deprivation of
goods or services that are necessary to meet essential needs or
to avoid physical or psychological harm.'';
(2) by redesignating paragraphs (4) through (14) and (15)
through (54) as paragraphs (5) through (15) and (17) through
(56), respectively;
(3) by inserting after paragraph (3) the following:
``(4) The term `adult protective services' means such
services provided to adults as the Secretary may specify and
includes services such as--
``(A) receiving reports of adult abuse, neglect, or
exploitation;
``(B) investigating the reports described in
subparagraph (A);
``(C) case planning, monitoring, evaluation, and
other case work and services; and
``(D) providing, arranging for, or facilitating the
provision of services, such as medical, social,
economic, legal, housing, law enforcement, or other
protective, emergency, or support services.'';
(4) in subparagraph (B)(i) of paragraph (12), as
redesignated by paragraph (2) of this subsection, by striking
``comprehensive'' and all that follows through
``psychological,'' and inserting ``comprehensive person-
centered assessment of the older individual (including the
physical, psychological, economic,'';
(5) in subparagraph (C) of paragraph (15), as redesignated
by paragraph (1) of this subsection, by inserting ``, their
family members,'' before ``and their primary'';
(6) by inserting after that paragraph (15) the following:
``(16)(A) The term `economic security' means access to the
assets, income, and community-based services necessary to
provide for adequate and unsubsidized housing, health care,
transportation, food and adequate nutrition, long-term care,
and goods and services to meet other basic human needs. Such
access shall be measured in a manner that shall be
geographically based, and take into account an individual's
life circumstances.
``(B) The term `economic security and benefits counseling'
means a supportive service that provides, to an older
individual, a comprehensive assessment of the Federal, State,
and community benefits and services for which the individual
qualifies, along with assistance in applying for and obtaining
benefits and services.'';
(7) by amending paragraph (19), as redesignated by
paragraph (2) of this subsection, to read as follows:
``(19) The term `elder justice' means--
``(A) from a societal perspective, efforts to--
``(i) prevent, detect, treat, intervene in,
and prosecute elder abuse, neglect, and
exploitation; and
``(ii) protect older individuals with
diminished capacity while maximizing their
autonomy; and
``(B) from an individual perspective, the
recognition of an older individual's rights, including
the right to be free of abuse, neglect, and
exploitation.'';
(8) in paragraph (20)(A), as redesignated by paragraph (2)
of this subsection, by striking ``The term `exploitation'
means'' and inserting ``The terms `exploitation' and `financial
exploitation' mean'';
(9) in paragraph (25), as redesignated by paragraph (2) of
this subsection, by striking ``at or below the poverty line.''
and inserting ``that is not more than 200 percent of the
poverty line.'';
(10) by striking paragraph (26), as redesignated by
paragraph (2) of this subsection, and inserting the following:
``(26) The term `greatest social need' means need caused by
noneconomic factors--
``(A) that--
``(i) restrict the ability of an individual
to perform normal daily tasks; or
``(ii) threaten the capacity of the
individual to live independently; and
``(B) which include--
``(i) physical and mental disabilities;
``(ii) language barriers including limited
English proficiency;
``(iii) cultural, social, or geographic
isolation (such as residence in a rural area),
including isolation caused by racial, minority,
or ethnic status, or status as an LGBT
individual;
``(iv) HIV-positive health status or
Alzheimer's disease or a related disorder with
neurological and organic brain dysfunction;
``(v) greatest health service need,
particularly a need posed by multiple chronic
health conditions or a condition that places an
individual at risk for falls;
``(vi) abuse, neglect (including self-
neglect), or financial exploitation, including
factors that are the basis of a referral to
adult protective services;
``(vii) status as a veteran; and
``(viii) status as a Holocaust survivor.'';
(11) in paragraph (30), as redesignated by paragraph (2) of
this subsection--
(A) in subparagraph (C), by inserting ``, including
opportunities for paid work and volunteer service in
the community'' after ``available''; and
(B) in subparagraph (E)--
(i) in the matter preceding clause (i), by
inserting ``, in a culturally and
linguistically competent manner,'' before ``the
entire community of older individuals''; and
(ii) in clause (i), by inserting after
``social need'' the following: ``(with
particular attention to individuals with
factors listed in paragraph (26)(B))'';
(12) in paragraph (31), as redesignated by paragraph (2) of
this subsection, by striking ``information and referral'' and
inserting ``information and referral assistance'';
(13) in paragraph (35), as redesignated by paragraph (2) of
this subsection--
(A) by redesignating clauses (i) and (ii) of
subparagraph (B) as subclauses (I) and (II),
respectively, and aligning the margins of the
subclauses with the margins of subclause (I) of
subparagraph (A)(i) of paragraph (34), as so
redesignated;
(B) by redesignating subparagraphs (A) and (B) as
clauses (i) and (ii), respectively, and aligning the
margins of the clauses with the margins of clause (ii)
of subparagraph (A) of that paragraph (34);
(C) by inserting ``(A)'' before ``The term''; and
(D) by adding at the end the following:
``(B) The term `integrated legal assistance delivery
system' means a collaboratively run, statewide network that is
established to provide direct legal assistance, in the most
efficient and impactful manner possible, targeted at older
individuals with greatest economic need and older individuals
with greatest social need (with particular attention to
individuals with factors listed in paragraph (26)(B)), in
coordination with the legal assistance developer for the State
and all State, regional, and local service providers engaged in
promoting or supporting elder rights.'';
(14) in paragraph (36), as redesignated by paragraph (2) of
this subsection--
(A) in subparagraph (A), by adding ``and'' at the
end;
(B) in subparagraph (B), by striking ``; and'' at
the end and inserting a period; and
(C) by striking subparagraph (C);
(15) in paragraph (37), as redesignated by paragraph (2) of
this subsection, by striking ``sections 307(a)(12) and'' and
inserting ``the activities carried out under section
307(a)(9)'';
(16) in paragraph (38), as redesignated by paragraph (2) of
this subsection, by inserting ``(including elder abuse and
neglect screening)'' after ``educational services'';
(17) in paragraph (50)(B), as redesignated by paragraph (2)
of this subsection, by striking ``subparagraphs (A) through (G)
of paragraph (8)'' and inserting ``subparagraphs (A) through
(I) of paragraph (14)''; and
(18) by adding at the end the following:
``(57) The term `care coordination' means a person- and
family-centered, assessment-based, and interdisciplinary
approach, to meet the needs and preferences of an older
individual and a family caregiver while enhancing the
capabilities of the older individual (including the ability to
self-direct services), that integrates health care, long-term
services and supports, and social services in a high-quality
and cost-effective manner.
``(58) The term `cultural and linguistic competence' means
competence in a set of behaviors, attitudes, and policies that
is--
``(A) used by an organization or among
professionals; and
``(B) enables effective work in cross-cultural
situations.
``(59) The term `family caregiver' means an adult family
member, or another individual, who is an informal provider of
in-home and community care to an older individual or to an
individual with Alzheimer's disease or a related disorder with
neurological and organic brain dysfunction.
``(60) The term `Holocaust survivor' means an individual
who--
``(A) lived in or fled from, between 1933 and 1945,
a country under a Nazi regime, under Nazi occupation,
or under the control of Nazi collaborators;
``(B) was persecuted between 1933 and 1945 on the
basis of race, religion, physical or mental disability,
sexual orientation, political affiliation, ethnicity,
or other basis; and
``(C) was a member of a group that was persecuted
by the Nazis.
``(61) The term `LGBT', used with respect to an individual,
means a lesbian, gay, bisexual, or transgender individual.
``(62) The term `person-centered', used with respect to a
service for an individual, means a service provided with an
approach designed to ensure that an outcome reflects the needs,
preferences, and situations of the individual.
``(63) The term `veteran' has the meaning given the term in
section 101 of title 38, United States Code.''.
(b) Conforming Amendments.--Section 102 of the Older Americans Act
of 1965 (42 U.S.C. 3002), as redesignated by subsection (a)(2), is
amended--
(1) in paragraph (39)(A), by striking ``as defined in
paragraph (5)'' and inserting ``as defined in paragraph (28)'';
(2) in paragraph (40), by striking ``(as defined in
paragraph (18)(B))'' and inserting ``(as defined in paragraph
(20)(B))''; and
(3) in paragraph (48)(D), by striking ``(as defined in
paragraph (18)(B))'' and inserting ``(as defined in paragraph
(20)(B))''.
TITLE II--ADMINISTRATION ON AGING
SEC. 201. ESTABLISHMENT OF ADMINISTRATION ON AGING.
Section 201 of the Older Americans Act of 1965 (42 U.S.C. 3011) is
amended--
(1) in subsection (d)(3)--
(A) in subparagraph (K), by striking ``; and'' and
inserting a semicolon;
(B) in subparagraph (L)--
(i) by striking ``Older Americans Act
Amendments of 1992'' and inserting ``Older
Americans Act Amendments of 2013''; and
(ii) by striking ``712(h)(4).'' and
inserting ``712(h)(5); and''; and
(C) by adding at the end the following:
``(M) collect and analyze best practices related to
screening for elder abuse and publish a report of such
best practices.'';
(2) in subsection (e)(2)--
(A) in the matter preceding subparagraph (A), by
inserting ``, and in coordination with the heads of
State adult protective services programs and the State
Long-Term Care Ombudsmen'' after ``and services'';
(B) in subparagraph (A), by striking ``and'' at the
end;
(C) in subparagraph (B), by striking the period and
inserting ``; and''; and
(D) by adding at the end the following:
``(C) to assist States with the development of Home
Care Consumer Bills of Rights and Plans for
Enforcement, to ensure that home care consumers, as
defined in section 736, have basic protections as
outlined in subsections (b) and (c) of section 705.'';
and
(3) by adding at the end the following:
``(g) The Assistant Secretary is authorized to use funds
appropriated to carry out this Act to implement activities authorized
under part I of subtitle B of title XX of the Social Security Act (42
U.S.C. 1397k et seq.), including the establishment of the Advisory
Board on Elder Abuse, Neglect, and Exploitation, and to continue the
work of the Elder Justice Coordinating Council.''.
