[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3057 Introduced in Senate (IS)]
<DOC>
116th CONGRESS
1st Session
S. 3057
To modernize the Older Americans Act of 1965, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 16, 2019
Ms. Collins (for herself and Mr. Casey) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To modernize 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 ``Modernization of the Older Americans
Act Amendments''.
SEC. 2. TABLE OF CONTENTS.
The table of contents of this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. References.
Sec. 4. Definitions.
TITLE I--MODERNIZING DEFINITIONS AND PROGRAMS UNDER THE ADMINISTRATION
ON AGING
Sec. 101. Reauthorization.
Sec. 102. Person-centered, trauma-informed services.
Sec. 103. Aging and Disability Resource Centers.
Sec. 104. Assistive technology.
Sec. 105. Vaccination.
Sec. 106. Malnutrition.
Sec. 107. Sexually transmitted diseases.
Sec. 108. Addressing chronic pain management.
Sec. 109. Screening for suicide risk.
Sec. 110. Addressing public health emergencies and emerging health
threats.
Sec. 111. Clarification regarding board and care facilities.
Sec. 112. Person-centered, trauma-informed services.
Sec. 113. Modernizing the review of applications and providing
technical assistance for disasters.
Sec. 114. Notification of availability of or updates to policies,
practices, and procedures through a uniform
e-format.
Sec. 115. Evidence-Based program adaptation.
Sec. 116. Business acumen provisions and clarification regarding
outside funding for area agencies on aging.
Sec. 117. National resource center for older individuals experiencing
the long-term and adverse consequences of
trauma.
Sec. 118. National Resource Center for Women and Retirement.
Sec. 119. Family caregivers.
Sec. 120. Coordination with Assistant Secretary for Mental Health and
Substance Use and Director of the Centers
for Disease Control and Prevention.
Sec. 121. Modernizing the Interagency Coordinating Committee on Healthy
Aging and Age-Friendly Communities.
Sec. 122. Professional standards for nutrition official under the
Assistant Secretary.
Sec. 123. Report on social isolation.
Sec. 124. Innovation, demonstration, and evaluation within aging
programs.
TITLE II--IMPROVING GRANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING
Sec. 201. Determinants of health.
Sec. 202. Younger onset Alzheimer's disease.
Sec. 203. Reauthorization.
Sec. 204. Hold harmless formula.
Sec. 205. Outreach efforts.
Sec. 206. Maintenance of effort for State Long-Term Care Ombudsman
program.
Sec. 207. Coordination with resource centers.
Sec. 208. Senior legal hotlines.
Sec. 209. Increase in limit on use of allotted funds for State
administrative costs.
Sec. 210. Improvements to nutrition programs.
Sec. 211. Review of reports.
Sec. 212. Other practices.
Sec. 213. Culturally appropriate, medically tailored meals.
Sec. 214. Nutrition services study.
Sec. 215. National Family Caregiver Support program.
Sec. 216. National Family Caregiver Support program cap.
TITLE III--MODERNIZING ACTIVITIES FOR HEALTH, INDEPENDENCE, AND
LONGEVITY
Sec. 301. Reauthorization.
Sec. 302. Falls prevention and chronic disease self-management
education.
Sec. 303. Technical assistance and innovation to improve transportation
for older individuals.
Sec. 304. Grant program for multigenerational collaboration.
TITLE IV--SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM
Sec. 401. Priority for the senior community service employment program.
Sec. 402. Authorization of appropriations.
TITLE V--ENHANCING GRANTS FOR NATIVE AMERICANS
Sec. 501. Reauthorization.
TITLE VI--MODERNIZING ALLOTMENTS FOR VULNERABLE ELDER RIGHTS PROTECTION
ACTIVITIES AND OTHER PROGRAMS
Sec. 601. Reauthorization; vulnerable elder rights protection
activities.
Sec. 602. Volunteer State long-term care ombudsman representatives.
Sec. 603. Prevention of elder abuse, neglect, and exploitation.
