Older Americans Act Reauthorization Act of 2014 - (Sec. 3) Amends the Older Americans Act of 1965 (OAA), with respect to the Administration on Aging to require the Director of the Office of Long-Term Care Ombudsman Programs to collect and analyze best practices related to responding to elder abuse, neglect, and exploitation in long-term care facilities, and publish a report of such best practices.
Makes it a duty and function of the Administration to: (1) provide information and technical assistance to states, area agencies on aging, and service providers, in collaboration with relevant federal agencies, on providing efficient person-centered transportation services, including across geographic boundaries; (2) identify model programs and provide information and technical assistance to the same entities to support modernization of multipurpose senior centers; and (3) provide technical assistance to and share best practices with states, area agencies on again, and Aging and Disability Resource Centers (ADRCs, on how to collaborate and coordinate services with health care entities in order to improve care coordination for individuals with multiple chronic illnesses.
Directs the Assistant Secretary of Aging to: (1) develop, when feasible, a consumer-friendly tool to assist older individuals and their families in choosing home and community-based services, with a particular focus on ways for consumers to assess how providers protect the health, safety, welfare, and rights of older individuals; and (2) ensure that programs authorized under OAA include training in the prevention of abuse, neglect, and exploitation and provision of services that address elder justice and exploitation of older individuals.
Requires ADRCs to provide information and referrals regarding available home and community-based services for individuals who are at risk for residing in, or who reside in, institutional settings, so that the individuals have the choice to remain in or to return to the community.
Extends through FY2018 the authorization of appropriations for the Administration, including the Eldercare Locator Service and pension counseling and information programs.
(Sec. 4) Reauthorizes appropriations for FY2014-FY2018 for: (1) specified supportive services, (2) congregate nutrition services, (3) home delivered nutrition services, (4) disease prevention and heath promotion services, (5) family caregiver support, and (6) the Nutrition Services Incentive Program.
Requires an area agency on aging plan to: (1) support modernization of multipurpose senior centers (including a plan to use the skills and services of older individuals in paid and unpaid work, including multigenerational and older individual to older individual work); and (2) arrange to increase public awareness of elder abuse, neglect, and exploitation, and remove barriers to education, prevention, investigation, and treatment of elder abuse, neglect, and exploitation.
Directs the Assistant Secretary to make grants to states for supportive services that include chronic condition self-care management and falls prevention services. Requires health screening services to include: (1) mental and behavioral health screening and falls prevention screening; as well as (2) screening for elder abuse, neglect, and exploitation.
Requires state nutritional projects to: (1) encourage the use of locally grown foods in meal preparations, and (2) contract with local producers and providers of locally grown foods.
Specifies that grants to states to provide, at multipurpose senior centers, at congregate meal sites, through home delivered meals programs, or at other appropriate sites disease prevention and health promotion services and information (as under current law) must be evidence-based.
Modifies the National Family Caregiver Support Program, making permanent the funding for the caregiver allotment. Redesignates grandparents and older individuals who are relative caregivers "older relative caregivers."
(Sec. 5) Authorizes the Assistant Secretary to make grants for continuing support for program integrity initiatives concerning the Medicare program that train senior volunteers to prevent and identify health care fraud and abuse.
Extends through FY2018 training, research, and discretionary projects and programs grant programs relating to older Americans.
Requires that specified grants and contracts provide for national trainings for directors of grant programs on aging instead of (as currently) an annual national meeting to train such directors.
Repeals the restriction of certain grants to national nonprofit organizations experienced in providing nationwide support and technical assistance to entities interested in the legal rights of older individuals. Allows such grants to go to any nonprofit organization so experienced.
Repeals certain grants for multidisciplinary centers and multidisciplinary systems, computer training, and ombudsman and advocacy demonstration project.
(Sec. 6) Extends through FY2018 the authorization of appropriations for community service senior opportunities programs.
(Sec. 7) Extends through FY2018 the authorization of appropriations for grants for the delivery of supportive services, including nutrition services to older American Indians, Alaskan Natives, and Native Hawaiians.