SEC. 202. FUNCTIONS OF ASSISTANT SECRETARY.
Section 202 of the Older Americans Act of 1965 (42 U.S.C. 3012) is
amended--
(1) in subsection (a)--
(A) in paragraph (5), by inserting ``economic
security,'' after ``nutrition,'';
(B) in paragraph (7), by inserting ``, including
economic security trends among such individuals'' after
``older individuals'';
(C) in paragraph (8), by striking ``older
individuals'' and inserting ``the health and economic
security of older individuals'';
(D) in paragraph (14), by inserting ``for working
with the Administrator of the Health Resources and
Services Administration and the Secretary of Labor to
identify and address workforce shortages involving such
personnel,'' after ``field of aging,'';
(E) by striking paragraph (15) and inserting the
following:
``(15)(A) as needed, provide technical assistance, training
through training packages, and other forms of instruction to
entities consisting of State agencies, area agencies on aging,
service providers, and community-based organizations, to ensure
that the entities develop and implement, in a culturally and
linguistically competent manner, programming, services, and
outreach for older individuals with greatest economic need and
older individuals with greatest social need (with particular
attention to providing services to individuals with factors
listed in section 102(26)(B); and
``(B) consult with national and community-based
organizations representing minority individuals to develop the
capacity of the Administration to provide such technical
assistance, training, and instruction.'';
(F) in paragraph (16)(C), by striking ``paragraphs
(2) and (5)(A)'' and inserting ``paragraphs (2) and
(4)(A)'';
(G) in paragraph (18), by amending subparagraph (B)
to read as follows:
``(B) make available to the Center--
``(i) for fiscal year 2014, not less than
$2,000,000; and
``(ii) for each subsequent fiscal year, not
less than the amount made available under this
subparagraph for fiscal year 2014.'';
(H) by striking paragraph (22) and inserting the
following:
``(22) develop guidelines for area agencies on aging to
follow in choosing and evaluating providers of legal assistance
with the capacity to work within an integrated legal assistance
delivery system;'';
(I) in paragraph (23), by striking all text
following ``developers'' and inserting ``referred to in
section 307(a)(13) and section 731;'';
(J) in paragraph (27), by striking ``and'' at the
end;
(K) in paragraph (28), by striking the period and
inserting a semicolon; and
(L) by adding at the end the following:
``(29)(A) encourage, provide technical assistance to and
share best practices with, States, area agencies on aging,
Aging and Disability Resource Centers, and service providers to
carry out outreach and coordinate activities with health care
entities, such as Federally qualified health centers, in order
to assure better care coordination for individuals with
multiple chronic illnesses; and
``(B) coordinate activities with other Federal agencies
that are working to improve care coordination and developing
new models and best practices for that coordination.'';
(2) in subsection (b)--
(A) in paragraph (8)--
(i) in subparagraph (D)--
(I) by inserting ``, and with
future planning for eligible care
recipients (as defined in section
372(a)) who are individuals with
disabilities described in section
372(a)(2)(B) and who are living with
older relative caregivers (as so
defined)'' after ``needs''; and
(II) by striking ``and'' at the
end;
(ii) in subparagraph (E), by striking the
semicolon at the end and inserting ``; and'';
and
(iii) by adding at the end the following:
``(F) to provide information relating to the
quality measures identified under paragraph (11)(A),
using the methods described in paragraph (11)(B), about
home and community-based long-term care programs,
service providers, and resources, when referring
consumers to those programs, providers, or
resources;'';
(B) in paragraph (10), by striking ``and'' at the
end;
(C) by redesignating paragraph (11) as paragraph
(12); and
(D) by inserting after paragraph (10) the
following:
``(11) identify, in consultation with States (either
directly or by entering into a contract under this subparagraph
and considering the recommendation of the contract recipient)
quality measures for home and community-based long-term care
programs, service providers, and resources that--
``(A) protect the health, safety, and welfare of
consumers who are referred to such programs; and
``(B) shall be identified after the Assistant
Secretary takes into account, at a minimum, information
regarding--
``(i) background checks of service
providers;
``(ii) licensure of agencies and
certification and training of service
providers; and
``(iii) consumer satisfaction regarding
programs, service providers, and resources, in
cases in which consumer satisfaction
information is available; and'';
(3) in subsection (e)(2)(B)--
(A) in clause (viii), by striking ``and'';
(B) by redesignating clause (ix) as clause (x); and
(C) by inserting after clause (viii) the following:
``(ix) organizations with expertise on economic
security, asset accumulation, and retirement planning;
and''; and
(4) by adding at the end the following:
``(g) The Assistant Secretary shall ensure, where appropriate, that
all programs funded under this Act include appropriate training in the
prevention of abuse, neglect, and exploitation and provision of
services that address elder justice and the exploitation of older
individuals.
``(h)(1) The Assistant Secretary shall establish and operate a
National Resource Center for Women and Retirement (referred to in this
subsection as the `Center').
``(2) The Assistant Secretary shall make available to the Center
such resources as are necessary for the Center to carry out effectively
the functions of the Center under this Act, which shall be an amount
not less than $279,000 for fiscal year 2014. In subsequent fiscal
years, the Assistant Secretary shall make available to the Center not
less than the amount of resources made available to the Center under
this paragraph for fiscal year 2014.
``(i)(1) Aging and Disability Resource Centers implemented under
subsection (b)(8) may carry out an assessment program, with respect to
informal caregivers and care recipients, that shall be modeled on the
family caregiver assessment program established under section 373(b).
``(2) For purposes of an informal caregiver assessment carried out
in accordance with paragraph (1), the following definitions shall
apply:
``(A) The term `care recipient' means--
``(i) an older individual;
``(ii) an individual with a disability; or
``(iii) an individual with a special need.
``(B) 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.
``(j)(1) The Assistant Secretary shall, directly or by grant or
contract, establish and operate the National Resource Center on
Lesbian, Gay, Bisexual, and Transgender Aging.
``(2) The Assistant Secretary shall develop and issue operating
standards and reporting requirements for the Center established under
paragraph (1).
``(3) The Assistant Secretary shall make available to the Center
such resources as are necessary for the Center to carry out effectively
the functions of the Center under this Act for fiscal year 2014. In
subsequent fiscal years, the Assistant Secretary shall make available
to the Center not less than the amount of resources made available to
the Center under this paragraph for fiscal year 2014.
``(k) The Assistant Secretary shall, directly or by grant or
contract, establish and operate a National Adult Protective Services
Resource Center.''.
SEC. 203. FEDERAL AGENCY CONSULTATION.
Section 203 of the Older Americans Act of 1965 (42 U.S.C. 3013) is
amended--
(1) in subsection (a)(3)(A), by striking ``older
individuals (with particular attention to low-income older
individuals, including low-income minority older individuals,
older individuals with limited English proficiency, and older
individuals residing in rural areas)'' and inserting ``older
individuals, older individuals with greatest economic need,
older individuals with greatest social need (with particular
attention to individuals with factors listed in section
102(26)(B)),'';
(2) in subsection (b)--
(A) in paragraph (18), by striking ``, and'' and
inserting a comma;
(B) in paragraph (19), by striking the period at
the end and inserting ``, and''; and
(C) by adding at the end the following:
``(20) the Patient Protection and Affordable Care Act,
including the amendments made by that Act (Public Law 111-148),
including programs that increase integration with community
health centers, as practicable.''; and
(3) in subsection (c)(6)--
(A) in subparagraph (A)--
(i) in clause (iii)--
(I) by inserting ``and economic''
after ``demographic''; and
(II) by striking ``and'' at the
end;
(ii) in clause (iv), by adding ``and'' at
the end; and
(iii) by adding at the end the following:
``(v) identifying and addressing workforce
shortages related to services and supports for older
individuals, and leveraging the resources of Federal
programs that are related to the programs carried out
under this Act, to address the shortages;'';
(B) in subparagraph (B)--
(i) in the matter preceding clause (i), by
inserting ``economic security,'' after
``housing,''; and
(ii) in clause (i), by inserting ``economic
security,'' after ``housing,'';
(C) in subparagraph (D), by inserting ``economic
security,'' after ``housing,'';
(D) in subparagraph (E), by inserting ``and
economic security'' after ``public health'';
(E) in subparagraph (F), by striking ``and'' at the
end;
(F) in subparagraph (G)--
(i) in the matter preceding clause (i), by
inserting ``economic security,'' after ``health
care,''; and
(ii) in clause (iii), by striking the
period at the end and inserting ``; and''; and
(G) by adding at the end the following:
``(H)(i) identify model Federal programs to assist older
individuals with achieving economic security; and
``(ii) propose greater coordination of efforts to provide
such assistance, including by creating an inventory of all
Federal programs aimed at reducing poverty and increasing the
economic security of older adults.''.
SEC. 204. EVALUATION.
Section 206 of the Older Americans Act of 1965 (42 U.S.C. 3017) is
amended--
(1) in subsection (a), by striking ``greatest economic
need'' and all that follows through ``areas),'' and inserting
``greatest economic need and unserved older individuals with
greatest social need (with particular attention to individuals
with factors listed in section 102(26)(B)),'';
(2) in subsection (c), by striking ``minority individuals''
and all that follows through ``disabilities'' and inserting
``individuals with greatest economic need and greatest social
need (with particular attention to individuals with factors
listed in section 102(26)(B))'';
(3) in subsection (d), by striking ``including, as
appropriate, health and nutrition education demonstration
projects conducted under section 307(f) the full contents of
which shall be'' and inserting ``and the full contents of those
summaries and analyses shall be'';
(4) by redesignating subsections (e) through (g) as
subsections (f) through (h), respectively;
(5) by inserting after paragraph (d) the following:
``(e) The Secretary shall prepare and submit to Congress an annual
report evaluating the impact of the programs and services provided
under this Act on the economic security of older individuals.''; and
(6) in subsection (h), as redesignated by paragraph (2), by
striking ``\1/2\ of''.
SEC. 205. REPORTS.