Sec. 604. Principles for person-directed services and supports during
serious illness.
Sec. 605. Extension of the Supporting Grandparents Raising
Grandchildren Act.
Sec. 606. Best practices for home and community-based ombudsmen.
Sec. 607. Senior home modification assistance initiative.
TITLE VII--MISCELLANEOUS
Sec. 701. Technical corrections.
SEC. 3. REFERENCES.
Except as otherwise expressly provided in this Act, wherever in
this Act an amendment or repeal is expressed in terms of an amendment
to, or a repeal of, a section or other provision, the reference shall
be considered to be made to that section or other provision of the
Older Americans Act of 1965 (42 U.S.C. 3001 et seq.).
SEC. 4. DEFINITIONS.
In this Act, the terms ``area agency on aging'', ``Assistant
Secretary'', ``greatest social need'', ``older individual'', and
``Secretary'' have the meanings given such terms in section 102 of the
Older Americans Act of 1965 (42 U.S.C. 3002).
TITLE I--MODERNIZING DEFINITIONS AND PROGRAMS UNDER THE ADMINISTRATION
ON AGING
SEC. 101. REAUTHORIZATION.
Section 216 (42 U.S.C. 3020f) is amended to read as follows--
``SEC. 216. AUTHORIZATION OF APPROPRIATIONS.
``(a) In General.--For purposes of carrying out this Act, there are
authorized to be appropriated for administration, salaries, and
expenses of the Administration $44,041,171 for fiscal year 2020,
$46,684,701 for fiscal year 2021, $49,485,783 for fiscal year 2022,
$52,454,930 for fiscal year 2023, $55,602,226 for fiscal year 2024,
$58,938,360 for fiscal year 2025, and $62,474,661 for fiscal year 2026.
``(b) Additional Authorizations.--There are authorized to be
appropriated--
``(1) to carry out section 202(a)(21) (relating to the
National Eldercare Locator Service), $2,186,227 for fiscal year
2020, $2,317,401 for fiscal year 2021, $2,456,445 for fiscal
year 2022, $2,603,832 for fiscal year 2023, $2,760,062 for
fiscal year 2024, $2,925,665 for fiscal year 2025, and
$3,101,206 for fiscal year 2026;
``(2) to carry out section 215, $1,992,460 for fiscal year
2020, $2,112,008 for fiscal year 2021, $2,238,728 for fiscal
year 2022, $2,373,052 for fiscal year 2023, $2,515,435 for
fiscal year 2024, $2,667,361 for fiscal year 2025, and
$2,826,343 for fiscal year 2026;
``(3) to carry out section 202 (relating to Elder Rights
Support Activities under this title), $1,375,011 for fiscal
year 2020, $1,457,511 for fiscal year 2021, $1,544,962 for
fiscal year 2022, $1,637,660 for fiscal year 2023, $1,735,919
for fiscal year 2024, $1,840,074 for fiscal year 2025, and
$1,950,479 for fiscal year 2026;
``(4) to carry out section 202(b) (relating to the Aging
and Disability Resource Centers), $8,708,043 for fiscal year
2020, $9,230,526 for fiscal year 2021, $9,784,357 for fiscal
year 2022, $10,371,419 for fiscal year 2023, $10,993,704 for
fiscal year 2024, $11,653,326 for fiscal year 2025, and
$12,352,525 for fiscal year 2026.''.
SEC. 102. PERSON-CENTERED, TRAUMA-INFORMED SERVICES.
Section 101(2) (42 U.S.C. 3001(2)) is amended by inserting
``(including access to person-centered, trauma-informed services as
appropriate)'' after ``health''.
SEC. 103. AGING AND DISABILITY RESOURCE CENTERS.
Section 102(4) (42 U.S.C. 3002(4)) is amended--
(1) in the matter preceding subparagraph (A), by inserting
``, in collaboration with (as appropriate) area agencies on
aging, centers for independent living (as described in part C
of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f
et seq.)), and other aging or disability entities'' after
``provides'';
(2) in subparagraph (B)--
(A) by inserting ``services, supports, and'' after
``plan for long-term''; and
(B) by inserting ``and choices'' after ``desires'';
and
(3) in subparagraph (D), by striking ``(29 U.S.C. 796f et
seq.), and other community-based entities,'' and inserting ``,
and other community-based entities, including other aging or
disability entities,''.