(Sec. 8) Revises requirements for ombudsman programs and vulnerable elder rights protection activities, among other changes: (1) extending a State Long-Term Care Ombudsman's responsiblity to any resident of a long-term care facility regardless of age; (2) making the State Long-Term Care Ombudsman responsible for the management, including fiscal management, of his or her Office; and (3) requiring the Ombudsman, when feasible, to continue to carry out certain functions on behalf of residents transitioning from a long-term care facility to a home care setting.
Requires the State Ombudsman and any designated local Ombudsman entity to identify, investigate, and resolve complaints of any residents of a long-term care facility, including residents with limited or no decisionmaking capacity and who have no known legal representative.
Requires a state to ensure that the access of Office representatives to long-term care facilities and residents be private and unimpeded.
Considers the Ombudsman and an Office representative to be a "health oversight agency" for purposes of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) so that release of residents' individually identifiable health information to the Ombudsman or representative is not precluded in cases in which specified requirements are otherwise met.
Revises conflict of interest requirements in the designation of an Ombudsman and any situation in which the Office is placed in a state organization.
Requires a state agency on aging to: (1) promote the submission of data on elder abuse, neglect, and exploitation for appropriate Administration or other designated databases; and (2) support and study innovative practices in communities to develop elder justice partnerships across disciplines for the prevention, investigation, and prosecution of abuse, neglect, and exploitation.
(Sec. 9) Includes behavioral health in programs for mental health.
(Sec. 10) Directs the Comptroller General (GAO) to study transportation services for older individuals.
(Sec. 11) Directs the Assistant Secretary for Aging to issue guidance to states on serving Holocaust survivors.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 1562 Introduced in Senate (IS)]
113th CONGRESS
1st Session
S. 1562
To reauthorize the Older Americans Act of 1965, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 30, 2013
Mr. Sanders (for himself, Mr. Alexander, and Mr. Harkin) introduced the
following bill; which was read twice and referred to the Committee on
Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To reauthorize 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.
This Act may be cited as the ``Older Americans Act Reauthorization
Act of 2013''.
SEC. 2. DEFINITIONS.
Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is
amended--
(1) by striking paragraph (1) and inserting the following:
``(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 striking paragraph (4) and inserting the following:
``(4) The term `Aging and Disability Resource Center' means
an entity, network, or consortium established by a State as
part of the State system of long-term care, to provide a
coordinated and integrated system for older individuals and
individuals with disabilities (as defined in section 3 of the
Americans with Disabilities Act of 1990 (42 U.S.C. 12102)), and
the caregivers of older individuals and individuals with
disabilities, that provides--
``(A) comprehensive information on the full range
of available public and private long-term care
programs, options, service providers, and resources
within a community, including information on the
availability of integrated long-term care services, and
Federal or State programs that provide long-term care
services and supports through home and community-based
service programs;
``(B) person-centered counseling to assist
individuals in assessing their existing or anticipated
long-term care needs and goals, and developing and
implementing a person-centered plan for long-term care
that is consistent with the desires of such an
individual and designed to meet the individual's
specific needs, goals, and circumstances;
``(C) access for individuals to the full range of
publicly supported long-term care services and supports
for which the individuals may be eligible, including
home and community-based service options, by serving as
a convenient point of entry for such programs and
supports; and
``(D) in cooperation with area agencies on aging,
centers for independent living described in part C of
title VII of the Rehabilitation Act of 1973 (29 U.S.C.
796f et seq.), and other community-based entities,
information and referrals regarding available home and
community-based services for individuals who are at
risk for residing in, or who reside in, institutional
settings, so that the individuals have the choice to
remain in or to return to the community.'';
(3) in paragraph (14)(B), by inserting ``oral health,''
after ``bone density,'';
(4) by striking paragraph (17) and inserting the following:
``(17) 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.'';
(5) in paragraph (18)(A), by striking ``term `exploitation'
means'' and inserting ``terms `exploitation' and `financial
exploitation' mean''; and
(6) by adding at the end the following:
``(55) 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 casework and services; and
``(D) providing, arranging for, or facilitating the
provision of medical, social service, economic, legal,
housing, law enforcement, or other protective,
emergency, or support services.''.