Section 207 of the Older Americans Act of 1965 (42 U.S.C. 3018) is
amended--
(1) in subsection (a)--
(A) in paragraph (2), by striking ``section
202(a)(19)'' and inserting ``section 202(a)(16)'';
(B) in paragraph (3), by striking ``, with
particular attention'' and all that follows through the
semicolon and inserting ``(with particular attention to
individuals with factors listed in section
102(26)(B));''; and
(C) in paragraph (4), by striking ``section
202(a)(17)'' and inserting ``section 202(a)(14)'';
(2) in subsection (b)--
(A) in paragraph (1)(C), by inserting ``and the
adult protection services programs of the States''
after ``of the States''; and
(B) in paragraph (3)(A), by striking ``Health Care
Finance Administration'' and inserting ``Centers for
Medicare & Medicaid Services'';
(3) in subsection (c)(5)--
(A) by striking ``economic need (including low-
income minority individuals and older individuals
residing in rural areas)'' and inserting ``economic
need''; and
(B) by striking ``social need (including low-income
minority individuals and older individuals residing in
rural areas)'' and inserting ``social need (with
particular attention to individuals with factors listed
in section 102(26)(B))''; and
(4) by adding at the end the following:
``(d) The Assistant Secretary shall ensure that no individual will
be required to provide information regarding the sexual orientation or
gender identity of the individual as a condition of participating in
activities or receiving services under this Act.''.
SEC. 206. CONFORMING AMENDMENTS.
(a) Appropriate Use of Funds.--Section 212(b)(3) of the Older
Americans Act of 1965 (42 U.S.C. 3020c(b)(3)) is amended--
(1) by striking ``social need,'' and inserting ``social
need (with particular attention to individuals with factors
listed in section 102(26)(B)) or''; and
(2) by striking ``, or an older'' and all that follows
through ``placement''.
(b) Administrative Expenses.--Section 215(j) of the Older Americans
Act of 1965 (42 U.S.C. 3020e-1(j)) is amended by striking ``section
216'' and inserting ``section 217''.
SEC. 207. AUTHORIZATION OF APPROPRIATIONS.
Section 216 of the Older Americans Act of 1965 (42 U.S.C. 3020f) is
amended--
(1) in subsection (a), by striking ``2007, 2008, 2009,
2010, and 2011'' and inserting ``2014, 2015, 2016, 2017, and
2018'';
(2) in subsection (b)--
(A) by striking ``section 202(a)(24)'' and
inserting ``section 202(a)(21)''; and
(B) by striking ``2007, 2008, 2009, 2010, and
2011'' and inserting ``2014, 2015, 2016, 2017, and
2018'';
(3) in subsection (c), by striking ``2007, 2008, 2009,
2010, and 2011'' and inserting ``2014, 2015, 2016, 2017, and
2018''; and
(4) by adding at the end the following:
``(d) National Adult Protective Services Resource Center.--There
are authorized to be appropriated to carry out section 201(i) (relating
to the National Adult Protective Services Resource Center), such sums
as may be necessary for fiscal years 2014, 2015, 2016, 2017, and 2018.
``(e) Advisory Committee To Assess, Coordinate, and Improve Legal
Assistance Activities.--There is authorized to be appropriated to carry
out section 216, not less than $300,000 for fiscal year 2014.''.
SEC. 208. ADVISORY COMMITTEE TO ASSESS, COORDINATE, AND IMPROVE LEGAL
ASSISTANCE ACTIVITIES.
Title II of the Older Americans Act of 1965 is amended--
(1) by redesignating section 216 (42 U.S.C. 3020f) as
section 217; and
(2) 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; Duties.--The Assistant Secretary shall appoint
members to the Committee and determine the activities of the Committee
(which shall include the study and report described in subsection (c)).
``(c) Study; Report.--The Committee shall conduct a study on the
legal services activities assistance system for older individuals. Not
later than 1 year 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 such study, including the Committee's
recommendations improving the legal services activities assistance
system for older individuals.
``(d) Regulations.--Not later than 180 days after receiving the
report described in subsection (c), the Assistant Secretary shall issue
regulations or guidance taking into consideration the recommendations
of the Committee.
``(e) Definition.--In this subsection, the term `legal assistance
activities' includes--
``(1) legal assistance made available to older individuals
with greatest economic need or with greatest social need;
``(2) activities of the National Legal Resource Center
carried out under section 420(a);
``(3) State legal assistance developer activities carried
out under section 731; and
``(4) any other directly related activity or program as
determined appropriate by the Assistant Secretary.''.
SEC. 209. CONSUMER PRICE INDEX.
(a) In General.--The Secretary of Labor, through the Bureau of
Labor Statistics and in consultation with the Assistant Secretary for
Aging, shall revise and improve the Experimental Price Index for the
Elderly published by the Bureau of Labor Statistics (commonly referred
to as the ``CPI-E'') in order for the CPI-E to be considered a reliable
measure in determining future cost of living adjustments that impact
Americans who are 62 years of age or older.
(b) Revision Requirements.--In carrying out subsection (a), the
Secretary of Labor shall--
(1) increase the number of individuals in the United States
who are 62 years of age and older (referred to in this section
as ``older adults'') sampled in the consumer expenditure survey
used to establish the CPI-E;
(2) establish samples of market-based items, stores, and
prices to represent the purchasing patterns of older adults;
and
(3) examine the medical care component, including the cost
and usage of prescription drugs, of the CPI-E taking into
account that older adults have different illnesses and health
care expenses, including dental expenses, than individuals in
the United States who are under 62 years of age.
(c) Report to Congress.--Not later than 2 years after the date of
enactment of this Act, the Secretary of Labor shall submit to Congress
a report that describes the revised CPI-E and the activities carried
out by the Secretary under this section.
SEC. 210. SENSE OF THE SENATE REGARDING APPROPRIATION LEVELS.
Title II of the Older Americans Act of 1965 (42 U.S.C. 3011 et
seq.), as amended by section 208, is further amended by adding at the
end the following:
``SEC. 218. SENSE OF THE SENATE REGARDING APPROPRIATION LEVELS.
``It is the sense of the Senate that the amount appropriated under
this Act should be not less than $2,675,000,000 for fiscal year 2014
and each subsequent year.''.
TITLE III--GRANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING
SEC. 301. PURPOSE; ADMINISTRATION.
Section 301(a)(2) of the Older Americans Act of 1965 (42 U.S.C.
3021(a)(2)) is amended--
(1) in subparagraph (E), by striking ``and'' at the end;
(2) in subparagraph (F), by striking the period and
inserting ``; and''; and
(3) by adding at the end the following:
``(G) Federally qualified health centers, as
defined in sections 1861(aa)(4) and 1905(l)(2)(B) of
the Social Security Act (42 U.S.C. 1395x(aa)(4),
1396d(l)(2)(B)).''.
SEC. 302. DEFINITION.
Section 302 of the Older Americans Act of 1965 (42 U.S.C. 3022) is
amended--
(1) by striking paragraph (3); and
(2) by redesignating paragraph (4) as paragraph (3).
SEC. 303. AUTHORIZATION OF APPROPRIATIONS.
Section 303 of the Older Americans Act of 1965 (42 U.S.C. 3023) is
amended--
(1) in subsection (a), by striking paragraph (1) and
inserting the following:
``(1) There are authorized to be appropriated to carry out part B
(relating to supportive services) such sums as may be necessary for
each of fiscal years 2014 through 2018.'';
(2) by striking subsection (b) and inserting the following:
``(b)(1) There are authorized to be appropriated to carry out
subpart 1 of part C (relating to congregate nutrition services) such
sums as may be necessary for each of fiscal years 2014 through 2018.
``(2) There are authorized to be appropriated to carry out subpart
2 of part C (relating to home delivered nutrition services) such sums
as may be necessary for fiscal years 2014 through 2018.'';
(3) by striking subsection (d) and inserting the following:
``(d) There are authorized to be appropriated to carry out part D
(relating to disease prevention and health promotion services) such
sums as may be necessary for each of fiscal years 2014 through 2018.'';
and
(4) by striking subsection (e) and inserting the following:
``(e) There are authorized to be appropriated to carry out part E
(relating to family caregiver support) such sums as may be necessary
for each of fiscal years 2014 through 2018.''.
SEC. 304. ALLOTMENTS.
Section 304(b) of such Act (42 U.S.C. 3024(b)) is amended, in the
first sentence, by striking ``part B'' and all that follows through
``part E,'' and inserting ``part B, C, or E''.
SEC. 305. ORGANIZATION.
Section 305 of the Older Americans Act of 1965 (42 U.S.C. 3025) is
amended--
(1) in subsection (a)--
(A) in paragraph (1)(E)--
(i) by striking ``greatest economic need''
and all that follows through ``rural areas)''
the first place it appears and inserting
``greatest economic need''; and
(ii) by striking ``greatest social need''
and all that follows through ``rural areas)''
and inserting ``greatest social need (with
particular attention to individuals with
factors listed in section 102(26)(B))''; and
(B) in paragraph (2)--
(i) in subparagraph (C)(ii), by striking
``areas'' and all that follows and inserting
``areas of older individuals with greatest
economic need and older individuals with
greatest social need (with particular attention
to individuals with factors listed in section
102(26)(B)); and'';
(ii) in subparagraph (E), by striking
``services to'' and all that follows through
``rural areas)'' and inserting ``services to
older individuals with greatest economic need
and older individuals with greatest social need
(with particular attention to individuals with
factors listed in section 102(26)(B)''; and
(iii) in subparagraph (G), by striking
clause (ii) and inserting the following:
``(ii) provide an assurance that the State
agency will undertake specific program
development, advocacy, and outreach efforts
focused on the needs of older individuals with
greatest social need (with particular attention
to individuals with factors listed in section
102(26)(B)) and older individuals with greatest
economic need; and'';
(2) in subsection (b)(5)(C)(i)(III), by striking ``planning
and services areas'' and inserting ``planning and service
areas''; and
(3) in subsection (d)(1), by striking ``greatest economic
or social need'' and inserting ``greatest economic need and
greatest social need (with particular attention to individuals
with factors listed in section 102(26)(B))''.
SEC. 306. AREA PLANS.