SEC. 104. ASSISTIVE TECHNOLOGY.
The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is
amended--
(1) in section 102(8) (42 U.S.C. 3002(8)), by adding at the
end the following:
``(C) The term `State assistive technology entity' means the
agency, office, or other entity designated under subsection (c)(1) of
section 4 of the Assistive Technology Act of 1998 (29 U.S.C. 3003) to
carry out State activities under such section.'';
(2) in section 306 (42 U.S.C. 3026)--
(A) in subsection (a)(6)--
(i) in subparagraph (G), by striking ``;
and'' and inserting a semicolon;
(ii) in subparagraph (H), by striking
``appropriate;'' and inserting ``appropriate;
and''; and
(iii) by adding at the end the following:
``(I) coordinate with the State assistive technology entity
to ensure access to, and acquisition of, assistive technology
in serving older individuals;''; and
(B) in subsection (b)(3)--
(i) in subparagraph (K)--
(I) by aligning the margins of the
subparagraph with the margins of
subparagraph (J); and
(II) by striking ``; and'' and
inserting a semicolon;
(ii) by redesignating subparagraph (L) as
subparagraph (M); and
(iii) by inserting after subparagraph (K)
the following:
``(L) assistive technology devices and services; and''; and
(3) in section 411(a) (42 U.S.C. 3032(a))--
(A) in paragraph (2), by inserting ``aligned with
evidence-based practice'' after ``applied social
research''; and
(B) in paragraph (10), by inserting ``consistent
with section 508 of the Rehabilitation Act of 1973 (29
U.S.C. 794d)'' after ``other technologies''.
SEC. 105. VACCINATION.
Section 102(14) (42 U.S.C. 3002(14)) is amended--
(1) in subparagraph (B), by inserting ``immunization
status,'' after ``oral health,''; and
(2) in subparagraph (D), by inserting ``infectious disease,
and vaccine-preventable disease,'' after ``cardiovascular
disease),''.
SEC. 106. MALNUTRITION.
The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is
amended--
(1) in section 102(14)(B), as amended by section 105(1), by
inserting ``(including screening for malnutrition)'' before the
semicolon at the end; and
(2) in section 330(1), by striking ``and food insecurity''
and inserting ``, food insecurity, and malnutrition''.
SEC. 107. SEXUALLY TRANSMITTED DISEASES.
Section 102(14)(D) (42 U.S.C. 3002(14)(D)), as amended by section
105(2), is further amended by inserting ``prevention of sexually
transmitted diseases,'' after ``vaccine-preventable disease,''.
SEC. 108. ADDRESSING CHRONIC PAIN MANAGEMENT.
Section 102(14)(D) (42 U.S.C. 3002(14)(D)), as amended by section
107, is further amended by inserting ``chronic pain management,'' after
``substance abuse reduction,''.
SEC. 109. SCREENING FOR SUICIDE RISK.
Section 102(14)(G) (42 U.S.C. 3002(14)(G)) is amended by inserting
``and screening for suicide risk'' after ``depression''.
SEC. 110. ADDRESSING PUBLIC HEALTH EMERGENCIES AND EMERGING HEALTH
THREATS.
Section 102(14) (42 U.S.C. 3002(14)) is amended--
(1) by redesignating subparagraphs (K) and (L) as
subparagraphs (L) and (M), respectively;
(2) by inserting after subparagraph (J) the following:
``(K) responses to public health emergencies and
emerging health threats;''; and
(3) in subparagraph (M), as so redesignated, by striking
``(A) through (K)'' and inserting ``(A) through (L)''.
SEC. 111. CLARIFICATION REGARDING BOARD AND CARE FACILITIES.