SEC. 3. ADMINISTRATION ON AGING.
(a) Best Practices.--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'' at the
end;
(B) in subparagraph (L)--
(i) by striking ``Older Americans Act
Amendments of 1992'' and inserting ``Older
Americans Act Reauthorization Act 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
responding to elder abuse, neglect, and exploitation in long-
term care facilities, and publish a report of such best
practices.''; and
(2) in subsection (e)(2), in the matter preceding
subparagraph (A), by inserting ``, and in coordination with the
heads of State adult protective services programs and the
Director of the Office of Long-Term Care Ombudsman Programs''
after ``and services''.
(b) Training.--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 ``health and
economic'' before ``needs of older individuals'';
(B) in paragraph (7), by inserting ``health and
economic'' before ``welfare'';
(C) in paragraph (14), by inserting ``(including
the Health Resources and Services Administration)''
after ``other agencies'';
(D) in paragraph (27), by striking ``and'' at the
end;
(E) in paragraph (28), by striking the period and
inserting a semicolon; and
(F) by adding at the end the following:
``(29) provide information and technical assistance to
States, area agencies on aging, and service providers, in
collaboration with relevant Federal agencies, on providing
efficient, person-centered transportation services, including
across geographic boundaries;
``(30) identify model programs and provide information and
technical assistance to States, area agencies on aging, and
service providers (including providers operating multipurpose
senior centers), to support the modernization of multipurpose
senior centers; and
``(31) provide technical assistance to and share best
practices with States, area agencies on aging, and Aging and
Disability Resource Centers, on how to collaborate and
coordinate services with health care entities, such as
Federally-qualified health centers, as defined in section
1905(l)(2)(B) of the Social Security Act (42 U.S.C.
1396d(l)(2)(B)), in order to improve care coordination for
individuals with multiple chronic illnesses.'';
(2) in subsection (b)--
(A) in paragraph (5)--
(i) in subparagraph (B), by striking
``and'' after the semicolon;
(ii) in subparagraph (C), by inserting
``and'' after the semicolon; and
(iii) by adding at the end the following:
``(D) when feasible, developing, in consultation
with States and national organizations, a consumer-
friendly tool to assist older individuals and their
families in choosing home and community-based services,
with a particular focus on ways for consumers to assess
how providers protect the health, safety, welfare, and
rights, including the rights provided under section
314, of older individuals;''; and
(B) in paragraph (8)--
(i) in subparagraph (B), by inserting ``to
identify and articulate goals of care and''
after ``individuals'';
(ii) in subparagraph (D)--
(I) by inserting ``respond to or''
before ``plan''; and
(II) by striking ``future long-term
care needs; and'' and inserting ``long-
term care needs;'';
(iii) in subparagraph (E), by adding
``and'' at the end; and
(iv) by adding at the end the following:
``(F) to provide information and referrals
regarding available home and community-based services
for individuals who are at risk for residing in, or who
reside in, institutional settings, so that the
individuals have the choice to remain in or to return
to the community.''; and
(3) by adding at the end the following:
``(g) The Assistant Secretary shall, as appropriate, ensure that
programs authorized 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.''.
(c) 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 ``202(a)(24)'' and inserting
``202(a)(21)''; and
(B) by striking ``2007, 2008, 2009, 2010, and
2011'' and inserting ``2014, 2015, 2016, 2017, and
2018''; and
(3) in subsection (c), by striking ``2007, 2008, 2009,
2010, and 2011'' and inserting ``2014, 2015, 2016, 2017, and
2018''.
SEC. 4. STATE AND COMMUNITY PROGRAMS ON AGING.
(a) Authorization of Appropriations.--Section 303 of the Older
Americans Act of 1965 (42 U.S.C. 3023) is amended--
(1) in subsection (a)(1), by striking ``fiscal years 2007''
and all that follows and inserting ``each of fiscal years 2014
through 2018.'';
(2) in subsection (b)--
(A) in paragraph (1), by striking ``fiscal years
2007'' and all that follows and inserting ``each of
fiscal years 2014 through 2018.''; and
(B) in paragraph (2), by striking ``fiscal years
2007'' and all that follows and inserting ``each of
fiscal years 2014 through 2018.'';
(3) in subsection (d), by striking ``fiscal years 2007''
and all that follows and inserting ``each of fiscal years 2014
through 2018.''; and
(4) in subsection (e)(2), by striking ``2011'' and
inserting ``2011 and each of fiscal years 2014 through 2018''.