Section 306 of the Older Americans Act of 1965 (42 U.S.C. 3026) is
amended--
(1) in subsection (a)--
(A) in paragraph (1)--
(i) by striking ``maintenance, or
construction of multipurpose senior centers''
and inserting ``maintenance, modernization, or
construction of multipurpose senior centers
(which system includes a plan to use the skills
and services of older individuals in paid and
unpaid work, including multigenerational work
and older individual-to-older individual
service activities, relating to such
maintenance, modernization, or construction, or
activities at the centers)'';
(ii) by striking ``greatest economic need''
and all that follows through ``rural areas)''
the first place it appears and inserting
``greatest economic need''; and
(iii) by striking ``greatest social need''
and all that follows through ``rural areas)
residing in such area,'' and inserting
``greatest social need (with particular
attention to individuals with factors listed in
section 102(26)(B)) residing in such area,'';
(B) in paragraph (2)(A)--
(i) by striking ``mental health services''
and inserting ``evidence-based behavioral
health services, evidence-based chronic
condition self-care management programs, and
evidence-based falls prevention programs''; and
(ii) by striking ``eligible)'' and
inserting ``eligible and shall include
information on paid and unpaid work
opportunities for older individuals, as
available)'';
(C) in paragraph (4)--
(i) in subparagraph (A)--
(I) in clause (i)(I), by striking
``will--'' and all that follows and
inserting ``will set specific
objectives, consistent with State
policy, for providing services to older
individuals with greatest economic
need, older individuals with greatest
social need (with particular attention
to individuals with factors listed in
section 102(26)(B)), and older
individuals at risk for institutional
placement; and'';
(II) in clause (i)(II), by striking
``items (aa) and (bb) of''; and
(III) in subclauses (I), (II), and
(III) of clause (ii), by striking
``low-income'' and all that follows
through ``rural areas'' and inserting
``individuals with greatest economic
need and individuals with greatest
social need (with particular attention
to individuals with factors listed in
section 102(26)(B))''; and
(ii) in subparagraph (B)(i)--
(I) in subclause (II), by striking
``economic need'' and all that follows
through ``rural areas)'' and inserting
``economic need'';
(II) in subclause (III), by
striking ``social need'' and all that
follows through ``rural areas)'' and
inserting ``social need (with
particular attention to individuals
with factors listed in section
102(26)(B))''; and
(III) in subclause (VII), by
inserting ``with multiple chronic
illnesses or'' after ``older
individuals'';
(D) in paragraph (6)--
(i) in subparagraph (D), by inserting
``(including acute care providers)'' after
``service providers'';
(ii) in subparagraph (E)(ii), by inserting
``and Federally qualified health centers, as
defined in sections 1861(aa)(4) and
1905(l)(2)(B) of the Social Security Act (42
U.S.C. 1395x(aa)(4), 1396d(l)(2)(B))'' after
``203(b)''; and
(iii) by adding at the end the following:
``(H) in coordination with the State agency and
with the State agency responsible for elder abuse
prevention services, increase public awareness of elder
abuse, neglect, and exploitation, and remove barriers
to elder abuse education, prevention, investigation,
and treatment; and
``(I) serve as an advocate in the corresponding
planning and service area for evidence-based falls
prevention programs and policies for older individuals
and, if possible, enter into partnerships with State
government agencies (such as the State health agency
and State transportation agency), local agencies, and
community-based organizations that implement evidence-
based falls prevention programs and policies;'';
(E) in paragraph (7)--
(i) in subparagraph (B)(iii), by striking
``placement, to permit such individuals'' and
inserting ``placement, with particular
attention to individuals with factors listed in
section 102(26)(B), to permit such at-risk
individuals'';
(ii) in subparagraph (C)--
(I) by inserting ``(including
falls)'' after ``injury''; and
(II) by striking ``and'' at the
end; and
(iii) in subparagraph (D), by adding
``and'' at the end;
(F) by striking paragraph (9) and inserting the
following:
``(9) provide assurances that the area agency on aging, in
carrying out the State Long-Term Care Ombudsman program
described in section 307(a)(9), will--
``(A) provide adequate funding to carry out an
effective Ombudsman program in compliance with this
Act; and
``(B) expend to carry out the program not less than
the total amount of funds appropriated under this Act
or made available through other resources, and expended
by the agency in fiscal year 2010, in carrying out such
a program under this Act;'';
(G) in paragraph (16), by striking ``and'' at the
end;
(H) in paragraph (17)--
(i) by inserting ``and revise'' after
``develop'';
(ii) by inserting ``and health'' after
``State emergency response''; and
(iii) by striking the period and inserting
``; and''; and
(I) by adding at the end the following:
``(18) include information describing--
``(A) how the area agency on aging will engage in
outreach to veterans who are eligible for services
under this Act; and
``(B) effective and efficient procedures for the
coordination of services provided under this Act with
services provided to veterans by the Department of
Veterans Affairs and other providers.''; and
(2) in subsection (b)--
(A) in paragraph (2)(B), by striking ``including
individuals'' and all that follows and inserting
``including older individuals with greatest economic
need and older individuals with greatest social need
(with particular attention to individuals with factors
listed in section 102(26)(B));''; and
(B) in paragraph (3)--
(i) in subparagraph (J), by striking
``and'';
(ii) by redesignating subparagraph (K) as
subparagraph (L); and
(iii) by inserting after subparagraph (J)
the following:
``(K) protection from elder abuse, neglect, and
exploitation; and''.
SEC. 307. STATE PLANS.
Section 307(a) of the Older Americans Act of 1965 (42 U.S.C.
3027(a)) is amended--
(1) in paragraph (2), by striking subparagraph (A) and
inserting the following:
``(A) evaluate, using uniform procedures described
in section 202(a)(26), the need for supportive services
(including legal assistance pursuant to paragraph (11),
information and assistance services, care coordination,
and transportation services), nutrition services,
economic security and benefits counseling, and
multipurpose senior centers within the State;'';
(2) in paragraph (4), by striking ``provided to
individuals'' and all that follows and inserting ``provided to
individuals with greatest economic need and individuals with
greatest social need (with particular attention to individuals
with factors listed in section 102(26)(B)).'';
(3) by striking paragraph (9) and inserting the following:
``(9) The plan shall provide assurances that the State
agency will carry out, through the Office of the State Long-
Term Care Ombudsman, a State Long-Term Care Ombudsman program
in accordance with section 712 and this title, and, in carrying
out the program, will--
``(A) provide adequate funding to carry out an
effective Ombudsman program in compliance with this
Act; and
``(B) expend to carry out the program not less than
the total amount of funds appropriated under this Act
or made available through other resources, and expended
by the agency in fiscal year 2010, in carrying out such
a program under this Act.'';
(4) in paragraph (11)--
(A) in the matter preceding subparagraph (A), by
striking ``legal assistance--'' and inserting ``legal
assistance, which shall be provided through an
integrated legal assistance delivery system--''; and
(B) in subparagraph (B), by striking ``individuals
with the greatest such need;'' and inserting
``individuals with greatest economic need and
individuals with greatest social need (with particular
attention to individuals with factors listed in section
102(26)(B)),'';
(5) by striking paragraph (15) and inserting the following:
``(15) The plan shall provide assurances that programming
and services will be provided in a culturally and
linguistically competent manner to older individuals with
greatest social need.'';
(6) in paragraph (16)--
(A) in subparagraph (A), by striking clauses (i)
through (vi) and inserting the following:
``(i) older individuals with greatest
economic need;
``(ii) older individuals with greatest
social need (with particular attention to
individuals with factors listed in section
102(26)(B)); and
``(iii) caregivers of individuals described
in clause (i) or (ii); and''; and
(B) in subparagraph (B)--
(i) by striking ``through (vi)'' and
inserting ``and (ii)''; and
(ii) by striking ``caretakers'' and
inserting ``caregivers'';
(7) in paragraph (23)(A), by striking ``with other State
services'' and inserting ``with other Federal and State health
care programs and services'';
(8) in paragraph (28)(B)--
(A) by striking clause (i) and inserting the
following:
``(i) the projected change in the number of
older individuals in the State, and information
indicating the dispersal and growth in the
number of older individuals with greatest
social need in each planning and service area
in the State;''; and
(B) in clause (ii), by striking ``including
individuals'' and all that follows and inserting
``including older individuals with greatest economic
need and older individuals with greatest social need
(with particular attention to individuals with factors
listed in section 102(26)(B));''; and
(9) by adding at the end the following:
``(31) The plan shall include information describing--
``(A) how the State agency will engage in outreach
to veterans who are eligible for services under this
Act; and
``(B) effective and efficient procedures for the
coordination of services provided under this Act with
services provided to veterans by the Department of
Veterans Affairs and other providers.
``(32) The plan shall include an assurance that the State
has made efforts to train relevant staff to recognize the
common signs and symptoms of possible dementia.''.
SEC. 308. PLANNING, COORDINATION, EVALUATION, AND ADMINISTRATION OF
STATE PLANS.
Section 308(a)(1) of the Older Americans Act of 1965 (42 U.S.C.
3028(a)(1)) is amended--
(1) by striking ``this Act, and'' and inserting ``this
Act,''; and
(2) by inserting before the period the following: ``, and
the modernization of such senior centers''.
SEC. 309. NUTRITION SERVICES INCENTIVE PROGRAM.
Section 311(e) of the Older Americans Act of 1973 (42 U.S.C.
3030a(e)) is amended by striking ``fiscal year 2007'' and all that
follows and inserting ``each of fiscal years 2014 through 2018''.
SEC. 310. CONSUMER CONTRIBUTIONS.
Section 315 of the Older Americans Act of 1965 (42 U.S.C. 3030c-2)
is amended--
(1) in subsection (b)--
(A) in paragraph (1), by striking ``185 percent''
and inserting ``200 percent''; and
(B) in paragraph (3), by adding at the end the
following: ``Contributions under this section shall be
used to supplement, and not to supplant, any other
funds expended for activities described in this Act.'';
(2) in subsection (c)(2), by striking ``participation of''
and all that follows through ``rural areas)'' and inserting
``participation of older individuals with greatest economic
need and older individuals with greatest social need (with
particular attention to individuals with factors listed in
section 102(26)(B))''; and
(3) in subsection (d)--
(A) by striking ``Not later'' and all that follows
through ``shall conduct'' and inserting ``Not later
than January 1, 2015, and annually thereafter, the
Assistant Secretary shall conduct, and submit to the
appropriate committees of Congress a report containing
the results of,''; and
(B) by striking ``(with particular'' and all that
follows through ``rural areas)'' and inserting ``,
including participation rates for individuals with
greatest economic need and individuals with greatest
social need (with particular attention to individuals
with factors listed in section 102(26)(B))''.