Section 102(35)(C) (42 U.S.C. 3002(35)(C)) is amended by striking
``for purposes of sections 307(a)(12) and 712,''.
SEC. 112. PERSON-CENTERED, TRAUMA-INFORMED SERVICES.
Section 102 (42 U.S.C. 3002) is amended--
(1) by redesignating paragraphs (41) through (54) as
paragraphs (42) through (55), respectively; and
(2) by inserting after paragraph (40) the following:
``(41) The term `person-centered, trauma-informed', with
respect to services, means services provided through an aging
program that--
``(A) use a holistic approach to providing services
or care;
``(B) promote the dignity, strength, and
empowerment of victims of trauma; and
``(C) incorporate evidence-based practices based on
knowledge about the role of trauma in trauma victims'
lives.''.
SEC. 113. MODERNIZING THE REVIEW OF APPLICATIONS AND PROVIDING
TECHNICAL ASSISTANCE FOR DISASTERS.
(a) Review of Applications.--Section 202 (42 U.S.C. 3012) is
amended--
(1) by amending subsection (a)(4) to read as follows:
``(4) administer the grants provided by this Act, but not
approve an application submitted by an applicant for a grant
for an activity under a provision of this Act for which such
applicant previously received a grant under such provision
unless the Assistant Secretary determines--
``(A) the activity for which such application was
submitted is being operated, or was operated,
effectively to achieve its stated purpose; and
``(B) such applicant--
``(i) has complied with the assurances
provided to the Assistant Secretary with the
application for such previous grant; and
``(ii) will comply with the assurances
provided with the application submitted for the
subsequent grant.''; and
(2) by adding at the end the following:
``(h) The Assistant Secretary shall publish, on an annual basis, a
list of centers and demonstration projects funded under each title of
this Act. The Assistant Secretary shall ensure that this information is
also directly provided to States and area agencies on aging.''.
(b) Addressing the Needs of Older Individuals in Disasters.--
Section 202(a) (42 U.S.C. 3012(a)) is amended--
(1) in paragraph (30), by striking ``; and'' and inserting
a semicolon;
(2) in paragraph (31), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(32) provide technical assistance to, and share best
practices with, States and area agencies on aging on how to
collaborate and coordinate activities and develop long-range
emergency preparedness plans with local and State emergency
response agencies, relief organizations, local and State
governments, Federal agencies as appropriate, and any other
institutions that have responsibility for disaster relief
service delivery.''.
SEC. 114. NOTIFICATION OF AVAILABILITY OF OR UPDATES TO POLICIES,
PRACTICES, AND PROCEDURES THROUGH A UNIFORM E-FORMAT.
Section 202(a) (42 U.S.C. 3012(a)), as amended by section 113(b),
is further amended--
(1) in paragraph (31), by striking ``; and'' and inserting
a semicolon;
(2) in paragraph (32), by striking the period and inserting
``; and''; and
(3) by adding at the end the following:
``(33) provide (to the extent practicable) a standardized
notification, to State agencies, area agencies on aging,
providers of services under this Act, and grantees or contract
awardees under this Act, through an electronic format (e-mail
or other electronic notification), of the availability of, or
updates to, policies, practices, and procedures under this
Act.''.
SEC. 115. EVIDENCE-BASED PROGRAM ADAPTATION.
(a) Functions of the Assistant Secretary.--Section 202 (42 U.S.C.
3012) is amended--
(1) in subsection (a)(28), by inserting before the
semicolon ``, including information and technical assistance on
delivery of such services in different settings''; and
(2) in subsection (b)(9)(B), by inserting before the
semicolon ``, including delivery of such services in different
settings''.
(b) Evidence-Based Disease Prevention and Health Promotion
Services.--Section 361(a) (42 U.S.C. 3030m(a)) is amended in the second
sentence by inserting ``provide technical assistance on the delivery of
evidence-based disease prevention and health promotion services in
different settings and for different populations, and'' before
``consult''.
SEC. 116. BUSINESS ACUMEN PROVISIONS AND CLARIFICATION REGARDING
OUTSIDE FUNDING FOR AREA AGENCIES ON AGING.