(b) Conforming Amendment.--Section 304(b) of the Older Americans
Act of 1965 (42 U.S.C. 3024(b)) is amended by striking ``subpart 1
of''.
(c) Planning and Service Areas.--Section 305(b)(5)(C)(i)(III) of
the Older Americans Act of 1965 (42 U.S.C. 3025(b)(5)(C)(i)(III)) is
amended by striking ``planning and services areas'' and inserting
``planning and service areas''.
(d) 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), by striking ``establishment,
maintenance, or construction of multipurpose senior
centers,'' and inserting ``establishment, maintenance,
modernization, or construction of multipurpose senior
centers (including a plan to use the skills and
services of older individuals in paid and unpaid work,
including multigenerational and older individual to
older individual work),''; and
(B) in paragraph (6)--
(i) in subparagraph (G), by adding ``and''
at the end; and
(ii) 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 education, prevention, investigation, and treatment
of elder abuse neglect, and exploitation education, as
appropriate;''; and
(2) in subsection (b)(3)--
(A) in subparagraph (J), by striking ``and'' at the
end;
(B) by redesignating subparagraph (K) as
subparagraph (L); and
(C) by inserting after subparagraph (J) the
following:
``(K) protection from elder abuse, neglect, and
exploitation; and''.
(e) Nutrition Services Incentive Program.--Section 311(e) of the
Older Americans Act of 1965 (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.''.
(f) Supportive Services.--Section 321 of the Older Americans Act of
1965 (42 U.S.C. 3030d) is amended--
(1) in subsection (a)--
(A) in paragraph (1), by striking ``or referral
services'' and inserting ``referral, chronic condition
self-care management, or falls prevention services'';
(B) in paragraph (8), by striking ``(including''
and all that follows and inserting the following:
``(including mental and behavioral health screening and
falls prevention services screening) to detect or
prevent (or both) illnesses and injuries that occur
most frequently in older individuals;'' and
(C) in paragraph (15), by inserting before the
semicolon the following: ``, and screening for elder
abuse, neglect, and exploitation'';
(2) in subsection (b)(1), by inserting ``or modernization''
after ``construction''; and
(3) in subsection (c), by inserting before the period the
following: ``, and pursue opportunities for the development of
intergenerational shared site models for programs or projects,
consistent with the purposes of this Act''.
(g) Home Delivered Nutrition Services Program.--Section 336(a)(1)
of the Older Americans Act of 1965 (42 U.S.C. 3030f(a)(1)) is amended
by striking ``canned'' and all that follows through ``meals'' and
inserting ``canned, or fresh foods and, as appropriate, supplemental
foods, and any additional meals''.
(h) Nutrition Services.--Section 339 of the Older Americans Act of
1965 (42 U.S.C. 3030g-21) is amended--
(1) in paragraph (1), by striking ``solicit'' and inserting
``utilize''; and
(2) in paragraph (2)--
(A) in subparagraph (J), by striking ``and'' at the
end;
(B) in subparagraph (K), by striking the period and
inserting ``; and''; and
(C) 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.''.
(i) Evidence-Based Disease Prevention and Health Promotion Services
Program.--Part D of title III of the Older Americans Act of 1965 (42
U.S.C. 3030m et seq.) is amended--
(1) in the part heading, by inserting ``Evidence-Based''
before ``Disease''; and
(2) in section 361(a), by inserting ``evidence-based''
after ``to provide''.
(j) Older Relative Caregivers.--
(1) Technical amendment.--Part E of title III of the Older
Americans Act of 1965 (42 U.S.C. 3030s et seq.) is amended by
striking the subpart heading for subpart 1.