SEC. 311. SUPPORTIVE SERVICES AND SENIOR CENTERS PROGRAM.
Section 321 of the Older Americans Act of 1965 (42 U.S.C. 3030d) is
amended--
(1) in subsection (a)--
(A) in paragraph (5)(C), by striking ``and letter
writing services'' and inserting ``evidence-based
chronic condition self-care management, letter writing
services, and evidence-based falls prevention
programs'';
(B) in paragraph (8)--
(i) by inserting ``, screening for elder
abuse and neglect, and falls prevention
screening'' after ``mental health screening'';
and
(ii) by striking ``illness, or both,'' and
inserting ``illnesses and injuries''; and
(C) in paragraph (15), by inserting before the
semicolon the following: ``and elder abuse and neglect
screening, chronic condition self-care management, and
falls prevention services''; and
(2) in subsection (b)(1), by inserting ``or modernization''
after ``construction''.
SEC. 312. NUTRITION SERVICES.
(a) In General.--Section 339 of the Older Americans Act of 1965 (42
U.S.C. 3030g-21) is amended--
(1) in paragraph (1)--
(A) by striking ``solicit'' and inserting
``utilize''; and
(B) by inserting ``, to help achieve development of
evidenced-based and cost-effective nutrition services''
after ``nutritional services''; and
(2) in paragraph (2)--
(A) in subparagraph (A), by amending clause (iii)
to read as follows:
``(iii) to the maximum extent practicable,
are adjusted and appropriately funded to meet
any special health-related or other dietary
needs of program participants, including needs
based on religious, cultural, or ethnic
requirements,'';
(B) in subparagraph (J), by striking ``and'' at the
end;
(C) in subparagraph (K), by striking the period and
inserting ``; and''; and
(D) by adding at the end the following:
``(L) where feasible, encourages the use of locally
grown foods in meal programs and identifies potential
partnerships and contracts with local producers and
providers of locally grown foods.''.
(b) Special Rule.--Section 339 of the Older Americans Act of 1965
(42 U.S.C. 3030g-21) is amended--
(1) by inserting before ``A State'' the following:
``(a) In General.--''; and
(2) by adding at the end the following:
``(b) Transportation.--Funds appropriated to carry out this part
may be used for transportation costs that can be demonstrated to be
directly related to the provision of services specified in this
part.''.
SEC. 313. DISEASE PREVENTION AND HEALTH PROMOTION SERVICES.
(a) Program.--Section 361 of the Older Americans Act of 1965 (42
U.S.C. 3030m) is amended--
(1) in subsection (a), in the first sentence--
(A) by inserting ``evidence-based'' after ``to
provide'';
(B) by inserting ``(including cognitive health
promotion services)'' after ``health promotion
services''; and
(C) by inserting before ``or at'' the following:
``at Federally qualified health centers (as defined in
sections 1861(aa)(4) and 1905(l)(2)(B) of the Social
Security Act (42 U.S.C. 1395x(aa)(4),
1396d(l)(2)(B))),''.
(2) Clinical preventive services.--Part D of title III of
the Older Americans Act of 1965 (42 U.S.C. 3030m et seq.) is
amended by adding at the end the following:
``SEC. 363. CLINICAL PREVENTIVE SERVICES.
``Congress finds that--
``(1) there are clinical preventive services (as defined in
a manner consistent with the recommendations of the U.S.
Preventive Services Task Force) covered under the Medicare
program carried out under title XVIII of the Social Security
Act (42 U.S.C. 1395 et seq.); and
``(2) older adults should receive the clinical preventive
services described in paragraph (1).''.
SEC. 314. NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM.
(a) Older Relative Caregiver.--Section 372 of such Act (42 U.S.C.
3030s) is amended--
(1) in subsection (a)--
(A) by striking ``this subpart:'' and inserting
``this part:''; and
(B) by striking paragraphs (1) and (2) and
inserting the following:
``(1) Child.--The term `child' means an individual who is
not more than 18 years of age.
``(2) Eligible care recipient.--The term `eligible care
recipient' means a relative, of an older relative caregiver,
who is--
``(A) a child; or
``(B) an individual with a disability who is not
less than 19 and not more than 59 years of age.
``(3) Older relative caregiver.--
``(A) In general.--The term `older relative
caregiver' means a caregiver, as defined in
subparagraph (B) or (C), who--
``(i) is 55 years of age or older; and
``(ii) lives with, is the informal provider
of in-home and community care to, and is the
primary caregiver for, an eligible care
recipient who is described in subparagraph (B)
or (C), respectively.
``(B) Caregiver for child.--For purposes of
subparagraph (A), the term `caregiver', used with
respect to an eligible care recipient who is a child,
means an individual who--
``(i) is the grandparent, stepgrandparent,
or other relative (other than the parent) by
blood, marriage, or adoption, of the eligible
care recipient;
``(ii) is the primary caregiver of the
eligible care recipient because the biological
or adoptive parents are unable or unwilling to
serve as the primary caregiver of the eligible
care recipient; and
``(iii) has a legal relationship to the
eligible care recipient, such as legal custody
or guardianship, or is raising the eligible
care recipient informally.
``(C) Caregiver of individual with a disability.--
For purposes of subparagraph (A), the term `caregiver',
used with respect to an eligible care recipient who is
an individual with a disability described in paragraph
(2)(B) means an individual who is the parent,
grandparent, or other relative by blood, marriage, or
adoption, of the eligible care recipient.''; and
(2) in subsection (b)(2)--
(A) by striking ``grandparents or older individuals
who are relative caregivers'' and inserting ``older
relative caregivers''; and
(B) by striking ``children'' and inserting
``eligible care recipients''.
(b) Program.--Section 373 of the Older Americans Act of 1965 (42
U.S.C. 3030s-1) is amended--
(1) in subsection (a)(2), by striking ``grandparents or
older individuals who are relative caregivers.'' and inserting
``older relative caregivers.'';
(2) by redesignating subsections (b) through (g) as
subsections (c) through (h), respectively;
(3) 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 (4), to assess the
needs of family caregivers for targeted support services.
``(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) 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.
``(4) Program requirements.--
``(A) Voluntary questionnaire.--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.
``(B) Referrals.--In the case where a questionnaire
completed by a family caregiver under subparagraph (A)
indicates that the family caregiver would benefit from
1 or more targeted support services, the agency
administering the program established under paragraph
(1) shall provide referrals to the family caregiver for
State, local, nonprofit, and private-sector caregiver
programs and other resources that provide such targeted
support services to such caregivers.
``(C) 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.'';
(4) in subsection (c), as redesignated by paragraph (2)--
(A) in paragraph (4), by striking ``and'' at the
end;
(B) in paragraph (5), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(6) the efforts of the Ombudsman to facilitate the
activities of, and support, the State Long-Term Care Ombudsman
program under title VII and this title, and the efforts of the
Ombudsman to facilitate the activities of, and support, family
and caregiver councils in long-term care facilities.'';
(5) in subsection (d), as redesignated by paragraph (2)--
(A) in paragraph (1)--
(i) in the matter preceding subparagraph
(A), by striking ``and grandparents and older
individuals who are relative caregivers,'' and
inserting ``and older relative caregivers,'';
(ii) in subparagraph (A), by striking
``paragraph (1) or (2) of''; and
(iii) in subparagraph (B)--
(I) by striking ``subsection (b),
in the case of a caregiver described in
paragraph (1)'' and inserting
``subsection (c), in the case of a
caregiver described in subsection
(a)(1)''; and
(II) by striking ``section
102(22).'' and inserting ``section
102(24).''; and
(B) in paragraph (2)--
(i) in subparagraph (A)--
(I) by inserting ``(with particular
attention to individuals with factors
listed in section 102(26)(B))'' after
``social need''; and
(II) by striking ``economic need''
and all that follows and inserting
``economic need; and'';
(6) in subsection (e), as redesignated by paragraph (2), by
striking ``subsection (b)'' and inserting ``subsection (c)'';
(7) in subsection (f)(3), as redesignated by paragraph (2),
in the second sentence, by striking ``or grandparents or older
individuals who are relative caregivers,'' and inserting
``older relative caregivers,'';
(8) in subsection (g)(1), as redesignated by paragraph
(2)--
(A) in subparagraph (A), by striking ``for fiscal
years 2007, 2008, 2009, 2010, and 2011'' and inserting
``for each of fiscal years 2014 through 2018''; and
(B) in subparagraph (B), by striking ``under
section 303'' and inserting ``under section 303(e)'';
and
(9) in subsection (h), as redesignated by paragraph (2)--
(A) in paragraph (2), by striking subparagraph (C)
and inserting the following:
``(C) Limitation.--A State may use not more than 10
percent of the total Federal and non-Federal share
available to the State under this part to provide
support services to--
``(i) older relative caregivers who provide
care for children; and
``(ii) older relative caregivers--
``(I) who provide care for
individuals described in section
372(a)(2)(B); and
``(II) who are the parents of the
individuals.''; and
(B) by adding at the end the following:
``(3) Use of funds for ombudsman program.--Amounts made
available to a State to carry out the State program under this
part may be used to support the Office of the State Long-Term
Care Ombudsman, including supporting the development of
resident and family councils.''.
(c) Elimination of Superfluous Subpart Designation.--
(1) Heading.--Part E of title III of such Act (42 U.S.C.
3030s et seq.) is amended by striking the subpart heading for
subpart 1.
(2) Conforming amendments.--Sections 373 (as amended by
subsection (b)) and 374 of such Act (42 U.S.C. 3030s-1, 3030s-
2) are further amended by striking ``this subpart'' in each
place it appears and inserting ``this part''.
TITLE IV--ACTIVITIES FOR HEALTH, INDEPENDENCE, AND LONGEVITY
SEC. 401. GRANT PROGRAMS.