(a) Assistance Relating to Growing and Sustaining Capacity.--
Section 202(b)(9) (42 U.S.C. 3012(b)(9)) is amended--
(1) in subparagraph (A), by striking ``and'' after the
semicolon at the end;
(2) in subparagraph (B), as amended by section 115(a)(2),
by inserting ``and'' after the semicolon at the end; and
(3) by adding at the end the following:
``(C) business acumen, capacity building,
organizational development, innovation, and other
methods of growing and sustaining the capacity of the
aging network to serve older individuals and caregivers
most effectively;''.
(b) Clarifying Partnerships for Area Agencies on Aging.--Section
306 (42 U.S.C. 3026) is amended by adding at the end the following:
``(g) Nothing in this Act shall restrict an area agency on aging
from providing services not provided or authorized by this Act,
including through--
``(1) contracts with health care payers;
``(2) consumer private pay programs; or
``(3) other arrangements with entities or individuals that
increase the availability of home- and community-based services
and supports in the planning and service area supported by the
area agency on aging.''.
SEC. 117. NATIONAL RESOURCE CENTER FOR OLDER INDIVIDUALS EXPERIENCING
THE LONG-TERM AND ADVERSE CONSEQUENCES OF TRAUMA.
Section 202 (42 U.S.C. 3012), as amended by section 113(a)(2), is
further amended by adding at the end the following:
``(i) The Assistant Secretary shall, directly or by grant or
contract, operate a national resource center that--
``(1) provides training and technical assistance to
agencies in the aging network delivering person-centered,
trauma-informed services to older individuals experiencing the
long-term and adverse consequences of trauma;
``(2) shares best practices with the aging network; and
``(3) makes grants to the agencies best positioned to
advance and improve the delivery of person-centered, trauma-
informed services for older individuals experiencing the long-
term and adverse consequences of trauma.''.
SEC. 118. NATIONAL RESOURCE CENTER FOR WOMEN AND RETIREMENT.
Section 202 (42 U.S.C. 3012), as amended by section 117, is further
amended by adding at the end the following:
``(j)(1) The Assistant Secretary shall, directly or by grant or
contract, operate the National Resource Center for Women and Retirement
(in this subsection referred to as the `Center').
``(2) The Center shall--
``(A) provide tools, such as basic financial management,
retirement planning, and other educational tools, that promote
financial literacy and help to identify and prevent fraud and
exploitation of older individuals who are women, and integrate
these tools with information on health and long-term care of
older individuals;
``(B) annually disseminate to the Assistant Secretary a
summary of outreach provided under this subsection, including
efforts to provide user-friendly consumer information and
public education materials with respect to the tools provided
under subparagraph (A);
``(C) develop targeted outreach strategies to older
individuals who are women in providing the tools under
subparagraph (A);
``(D) provide technical assistance to State agencies and to
other public and nonprofit private agencies and organizations
in providing the tools under subparagraph (A); and
``(E) develop partnerships and collaborations to address
objectives under this subsection.''.
SEC. 119. FAMILY CAREGIVERS.
(a) Administration.--Section 202 (42 U.S.C. 3012), as amended by
section 118, is further amended by adding at the end the following:
``(k) The Assistant Secretary shall carry out the RAISE Family
Caregivers Act (42 U.S.C. 3030s note).''.
(b) Sunset.--Section 6 of the RAISE Family Caregivers Act (42
U.S.C. 3030s note) is amended by striking ``3 years'' and inserting ``8
years''.
(c) Conforming Amendment.--Section 2(3) of the RAISE Family
Caregivers Act (42 U.S.C. 3030s note) is amended by inserting ``acting
through the Assistant Secretary for Aging'' before the period at the
end.
SEC. 120. COORDINATION WITH ASSISTANT SECRETARY FOR MENTAL HEALTH AND
SUBSTANCE USE AND DIRECTOR OF THE CENTERS FOR DISEASE
CONTROL AND PREVENTION.