(2) Definitions.--Section 372 of such Act (42 U.S.C. 3030s)
is amended--
(A) in subsection (a)--
(i) in paragraph (1), by striking ``or who
is an individual with a disability''; and
(ii) by striking paragraph (2) and
inserting the following:
``(2) Individual with a disability.--The term `individual
with a disability' means an individual with a disability, as
defined in section 3 of the Americans with Disabilities Act of
1990 (42 U.S.C. 12102), who is not less than 18 and not more
than 59 years of age.
``(3) Older relative caregiver.--The term `older relative
caregiver' means a caregiver who--
``(A)(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, a child or an individual with a
disability;
``(B) in the case of a caregiver for a child--
``(i) is the grandparent, stepgrandparent,
or other relative (other than the parent) by
blood, marriage, or adoption, of the child;
``(ii) is the primary caregiver of the
child because the biological or adoptive
parents are unable or unwilling to serve as the
primary caregivers of the child; and
``(iii) has a legal relationship to the
child, such as legal custody, adoption, or
guardianship, or is raising the child
informally; and
``(C) in the case of a caregiver for an individual
with a disability, is the parent, grandparent, or other
relative by blood, marriage, or adoption, of the
individual with a disability.''; and
(B) in subsection (b)--
(i) by striking ``subpart'' and all that
follows through ``family caregivers'' and
inserting ``part, for family caregivers'';
(ii) by striking ``; and'' and inserting a
period; and
(iii) by striking paragraph (2).
(k) National Family Caregiver Support 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) in subsection (c)--
(A) in paragraph (1), in the matter preceding
subparagraph (A), by striking ``grandparents and older
individuals who are relative caregivers, and who'' and
inserting ``older relative caregivers, who''; and
(B) in paragraph (2)(B), by striking ``to older
individuals providing care to individuals with severe
disabilities, including children with severe
disabilities'' and inserting ``to older relative
caregivers of children with severe disabilities, or
individuals with disabilities who have severe
disabilities'';
(3) in subsection (e)(3), by striking ``grandparents or
older individuals who are relative caregivers'' and inserting
``older relative caregivers'';
(4) in subsection (f)(1)(A), by striking ``for fiscal years
2007, 2008, 2009, 2010, and 2011'' and inserting ``for a fiscal
year''; and
(5) in subsection (g)(2)(C), by striking ``grandparents and
older individuals who are relative caregivers of a child who is
not more than 18 years of age'' and inserting ``older relative
caregivers''.
(l) Conforming Amendment.--Part E of title III is amended by
striking ``this subpart'' each place it appears and inserting ``this
part''.
SEC. 5. ACTIVITIES FOR HEALTH, INDEPENDENCE, AND LONGEVITY.
(a) 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'' at the
end;
(B) by redesignating paragraph (13) as paragraph
(14); and
(C) by inserting after paragraph (12) the
following:
``(13) continuing support for program integrity initiatives
concerning the Medicare program under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.) that train senior
volunteers to prevent and identify health care fraud and abuse;
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''.
(b) Native American Programs.--Section 418(b) of the Older
Americans Act of 1965 (42 U.S.C. 3032g(b)) is amended by striking ``a
national meeting to train'' and inserting ``national trainings for''.
(c) Legal Assistance for Older Americans.--Section 420(c) of the
Older Americans Act of 1965 (42 U.S.C. 3032i(c)) is amended by striking
``national''.
(d) Repeals.--Sections 415, 419, and 421 of the Older Americans Act
of 1965 (42 U.S.C. 3032d, 3032h, 3032j) is repealed.
(e) Conforming Amendment.--Section 417(a)(1) of the Older Americans
Act of 1965 (42 U.S.C. 3032f(a)(1)) is amended by striking
``grandparents and other older individuals who are relative
caregivers'' and inserting ``older relative caregivers (as defined in
section 372)''.
SEC. 6. COMMUNITY SERVICE SENIOR OPPORTUNITIES.
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. 7. GRANTS FOR NATIVE AMERICANS.
Section 643(2) of the Older Americans Act of 1965 (42 U.S.C.
3057n(2)) is amended by striking ``fiscal year 2011'' and inserting
``each of fiscal years 2014 through 2018''.
SEC. 8. VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES.