Section 411 of the Older Americans Act of 1965 (42 U.S.C. 3032) is
amended--
(1) in subsection (a)--
(A) in paragraph (12), by striking ``; and'' and
inserting a semicolon;
(B) by redesignating paragraph (13) as paragraph
(14); and
(C) by inserting after paragraph (12) the
following:
``(13) supporting programs that enable the mobility and
self-sufficiency of older individuals with the greatest
economic need and older individuals with the greatest social
need by providing transportation services and resources; and'';
and
(2) in subsection (b), by striking ``for fiscal years
2007'' and all that follows through ``2011'' and inserting
``for each of fiscal years 2014 through 2018''.
SEC. 402. COMMUNITY INNOVATIONS FOR AGING IN PLACE.
Section 422 of the Older Americans Act of 1965 (42 U.S.C. 3032k) is
amended by adding at the end the following:
``(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $5,000,000 for each of fiscal
years 2014 through 2018.''.
SEC. 403. MULTIPURPOSE SENIOR CENTER MODERNIZATION, TRAINING, AND
SUPPORT.
Part A of title IV of the Older Americans Act of 1965 (42 U.S.C.
3032 et seq.) is amended by adding at the end the following:
``SEC. 423. MULTIPURPOSE SENIOR CENTER MODERNIZATION, TRAINING, AND
SUPPORT.
``(a) Program Authorized.--The Assistant Secretary shall award
grants and enter into contracts with eligible entities to carry out
projects to--
``(1) support and promote modern multipurpose senior center
models which yield vibrant, multiservice, multigenerational
centers for older individuals, families of older individuals,
and others in the community to gain skills, resources, and
connections needed to meet the challenges that occur with
continuum of care and quality of life;
``(2) build an evidence base of modern, replicable
practices that allow senior centers to serve a diverse array of
older individuals, as well as their families and other
caregivers, leveraging innovative partnerships and public and
private resources to develop and expand programs; and
``(3) mobilize services and leverage resources to support
the role of multipurpose senior centers as community focal
points, as provided in section 306(a)(3), and for the
establishment, construction, maintenance, and operation of
centers, as described in sections 303(c)(2) and 306(a)(1),
including development of intergenerational shared site models,
consistent with the purposes of this Act.
``(b) Use of Funds.--An eligible entity shall use funds made
available under a grant awarded, or a contract entered into, under
subsection (a) to--
``(1) carry out a project described in subsection (a); and
``(2) evaluate the project in accordance with subsection
(e).
``(c) Eligible Entity.--For purposes of this section, the term
`eligible entity' means--
``(1) a multipurpose senior center that has met national
accreditation and fiduciary standards; and
``(2) a regional partnership or collaboration of
multipurpose senior centers or State association of senior
centers in which not less than 2 centers are accredited.
``(d) Competitive Grants for Technical Assistance.--
``(1) Grants.--The Assistant Secretary shall make a grant,
on a competitive basis, to an eligible nonprofit organization
described in paragraph (2), to enable the organization to--
``(A) provide training and technical assistance to
recipients of grants under this section and other
multipurpose senior centers to adopt and tailor
evidence-based modernization strategies and practices
to respond to the economic and health needs of the
diverse and growing aging populations in their own
communities; and
``(B) carry out other duties, as determined by the
Assistant Secretary.
``(2) Eligible nonprofit organization.--To be eligible to
receive a grant under this subsection, an organization shall be
a nonprofit organization (including a partnership of nonprofit
organizations), that--
``(A) has experience and expertise in providing
technical assistance to a range of multipurpose senior
centers and experience evaluating and reporting on
programs; and
``(B) has demonstrated knowledge of and expertise
in multipurpose senior center accreditation or other
standards of excellence.
``(e) Local Evaluation and Report.--
``(1) Evaluation.--Each entity receiving a grant or a
contract under subsection (a) to carry out a project described
in subsection (a) shall evaluate the project, leadership, and
resources for the modernization of multipurpose senior centers.
``(2) Report.--The entity described in paragraph (1) shall
submit a report to the Assistant Secretary containing the
evaluation not later than 6 months after the expiration of the
period for which the grant or contract is in effect.
``(f) Report to Congress.--Not later than 6 months after the
Assistant Secretary receives the reports described in subsection
(e)(2), the Assistant Secretary shall prepare and submit to Congress a
report that describes the results of the evaluations.''.
SEC. 404. DEMONSTRATION PROGRAM ON CARE COORDINATION AND SERVICE
DELIVERY.
Part A of title IV of the Older Americans Act of 1965 (42 U.S.C.
3032 et seq.), as amended by section 403, is further amended by adding
at the end the following:
``SEC. 424. DEMONSTRATION PROGRAM ON CARE COORDINATION AND SERVICE
DELIVERY.
``(a) Establishment of Demonstration Program.--
``(1) In general.--The Assistant Secretary shall carry out
a demonstration program in accordance with this section. The
Assistant Secretary shall award grants to eligible entities (as
determined by the Secretary) to implement demonstration
projects that focus on care coordination and service delivery
redesign for older individuals with chronic illness or at risk
of institutional placement by--
``(A) designing and testing new models of care
coordination and service delivery that thoughtfully and
effectively deploy advanced aides to improve efficiency
and quality of care for frail older individuals; and
``(B) giving direct-care workers opportunities for
career advancement through additional training, an
expanded role, and increased compensation.
``(2) Direct-care worker.--In this section, the term
`direct-care worker' has the meaning given that term in the
2010 Standard Occupational Classifications of the Department of
Labor for Home Health Aides [31-1011], Psychiatric Aides [31-
1013], Nursing Assistants [31-1014], and Personal Care Aides
[39-9021].
``(b) Planning and Implementation Awards Under the Program.--
``(1) In general.--Each eligible entity that receives a
grant under this section shall receive a grant for planning and
implementation activities related to the demonstration project
to be carried out by the entity.
``(2) Amount.--The amount awarded under paragraph (1) for
all grants--
``(A) for planning activities, shall not exceed
$600,000; and
``(B) for implementation activities, shall not
exceed $2,900,000.
``(3) Terms.--Planning activities carried out under a grant
awarded under paragraph (1) shall be completed not later than 1
year after the grant is awarded. Implementation activities
carried out under such a grant shall be completed not later
than 2 years after the grant is awarded.
``(4) Evaluation and report.--Each recipient of a grant
under paragraph (1), in consultation with an independent
evaluation contractor, shall conduct an evaluation and submit
to the Secretary a report on the implementation of activities
conducted under the demonstration project, including such
information as the Secretary may require.''.
SEC. 405. GRANTS OR CONTRACTS TO FACILITATE LOW-INCOME ACCESS TO DENTAL
CARE.
Part A of title IV of the Older Americans Act of 1965, as amended
by section 404, is further amended by adding at the end the following:
``SEC. 425. GRANTS OR CONTRACTS TO FACILITATE LOW-INCOME ACCESS TO
DENTAL CARE.
``(a) Definition.--In this section, the term `medically recommended
dental care' means treatment of an oral disease or other oral
condition, on the referral of a physician or other health care
professional, to sustain or improve overall health, prevent
exacerbation of a co-morbid condition, or as a prerequisite to a
required medical therapy.
``(b) Grants.--The Secretary shall award competitive grants to, or
enter into contracts with, eligible entities to fund the employment
costs of professionals who will use grant or contract funds to--
``(1) coordinate the provision of medically recommended
dental care to eligible individuals by volunteer dentists in a
manner consistent with State licensing laws; and
``(2) verify the medical, dental, and financial needs of
eligible individuals who may be eligible for free medically
recommended dental care.
``(c) Eligibility.--
``(1) Eligible entity.--To be eligible to receive a grant
or contract under subsection (b), an entity shall be a
nonprofit organization that provides for the participation of
eligible individuals in a free dental services program on a
national basis.
``(2) Eligible individual.--To be eligible to participate
in a program described in paragraph (1), individuals shall be
those with greatest economic need and individuals with greatest
social need (with particular attention to individuals with
factors listed in section 102(26)(B)).
``(d) Use of Funds.--An entity shall use amounts received under a
grant or contract under this section to establish, expand, or operate a
program to coordinate the provision of free medically recommended
dental care through volunteer dentists to eligible individuals.
``(e) Evaluation and Report.--
``(1) Evaluation.--Each entity that receives a grant or
contract under this section shall evaluate the number of
patients served under the grant or contract, and the
effectiveness of the program described in subsection (d) in
reducing medical expenses associated with the disease or
condition for which care described in subsection (d) was
provided.
``(2) Report.--The entity shall submit a report containing
the results of the evaluation to the Assistant Secretary, not
later than 6 months after the end of the period of the grant or
contract.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $2,000,000 for each of fiscal
years 2014 through 2018.''.
SEC. 406. NATIONAL RESOURCE CENTER ON FAMILY CAREGIVING.
Part A of title IV of the Older Americans Act of 1965 (42 U.S.C.
3032 et seq.), as amended by section 405, is further amended by adding
at the end the following:
``SEC. 426. NATIONAL RESOURCE CENTER ON FAMILY CAREGIVING.
``(a) Establishment.--The Secretary of Health and Human Services
shall award a grant to or enter into a cooperative agreement with a
public or private nonprofit entity to establish a National Resource
Center on Family Caregiving (referred to in this section as the
`Center').
``(b) Development.--The Assistant Secretary shall develop and issue
operating standards and reporting requirements for the Center
established under subsection (a).
``(c) Authorization.--There is authorized to be appropriated to
carry out this section, $2,000,000 for each of fiscal years 2014
through 2018.''.
SEC. 407. CONFORMING AMENDMENT.
Section 417(c)(2) of the Older Americans Act of 1965 (42 U.S.C.
3032f(c)(2)) is amended by striking ``older individuals and
communities'' and all that follows and inserting ``communities with
greatest need, older individuals with greatest economic need, and older
individuals with greatest social need (with particular attention to
individuals with factors listed in section 102(26)(B));''.
TITLE V--COMMUNITY SERVICE SENIOR OPPORTUNITIES
SEC. 501. OLDER AMERICAN COMMUNITY SERVICE EMPLOYMENT PROGRAM.