The Assistant Secretary shall, in performing the functions of the
Administration on Aging under section 202(a)(5) of the Older Americans
Act of 1965 (42 U.S.C. 3012(a)(5)) related to health (including mental
and behavioral health) services, coordinate with the Assistant
Secretary for Mental Health and Substance Use and the Director of the
Centers for Disease Control and Prevention--
(1) in the planning, development, implementation, and
evaluation of evidence-based policies, programs, practices, and
other activities pertaining to the prevention of suicide among
older individuals, including the implementation of evidence-
based suicide prevention programs and strategies identified by
the National Center for Injury Prevention and Control at the
Centers for Disease Control and Prevention and other entities,
as applicable; and
(2) in providing and incorporating technical assistance for
the prevention of suicide among older individuals, including
technical assistance related to the Suicide Prevention
Technical Assistance Center established under section 520C of
the Public Health Service Act (42 U.S.C. 290bb-34).
SEC. 121. MODERNIZING THE INTERAGENCY COORDINATING COMMITTEE ON HEALTHY
AGING AND AGE-FRIENDLY COMMUNITIES.
(a) Federal Agency Consultation.--Section 203(c) (42 U.S.C.
3013(c)) is amended--
(1) in paragraph (1)--
(A) by striking ``the Federal officials'' and
inserting ``other Federal officials'';
(B) by striking ``Committee on Aging'' and
inserting ``Committee on Healthy Aging and Age-Friendly
Communities''; and
(C) by inserting ``and the development of a
national set of recommendations, in accordance with
paragraph (6), to support the ability of older
individuals to age in place and access preventive
health care, promote age-friendly communities, and
address the ability of older individuals to access
long-term care supports, including access to caregivers
and home- and community-based health services'' before
the period;
(2) in paragraph (4), by adding at the end the following:
``The first term, after the date of enactment of the
Modernization of the Older Americans Act Amendments, shall
start not later than 1 year after such date of enactment.'';
(3) in paragraph (6)--
(A) in the matter preceding subparagraph (A), by
striking ``The Committee shall'' and inserting ``The
recommendations described in paragraph (1) may include
recommendations for'';
(B) in subparagraph (A)--
(i) by striking ``share information with
and establish an ongoing system to'' and
inserting ``ways to''; and
(ii) by striking ``for older individuals
and recommend improvements'' and all that
follows through ``accessibility of such
programs and services'' and inserting ``that
impact older individuals'';
(C) in subparagraph (B), by striking ``identify,
promote, and implement (as appropriate),'';
(D) in subparagraph (C)--
(i) by inserting ``ways to'' before
``collect'';
(ii) by striking ``older individuals and'';
and
(iii) by striking ``the individuals to
ensure'' and all that follows through
``information'' and inserting ``older
individuals to ensure that such information is
accessible'';
(E) in subparagraph (D), by striking ``work with''
and all that follows through ``member agencies to
ensure'' and inserting ``ways to ensure'';
(F) in subparagraph (E), by striking ``seek input''
and all that follows through ``foundations'' and
inserting ``seeking input from and consulting with
nonprofit organizations, academic or research
institutions, community-based organizations,
philanthropic organizations, or other entities
supporting age-friendly communities'';
(G) in subparagraph (F), by striking ``identify''
and inserting ``identifying''; and
(H) by amending subparagraph (G) to read as
follows:
``(G) ways to improve coordination to provide housing,
health care, and other supportive services to older
individuals.'';
(4) in paragraph (7)(A)(i), by striking ``services for
older individuals'' and inserting ``services that impact older
individuals''; and
(5) by adding at the end the following:
``(9) In this subsection, the term `age-friendly community' means a
community that--
``(A) is taking measurable steps to--
``(i) include adequate and accessible housing,
public spaces and buildings, safe and secure paths,
variable route transportation services, and programs
and services designed to support health and well-being;
``(ii) respect and include older individuals in
social opportunities, civic participation,
volunteerism, and employment; and
``(iii) facilitate access to supportive services
for older individuals;
``(B) is not an assisted living facility or long-term care
facility; and
``(C) has a plan in place to meet local needs for housing,
transportation, civic participation, social connectedness, and
accessible public spaces.''.