(a) Ombudsman Definitions.--Section 711(6) of the Older Americans
Act of 1965 (42 U.S.C. 3058f(6)) is amended by striking ``older''.
(b) Ombudsman Programs.--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 decision-making 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 communicated (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 that
outcome; and'';
(ii) in subparagraph (D), by striking
``regular and timely'' and inserting ``regular,
timely, private, and unimpeded'';
(iii) in subparagraph (H)(iii)--
(I) by inserting ``, actively
encourage, and assist in'' after
``provide technical support for''; and
(II) by striking ``and'' after the
semicolon;
(iv) by redesignating subparagraph (I) as
subparagraph (J); and
(v) by inserting after subparagraph (H) the
following:
``(I) when feasible, continue to carry out the
functions described in this section on behalf of
residents transitioning from a long-term care facility
to a home care setting; and''; and
(C) in paragraph (5)(B)--
(i) in clause (vi)--
(I) by inserting ``, actively
encourage, and assist in'' after
``support''; and
(II) by striking ``and'' after the
semicolon;
(ii) by redesignating clause (vii) as
clause (viii); and
(iii) by inserting after clause (vi) the
following:
``(vii) identify, investigate, and resolve
complaints described in clause (iii) that are
made by or on behalf of residents with limited
or no decision-making 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 communicated (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 that
outcome; and'';
(2) in subsection (b)--
(A) in paragraph (1)--
(i) in subparagraph (A), by striking
``access'' and inserting ``private and
unimpeded access''; and
(ii) in subparagraph (B)--
(I) in clause (i)--
(aa) in the matter
preceding subclause (I), by
striking ``the medical and
social records of a'' and
inserting ``all files, records,
and other information
concerning a''; and
(bb) in subclause (II), by
striking ``to consent'' and
inserting ``to communicate
consent''; and
(II) in clause (ii), in the matter
before subclause (I), by striking ``the
records'' and inserting ``the files,
records, and information''; 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 (d)--
(A) in paragraph (1), by striking ``files'' and
inserting ``files, records, and other information'';
and
(B) in paragraph (2)--
(i) in subparagraph (A)--
(I) by striking ``files and
records'' each place such term appears
and inserting ``files, records, and
other information''; and
(II) by striking ``and'' after the
semicolon;
(ii) in subparagraph (B)--
(I) by striking ``files or
records'' and inserting ``files,
records, or other information''; and
(II) in clause (iii), by striking
the period at the end and inserting ``;
and''; and
(iii) by adding at the end the following:
``(C) notwithstanding subparagraph (B), ensure that
the Ombudsman may disclose information as needed in
order to best serve residents with limited or no
decision-making capacity who have no known legal
representative and are unable to communicate consent,
in order for the Ombudsman to carry out the functions
and duties described in paragraphs (3)(A)(i) and
(5)(B)(vi) of subsection (a).'';
(4) by striking subsection (f) and inserting the following:
``(f) Conflict of Interest.--
``(1) Individual conflict of interest.--The State agency
shall--
``(A) ensure that no individual, or member of the
immediate family of an individual, involved in the
designation of the Ombudsman (whether by appointment or
otherwise) or the designation of an entity designated
under subsection (a)(5), is subject to a conflict of
interest;
``(B) ensure that no officer or employee of the
Office, representative of a local Ombudsman entity, or
member of the immediate family of the officer,
employee, or representative, is subject to a conflict
of interest; and
``(C) ensure that the Ombudsman--
``(i) does not have a direct involvement in
the licensing or certification of a long-term
care facility or of a provider of a long-term
care service;
``(ii) does not have an ownership or
investment interest (represented by equity,
debt, or other financial relationship) in a
long-term care facility or a long-term care
service;
``(iii) is not employed by, or
participating in the management of, a long-term
care facility or a related organization, and
has not been employed by such a facility or
organization within 1 year before the date of
the determination involved;
``(iv) does not receive, or have the right
to receive, directly or indirectly,
remuneration (in cash or in kind) under a
compensation arrangement with an owner or
operator of a long-term care facility;
``(v) does not have management
responsibility for, or operate under the
supervision of an individual with management
responsibility for, adult protective services;
and
``(vi) 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).