Section 502 of the Older Americans Act of 1965 (42 U.S.C. 3056) is
amended--
(1) in subsection (a)(1)--
(A) by striking ``To foster individual economic
self-sufficiency and'' and inserting ``To further the
goal of economic security, foster individual economic
self-sufficiency, grow local economies, improve the
quality of life in local communities, and''; and
(B) by striking ``persons who are age 55'' and
inserting ``persons who are not economically secure and
who are age 55''; and
(2) in subsection (b)(1)--
(A) in subparagraph (E), by striking ``support for
children,'' and inserting ``support for adults,
children,''; and
(B) in subparagraph (M), by striking ``and eligible
individuals with greatest economic need'' and inserting
``eligible individuals with disabilities, eligible
individuals with greatest economic need, and eligible
individuals with greatest social need''.
SEC. 502. INTERAGENCY COOPERATION.
Section 514 of the Older Americans Act of 1965 (42 U.S.C. 3056l) is
amended--
(1) in subsection (c)(1), by striking ``individuals with
greatest economic need, individuals with greatest social
need,'' and inserting ``individuals with greatest economic
need, individuals with greatest social need (with particular
attention to individuals with factors listed in section
102(26)(B)),''; and
(2) in subsection (e)(1), by striking ``minority'' and all
that follows through ``economic need,'' and inserting
``individuals with greatest economic need, individuals with
greatest social need,''.
SEC. 503. AUTHORIZATION OF APPROPRIATIONS.
Section 517(a) of the Older Americans Act of 1965 (42 U.S.C.
3056o(a)) is amended by striking ``fiscal years 2007, 2008, 2009, 2010,
and 2011'' and inserting ``each of fiscal years 2014 through 2018''.
SEC. 504. STUDY ON FEASIBILITY OF TRANSFER OF PROGRAM.
(a) Study.--The Assistant Secretary for Aging of the Department of
Health and Human Services, and the Secretary of Labor, shall study the
feasibility of transferring the program carried out under title V of
the Older Americans Act of 1965 (42 U.S.C. 3056 et seq.) to the
Administration on Aging.
(b) Report.--Not later than 2 years after the date of enactment of
this Act, the Assistant Secretary and the Secretary shall submit a
report containing the results of the study to the appropriate
committees of Congress.
TITLE VI--GRANTS FOR NATIVE AMERICANS
SEC. 601. TECHNICAL AMENDMENT.
Section 611 of such Act (42 U.S.C. 3057b) is amended by striking
``(a)'' in the matter preceding paragraph (1).
SEC. 602. CONFORMING AMENDMENT.
Section 631(b) of the Older Americans Act of 1965 (42 U.S.C. 3057k-
11(b)) is amended by striking ``subsections (c), (d), and (e)'' and
inserting ``subsections (d), (e), and (f)''.
SEC. 603. REAUTHORIZATION OF FUNDING FOR GRANTS FOR NATIVE AMERICANS.
Section 643(2) of the Older Americans Act of 1965 (42 U.S.C.
3057n(2)) is amended by striking ``part C,'' and all that follows and
inserting ``part C, not less than $8,400,000 for each of fiscal years
2014 through 2018.''.
TITLE VII--VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES
SEC. 701. ESTABLISHMENT.
Section 701 of the Older Americans Act of 1965 (42 U.S.C. 3058) is
amended--
(1) by inserting ``and grants'' after ``allotments''; and
(2) by adding at the end the following: ``The Assistant
Secretary, to the maximum extent practicable, shall ensure that
education and public awareness activities under this title are
fully integrated with programs under this Act.''.
SEC. 702. AUTHORIZATION OF APPROPRIATIONS.
Chapter 1 of subtitle A of title VII of the Older Americans Act of
1965 is amended by inserting after section 702 (42 U.S.C. 3058a) the
following:
``SEC. 702A. AUTHORIZATION OF APPROPRIATIONS FOR STATE HOME CARE
OMBUDSMAN PROGRAM.
``There are authorized to be appropriated to carry out chapter 5
such sums as may be necessary for fiscal year 2014 and each subsequent
fiscal year.''.
SEC. 703. GRANTS.
Section 703 of the Older Americans Act of 1965 (42 U.S.C. 3058b) is
amended by adding at the end the following:
``(d) Grants for State Home Care Ombudsman Programs.--The Assistant
Secretary shall use funds made available under section 702A to award
grants, on a competitive basis, to States for State Home Care Ombudsman
Programs.''.
SEC. 704. ELIGIBILITY.
Section 704 of the Older Americans Act of 1965 (42 U.S.C. 3058c) is
amended, in the matter preceding paragraph (1), by inserting ``or
grants'' after ``allotments''.
SEC. 705. ADDITIONAL STATE PLAN REQUIREMENTS.
Section 705 of the Older Americans Act of 1965 (42 U.S.C. 3058d) is
amended--
(1) in subsection (a)--
(A) in the matter preceding paragraph (1), by
inserting ``or grant'' after ``allotment'';
(B) in paragraph (1), by striking ``requirements of
the chapter and this chapter'' and inserting
``requirements of this chapter and this subtitle'';
(C) in paragraph (2), by inserting ``family
caregivers,'' after ``title VI,'';
(D) in paragraph (4), by striking ``enactment of
this subtitle'' and inserting ``enactment of the
chapter'';
(E) in paragraph (6), by striking ``and'' at the
end;
(F) in paragraph (7), by striking the period and
inserting ``; and''; and
(G) by adding at the end the following:
``(8) an assurance that the State has--
``(A) a Home Care Consumer Bill of Rights and a
Plan for Enforcement of such a Bill, developed in
accordance with the procedures described under
paragraph (2) and as approved by the Assistant
Secretary, and the State shall include a copy of the
Bill and Plan; or
``(B) a waiver of subparagraph (A) from the
Assistant Secretary and a proposal for developing and
submitting for approval a Home Care Consumer Bill of
Rights and Plan for Enforcement.'';
(2) by redesignating subsection (b) as subsection (d);
(3) by inserting after subsection (a) the following:
``(b) Home Care Consumer Bill of Rights.--The Home Care Consumer
Bill of Rights referred to in subsection (a)(8) shall, at a minimum--
``(1) address a home care consumer's right to basic safety;
``(2) address a home care consumer's right to access
information about the cost of home care services prior to
receiving those services;
``(3) address a home care consumer's right to choice,
participation, and self-determination;
``(4) address a home care consumer's right to redress
grievances; and
``(5) meet any other guidelines determined to be
appropriate by the Assistant Secretary.
``(c) Plan for Enforcement.--The Plan for Enforcement referred to
in subsection (a)(8) shall include a description of how State entities
with a role in protecting older individuals will coordinate activities
to enforce the Home Care Consumer Bill of Rights.''; and
(4) by adding at the end the following:
``(e) Definition.--In this section, the term `home care consumer'
and `home care services' have the meanings given the terms in section
736.''.
SEC. 706. DEFINITIONS.
Section 711(6) of the Older Americans Act of 1965 (42 U.S.C.
3058f(6)) is amended by striking ``older individual'' and inserting
``individual''.
SEC. 707. STATE LONG-TERM CARE OMBUDSMAN PROGRAM.
Section 712 of the Older Americans Act of 1965 (42 U.S.C. 3058g) is
amended--
(1) in subsection (a)--
(A) in paragraph (2), by adding at the end the
following: ``The Ombudsman shall be responsible for the
management, including the fiscal management, of the
Office.'';
(B) in paragraph (3)--
(i) in subparagraph (A), by striking clause
(i) and inserting the following:
``(i) are made by or on behalf of
residents, including residents with limited or
no decisionmaking capacity and who have no
known legal representative, and if such a
resident is unable to communicate consent for
an Ombudsman to work on a complaint directly
involving the resident, the Ombudsman shall
seek evidence to indicate what outcome the
resident would have desired (and, in the
absence of evidence to the contrary, shall
assume that the resident wishes to have the
resident's health, safety, welfare, and rights
protected) and shall work to accomplish the
desired outcome;'';
(ii) in subparagraph (D), by striking
``regular and timely'' and inserting ``regular,
timely, private, and unimpeded''; and
(iii) in subparagraph (H)(iii), by striking
``provide technical support for'' and inserting
``actively encourage and assist in'';
(C) in paragraph (4)--
(i) in the paragraph header, by striking
``Contracts and arrangements'' and inserting
``Organizational placement''; and
(ii) by striking subparagraph (B) and
inserting the following:
``(B) Identifying, removing, and remedying
organizational conflict.--
``(i) In general.--The State agency may not
operate the Office or carry out the program,
directly, or by contract or other arrangement
with any public agency or nonprofit private
organization, in a case in which there is an
organizational conflict of interest unless such
conflict has been--
``(I) identified by the State
agency;
``(II) disclosed by the State
agency to the Assistant Secretary in
writing; and
``(III) remedied in accordance with
this subparagraph.
``(ii) Action by administration.--In a case
in which a potential or actual organizational
conflict of interest involving the Office is
disclosed or reported to the Assistant
Secretary by any person or entity, the
Assistant Secretary shall require that the
State agency--
``(I) remove the conflict; or
``(II) submit, and obtain the
approval of the Assistant Secretary
for, an adequate remedial plan that
indicates how the Ombudsman will be
unencumbered in fulfilling all of the
functions specified in paragraph (3).