(b) Administration of the Act.--Section 205(a)(2) (42 U.S.C.
3016(a)(2)) is amended--
(1) by redesignating subparagraph (C) as subparagraph (D);
and
(2) by inserting after subparagraph (B) the following:
``(C) The Assistant Secretary may provide technical assistance,
including through the regional offices of the Administration, to State
agencies, area agencies on aging, local government agencies, or leaders
in age-friendly communities (as defined, for purposes of this
subparagraph, in section 203(c)(9)) regarding--
``(i) dissemination of, or consideration of ways to
implement, best practices and recommendations from the
Interagency Coordinating Committee on Healthy Aging and Age-
Friendly Communities established under section 203(c); and
``(ii) methods for managing and coordinating existing
programs to meet the needs of growing age-friendly
communities.''.
SEC. 122. PROFESSIONAL STANDARDS FOR NUTRITION OFFICIAL UNDER THE
ASSISTANT SECRETARY.
Section 205(a)(2)(D)(ii) (42 U.S.C. 3016(a)(2)(D)(ii)), as
redesignated by section 121(b)(1), is amended to read as follows:
``(ii) be a registered dietitian or registered dietician
nutritionist.''.
SEC. 123. REPORT ON SOCIAL ISOLATION.
(a) Preparation of Report.--
(1) In general.--The Secretary shall, in carrying out
activities under section 206(a) of the Older Americans Act of
1965 (42 U.S.C. 3017(a)), prepare a report on programs
authorized by such Act (42 U.S.C. 3001 et seq.), and supported
or funded by the Administration on Aging, that include a focus
on addressing the negative impacts associated with social
isolation through targeting older individuals identified in
greatest social need, as appropriate.
(2) Impact.--Such report shall identify--
(A) whether social isolation is being adequately
addressed under such programs, including, to the extent
practicable--
(i) the prevalence of social isolation in
rural areas and in urban areas;
(ii) the public health impacts associated
with social isolation; and
(iii) the role of preventive measures or of
services, including nutrition services, in
addressing the negative impacts associated with
social isolation among older individuals; and
(B) public awareness of and efforts to address the
negative public health impacts associated with social
isolation.
(3) Types of programs.--Such report shall identify whether
programs described in paragraph (1)--
(A) support projects in local communities and
involve diverse sectors associated with such
communities to decrease the negative impacts associated
with social isolation among older individuals and
caregivers;
(B) support outreach activities to screen older
individuals for negative impacts associated with social
isolation; and
(C) include a focus on decreasing the negative
impacts associated with social isolation.
(4) Recommendations.--Such report shall, as appropriate,
include recommendations for reducing the negative impacts
associated with social isolation and to address any impacts
identified under clauses (i) through (iii) of subparagraph (A),
and subparagraph (B), of paragraph (2).
(b) Submission of Report.--
(1) Interim status report.--Not later than 2 years after
the date of enactment of this Act, the Secretary shall submit
an interim report, to the committees of the Senate and of the
House of Representatives with jurisdiction over the Older
Americans Act of 1965 (42 U.S.C. 3001 et seq.), and the Special
Committee on Aging of the Senate, on the status of the
evaluation underway to develop the final report required under
this section.
(2) Final report.--Not later than 5 years after the date of
enactment of this Act, the Secretary shall submit a final
report of the report required under this section to the
committees of the Senate and of the House of Representatives
with jurisdiction over the Older Americans Act of 1965 (42
U.S.C. 3001 et seq.), and the Special Committee on Aging of the
Senate.
SEC. 124. INNOVATION, DEMONSTRATION, AND EVALUATION WITHIN AGING
PROGRAMS.