``(2) Organizational conflict of interest.--
``(A) In general.--The State agency shall comply
with subparagraph (B)(i) in a case in which the Office
poses an organizational conflict of interest, including
a situation in which the Office is placed in an
organization that--
``(i) is responsible for licensing,
certifying or surveying 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 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
or discharge of individuals to or from such
facilities.
``(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 (within the
meaning of subparagraph (A)) unless such
conflict of interest 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 assistant secretary.--In a
case in which a potential or actual
organizational conflict of interest (within the
meaning of subparagraph (A)) 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, in accordance with the policies
and procedures established by the State agency
under section 705(a)(5)(D)(iii)--
``(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 subsection
(a)(3).''; and
(5) in subsection (h)--
(A) in paragraph (3)(A)(i), by striking ``older'';
(B) in paragraph (4), by striking all that precedes
``procedures'' and inserting the following:
``(4) strengthen and update'';
(C) by redesignating paragraphs (4) through (9) as
paragraphs (5) through (10), respectively;
(D) by inserting after paragraph (3) the following:
``(4) ensure that the Ombudsman or a designee participates
in training provided by the National Ombudsman Resource Center
established in section 202(a)(18);'';
(E) in paragraph (6)(A), as redesignated by
subparagraph (B) of this paragraph, by striking
``paragraph (4)'' and inserting ``paragraph (5)'';
(F) 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
(G) in paragraph (10), as redesignated by
subparagraph (B) of this paragraph, by striking ``(6),
or (7)'' and inserting ``(7), or (8)''.
(c) Ombudsman Regulations.--Section 713 of the Older Americans Act
of 1965 (42 U.S.C. 3058h) is amended--
(1) in paragraph (1), by striking ``paragraphs (1) and (2)
of section 712(f)'' and inserting ``subparagraphs (A) and (B)
of section 712(f)(1)''; and
(2) in paragraph (2), by striking ``subparagraphs (A)
through (D) of section 712(f)(3)'' and inserting ``clauses (i)
through (vi) of section 712(f)(1)(C)''.
(d) Prevention of Elder Abuse, Neglect, and Exploitation.--Section
721 of the Older Americans Act of 1965 (42 U.S.C. 3058i) is amended--
(1) in subsection (b)--
(A) by redesignating paragraphs (5) through (12) as
paragraphs (6) through (13), respectively;
(B) by inserting after paragraph (4) the following:
``(5) promoting the submission of data on elder abuse,
neglect, and exploitation for the appropriate database of the
Administration or another database specified by the Assistant
Secretary;'';
(C) in paragraph (10)(C), as redesignated by
paragraph (1) of this subsection--
(i) in clause (ii), by inserting ``, such
as forensic specialists,'' after ``such
personnel''; and
(ii) in clause (v), by inserting before the
comma the following: ``, including programs and
arrangements that protect against financial
exploitation''; and
(D) in paragraph (12), as redesignated by paragraph
(1) of this subsection--
(i) in subparagraph (D), by striking
``and'' at the end; and
(ii) by adding at the end the following:
``(F) supporting and studying innovative practices
in communities to develop partnerships across
disciplines for the prevention, investigation, and
prosecution of abuse, neglect, and exploitation; and'';
and
(2) in subsection (e)(2), in the matter preceding
subparagraph (A)--
(A) by striking ``subsection (b)(9)(B)(i)'' and
inserting ``subsection (b)(10)(B)(i)''; and
(B) by striking ``subsection (b)(9)(B)(ii)'' and
inserting ``subsection (b)(10)(B)(ii)''.
SEC. 9. BEHAVIORAL HEALTH.