``(C) Organizational conflict of interest.--In this
paragraph, the term `organizational conflict of
interest' includes a situation in which the Office is
placed in an organization that--
``(i) is responsible for licensing or
certifying long-term care services in the
State;
``(ii) is an association (or an affiliate
of such an association) of long-term care
facilities, or of any other residential
facilities for older individuals;
``(iii) provides long-term care services,
including programs carried out under a Medicaid
waiver approved under section 1115 of the
Social Security Act (42 U.S.C. 1315) or under
subsection (c) or (b) of section 1915 of the
Social Security Act (42 U.S.C. 1396n), or under
a Medicaid State plan amendment under
subsection (i), (j), or (k) of section 1915 of
the Social Security Act (42 U.S.C. 1396n);
``(iv) provides long-term care case
management;
``(v) sets rates for long-term care
services;
``(vi) provides adult protective services;
``(vii) is responsible for eligibility
determinations for the Medicare program carried
out under title XVIII, or the Medicaid program
carried out under title XIX, of the Social
Security Act (42 U.S.C. 1395 et seq., 1396 et
seq.);
``(viii) conducts preadmission screening
for placements in facilities described in
clause (ii); or
``(ix) makes decisions regarding admission
of individuals to such facilities.''; and
(D) in paragraph (5)(B)(vi), by striking
``support'' and inserting ``actively encourage and
assist in'';
(2) in subsection (b)--
(A) in paragraph (1)--
(i) in subparagraph (A), by striking
``access'' and inserting ``private and
unimpeded access'';
(ii) in subparagraph (B)(i)--
(I) in the matter preceding
subclause (I), by striking ``the
medical and social records of a'' and
inserting ``all records concerning a'';
and
(II) in subclause (II), by striking
``to consent'' and inserting ``to
communicate consent'';
(iii) by redesignating subparagraphs (C)
and (D) as subparagraphs (E) and (F),
respectively; and
(iv) by inserting after subparagraph (B)
the following:
``(C) such access as is necessary to advocate for a
resident's desired outcome to the extent that the
resident can express the outcome desired, even if the
resident is unable to communicate consent;
``(D) access to the records of a resident who is
unable to communicate consent in a case in which--
``(i) the access is necessary to
investigate and resolve a complaint described
in subsection (a)(3);
``(ii) a legal guardian of the resident
refuses to give permission for the access;
``(iii) a representative of the Office has
reasonable cause to believe that the guardian
is not acting in the best interests of the
resident by refusing;
``(iv) the resident has no other known
legal representative; and
``(v) the representative of the Office
obtains the approval of the Ombudsman;''; and
(B) by adding at the end the following:
``(3) Health oversight agency.--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), or the requirements of paragraph (1)(D) are
otherwise met.'';
(3) in subsection (c)(2)(D), by striking ``section
202(a)(21)'' and inserting ``section 202(a)(18)'';
(4) in subsection (d)--
(A) in paragraph (1), by striking ``files'' and
inserting ``information''; and
(B) in paragraph (2)--
(i) in subparagraph (A), by striking
``files and records'' each place such term
appears and inserting ``information''; and
(ii) in subparagraph (B), by striking
``files or records'' and inserting
``information'';
(5) in subsection (f)(3)--
(A) in subparagraph (C), by striking ``facility;
and'' and inserting ``facility or a related
organization, and has not been employed by such a
facility or organization within 2 years before the date
of the determination involved;'';
(B) in subparagraph (D), by striking ``and'' at the
end; and
(C) by adding at the end the following:
``(E) does not have management responsibility for,
or operate under the supervision of, an agency with
responsibility for adult protective services; and
``(F) does not serve as a guardian or in another
fiduciary capacity for residents of long-term care
facilities in an official capacity (as opposed to
serving as a guardian or fiduciary, for a family
member, in a personal capacity); and'';
(6) in subsection (h)--
(A) in paragraph (4), by striking all that precedes
``procedures'' and inserting the following:
``(4) strengthen and update'';
(B) by redesignating paragraphs (4) through (9) as
paragraphs (5) through (10), respectively;
(C) by inserting after paragraph (3) the following:
``(4) ensure that the Ombudsman or a designee attends
training provided by the Administration through the National
Ombudsman Resource Center established in section 202(a)(18);'';
(D) in paragraph (7)(A), as redesignated by
subparagraph (B) of this paragraph, by striking
``subtitle C of the'' and inserting ``subtitle C of
title I of the''; and
(E) in paragraph (10), as redesignated by
subparagraph (B) of this paragraph, by striking ``(6),
or (7)'' and inserting ``(7), or (8)''; and
(7) by adding at the end the following:
``(k) Ensuring Effective Programs and Residents' Rights.--The State
agency shall ensure the Office--
``(1) provides long-term care facility residents with
private and unimpeded access to the Office, including access to
all records concerning the resident; and
``(2) allows all long-term care facility residents to
receive services from the Office.''.
SEC. 708. PREVENTION OF ELDER ABUSE, NEGLECT, AND EXPLOITATION.
Section 721(b) of the Older Americans Act of 1965 (42 U.S.C.
3058i(b)) is amended--
(1) in paragraph (2), by striking the semicolon and
inserting the following: ``, including education and outreach
to professionals including postal carriers, employees of
financial institutions, firefighters, meter readers, and other
community professionals who are in a position to observe an
older individual on a daily or regular basis;'';
(2) in paragraph (4), by inserting before the semicolon the
following: ``and submit data on the prevalence of elder abuse,
neglect, and exploitation for the appropriate database of the
Administration or another database specified by the Assistant
Secretary'';
(3) by redesignating paragraphs (8) through (12) as
paragraphs (9) through (13), respectively;
(4) by inserting after paragraph (7) the following:
``(8) conducting appropriate training to ensure cultural
sensitivity in the provision of elder rights services,
including training in cultural issues associated with abuse;'';
(5) in subparagraph (C) of paragraph (10), as redesignated
by paragraph (3) of this section--
(A) in clause (ii), by inserting ``, such as
forensic accountants,'' after ``such personnel''; and
(B) in clause (v), by striking the comma at the end
and inserting ``, including programs and arrangements
that will safeguard victims' or potential victims'
finances, such as daily money management programs and
conservatorships,'';
(6) in paragraph (12), as redesignated by paragraph (3) of
this section--
(A) in subparagraph (D), by striking ``and'' at the
end; and
(B) by adding at the end the following:
``(F) supporting and studying innovative practices
in local communities, to develop partnerships across
disciplines for the prevention, investigation, and
prosecution of exploitation;'';
(7) in paragraph (13), as redesignated by paragraph (3) of
this section--
(A) in subparagraph (B), by striking ``or'' at the
end;
(B) in subparagraph (C), by striking the period at
the end and inserting ``; or''; and
(C) by adding at the end the following:
``(D) older individuals who are Holocaust
survivors; and''; and
(8) by adding at the end the following:
``(14) developing a State Home Care Consumer Bill of Rights
and Plan for Enforcement (as described in section 705) to
protect home care consumers (as defined in section 736) from
abuse, neglect, and exploitation.''.
SEC. 709. STATE LEGAL ASSISTANCE DEVELOPMENT.
Section 731 of the Older Americans Act of 1965 (42 U.S.C. 3058j) is
amended by striking ``A State agency'' and all that follows through
``to ensure--'' and inserting the following:
``(a) State Legal Services Developer.--A State agency shall provide
the services of an individual who shall be known as a State legal
services developer, who shall promote, and may facilitate, the
development and operation of an integrated legal assistance delivery
system for the State. To the maximum extent practicable, the individual
selected to serve as the developer shall--
``(1) agree to serve as the developer on a full-time basis;
``(2) have a law degree from an accredited law school or
have been admitted to practice law in any jurisdiction in the
United States; and
``(3) possess other knowledge, skills, training, and
education that reflect a comprehensive understanding of legal
services for older individuals.
``(b) Other Personnel.--In addition to the State legal services
developer, the State agency shall provide the services of other
personnel, sufficient to ensure--''.
SEC. 710. STATE HOME CARE OMBUDSMAN PROGRAMS.
Subtitle A of title VII of the Older Americans Act of 1965 (42
U.S.C. 3058 et seq.) is amended by adding at the end the following:
``CHAPTER 5--STATE HOME CARE OMBUDSMAN PROGRAMS
``SEC. 736. DEFINITIONS.
``In this chapter:
``(1) Home care consumer.--The term `home care consumer'
means a person who receives services in the person's home or
community, which may include home care services provided
through this Act, the Medicare program under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.), the Medicaid
program under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.), or another public or private funding source.
``(2) Home care ombudsman program.--The term `home care
ombudsman program' means a State Home Care Ombudsman Program
described in section 737(a)(1).
``(3) Home care services.--The term `home care services'
means home and community-based services, including personal
care services designed to assist an individual in the
activities of daily living such as bathing, exercising,
personal grooming, and getting in and out of bed.
``SEC. 737. PROGRAM.
``(a) Establishment.--
``(1) In general.--In order to be eligible to receive a
grant under section 703(d) from funds appropriated under
section 702A and made available to carry out this chapter, a
State agency shall, in accordance with this section, agree to
carry out a State Home Care Ombudsman Program within the Office
of the State Long-Term Care Ombudsman.
``(2) Home care ombudsman program.--The home care ombudsman
program shall be carried out by the State Long-Term Care
Ombudsman. The Ombudsman and other entities carrying out the
home care ombudsman program shall have authorities,
requirements, and functions with respect to that program, and
home care services provided and home care consumers served
under that program, that are equivalent (as determined by the
Secretary) to the authorities, requirements, and functions the
Ombudsman and other entities have in carrying out the State
Long-Term Care Ombudsman Program under chapter 2, and long-term
care provided and long-term care consumers served under that
program.
``(b) Maintenance of Effort.--A State, in using the funds made
available for a fiscal year through a grant received under section
703(d), shall maintain the expenditures of the State for home care
ombudsman services at a level that is not less than the level of such
expenditures maintained by the State for the preceding fiscal year.
``(c) Evaluation.--The Assistant Secretary shall--
``(1) in conjunction with the Director of the Office of
Long-Term Care Ombudsman Programs and the heads of other
entities determined to be necessary by the Assistant Secretary,
collect from the States and analyze data from the home care
ombudsman programs relating to complaints and conditions
concerning home care services and home care consumers and
within 1 year after receipt of the data, submit a report to
Congress outlining best practices for carrying out a home care
ombudsman program; and
``(2) make the report available to States.''.
TITLE VIII--GERIATRICS AND GERONTOLOGY
SEC. 801. PRIMARY HEALTH SERVICES.
Section 331(a)(3)(D) of the Public Health Service Act (42 U.S.C.
254d(a)(3)(D)) is amended by inserting ``geriatrics, gerontology,''
after ``pediatrics,''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Committee on Health, Education, Labor, and Pensions Senate Subcommittee on Primary Health and Retirement Security. Hearings held. With printed Hearing: S.Hrg. 113-791.
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