The Older Americans Act of 1965 is amended--
(1) in section 102 (42 U.S.C. 3002)--
(A) in paragraph (14)(G), by inserting ``and
behavioral'' after ``mental'';
(B) in paragraph (36), by inserting ``and
behavioral'' after ``mental''; and
(C) in paragraph (47)(B), by inserting ``and
behavioral'' after ``mental'';
(2) in section 201(f)(1) (42 U.S.C. 3011(f)(1)), by
inserting ``and behavioral'' after ``mental'';
(3) in section 202(a)(5) (42 U.S.C. 3012(a)(5)), by
inserting ``and behavioral'' after ``mental'';
(4) in section 306(a) (42 U.S.C. 3026(a))--
(A) in paragraph (2)(A), by inserting ``and
behavioral'' after ``mental''; and
(B) in paragraph (6)(F), by striking ``mental
health services'' each place such term appears and
inserting ``mental and behavioral health services'';
and
(5) in section 321(a) (42 U.S.C. 3030d)--
(A) in paragraph (1), as amended by section 4(f),
by inserting ``and behavioral'' after ``mental'';
(B) in paragraph (8), as amended by section 4(f),
by inserting ``and behavioral'' after ``mental'';
(C) in paragraph (14)(B), by inserting ``and
behavioral'' after ``mental''; and
(D) in paragraph (23), by inserting ``and
behavioral'' after ``mental''.
SEC. 10. STUDY ON TRANSPORTATION SERVICES.
(a) Study.--
(1) In general.--Because access to transportation services
is critical for millions of older individuals in the United
States, to allow them to maintain independence, health, and
quality of life, the Comptroller General of the United States
shall conduct a study of transportation services for older
individuals.
(2) Contents.--In conducting the study, the Comptroller
General--
(A) shall identify challenges and barriers
affecting the aging network in providing, accessing, or
coordinating efficient and effective transportation
services, including challenges and barriers in
coordinating services with Federal agencies and
programs such as the Department of Transportation and
Medicaid program under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.); and
(B) shall examine any Federal program requirements
that may result in challenges or barriers to the
coordination of transportation services within the
aging network at the local level.
(b) Report.--Not later than 18 months after the date of enactment
of this Act, the Comptroller General shall issue a report. The report
shall contain a detailed description of the findings and conclusions of
the study, including any recommendations for administrative and other
changes to enhance transportation services provided by the aging
network. The Comptroller General shall submit the report to the
Committee on Education and the Workforce of the House of
Representatives and the Committee on Health, Education, Labor, and
Pensions of the Senate.
SEC. 11. GUIDANCE ON SERVING HOLOCAUST SURVIVORS.
(a) In General.--Because the services under the Older Americans Act
of 1965 (42 U.S.C. 3001 et seq.) are critical to meeting the urgent
needs of Holocaust survivors to age in place with dignity, comfort,
security, and quality of life, the Assistant Secretary for Aging shall
issue guidance to States, that shall be applicable to States, area
agencies on aging, and providers of services for older individuals,
with respect to serving Holocaust survivors, including guidance on
promising practices for conducting outreach to that population. In
developing the guidance, the Assistant Secretary for Aging shall
consult with experts and organizations serving Holocaust survivors, and
shall take into account the possibility that the needs of Holocaust
survivors may differ based on geography.
(b) Contents.--The guidance shall include the following:
(1) How nutrition service providers may meet the special
health-related or other dietary needs of participants in
programs under the Older Americans Act of 1965, including needs
based on religious, cultural, or ethnic requirements.
(2) How transportation service providers may address the
urgent transportation needs of Holocaust survivors.
(3) How State long-term care ombudsmen may address the
unique needs of residents of long-term care facilities for whom
institutional settings may produce sights, sounds, smells,
emotions, and routines, that can induce panic, anxiety, and
retraumatization as a result of experiences from the Holocaust.
(4) How supportive services providers may consider the
unique needs of Holocaust survivors.
(5) How other services provided under that Act, as
determined by the Assistant Secretary for Aging, may serve
Holocaust survivors.
(c) Date of Issuance.--The guidance described in subsection (a)
shall be issued not later than 180 days after the date of enactment of
this Act.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Committee on Health, Education, Labor, and Pensions. Ordered to be reported with an amendment in the nature of a substitute favorably.
Committee on Health, Education, Labor, and Pensions. Reported by Senator Harkin with an amendment in the nature of a substitute. Without written report.
Committee on Health, Education, Labor, and Pensions. Reported by Senator Harkin with an amendment in the nature of a substitute. Without written report.
Placed on Senate Legislative Calendar under General Orders. Calendar No. 290.
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