(a) In General.--Section 206 (42 U.S.C. 3017) is amended--
(1) by striking the section heading and inserting the
following:
``SEC. 206. EVALUATION.'';
(2) in subsection (a)--
(A) by striking ``(a) The Secretary'' and inserting
the following:
``(a) In General.--
``(1) Measuring and evaluating the impact of programs.--The
Secretary''; and
(B) by adding at the end the following:
``(2) Innovation, demonstration, and evaluation within
aging programs.--
``(A) In general.--The Secretary shall be
responsible for all activities related to demonstration
and evaluation of aging programs under this Act.
``(B) Evaluation activities.--The Secretary shall
review, coordinate, and streamline the evaluation of
programs (including demonstration projects) authorized
by this Act to ensure enhanced program outcomes. Such
activities shall include--
``(i) overseeing analyses of data obtained
in connection with such programs to evaluate,
where feasible, the relationship of such
programs to--
``(I) the determinants of health
for program participants; and
``(II) health care expenditures,
including under the Medicare program
under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.)
and the Medicaid program under title
XIX of such Act (42 U.S.C. 1396 et
seq.);
``(ii) disseminating the findings from
evaluations of programs authorized by this Act
throughout the aging network in electronic
format and any other format determined
appropriate by the Secretary;
``(iii) publicly posting the findings from
evaluations of such programs in an electronic
format, including webinar as appropriate;
``(iv) replicating successful demonstration
projects under title IV of this Act, including
on a national scale as appropriate; and
``(v) providing, directly or through grant
or contract, for research on and an evaluation
of programs under this Act, which shall
include, to the extent practicable, an analysis
of the relationship of such programs, including
demonstration projects under title IV of this
Act, to health care expenditures under the
Medicare program under title XVIII of the
Social Security Act and Medicaid program under
title XIX of such Act.
``(C) Demonstration projects.--The Secretary--
``(i) shall require selected demonstration
projects authorized by title IV after the date
of enactment of the Modernization of the Older
Americans Act Amendments to be targeted to--
``(I) address the determinants of
health for program participants;
``(II) show the relationship to
health care expenditures, including, to
the extent practicable, by measuring a
reduction in health expenditures, and
preserve or enhance quality of care
furnished to individuals, which may
include health expenditures and quality
of care under the Medicare program
under title XVIII of the Social
Security Act and the Medicaid program
under title XIX of such Act; and
``(III) contain performance
standards and measures, developed by
the Secretary, to evaluate whether such
demonstration projects are achieving
the objectives described in subclauses
(I) and (II); and
``(ii) may, in selecting demonstration
projects authorized by title IV after the date
of enactment of the Modernization of the Older
Americans Act Amendments, prioritize
demonstration projects involving--
``(I) multigenerational engagement;
``(II) support for caregivers
caring for individuals of any age;
``(III) community-based
partnerships; or
``(IV) any other activity described
in title IV that the Secretary
determines will achieve the objectives
of this subsection.
``(D) 5-year plans.--Not later than December 1,
2020, and every fifth December 1 thereafter, the
Secretary, shall prepare and publish in the Federal
Register for public comment a draft of a 5-year plan
that establishes a framework for evaluating programs
authorized by this Act (other than demonstration
projects evaluated in accordance with subparagraph
(C)), including programs authorized by title III, V,
VI, or VII, and explains the basis for such
framework.'';
(3) in subsection (b), by striking ``(b) The Secretary''
and inserting the following:
``(b) Standards for Title IV Grants or Contracts.--The Secretary'';
(4) in subsection (c), by striking ``(c) In carrying out''
and inserting the following:
``(c) Consultation.--In carrying out'';
(5) in subsection (d), by striking ``(d) The Secretary
shall'' and inserting the following:
``(d) Summaries and Analyses.--The Secretary shall'';
(6) in subsection (e), by striking ``(e) The Secretary
shall'' and inserting the following:
``(e) Property of the United States.--The Secretary shall'';
(7) in subsection (f), by striking ``(f) Such information''
and inserting the following:
``(f) Availability by Departments and Agencies.--Such
information''; and
(8) in subsection (g), by striking ``(g) From the total
amount'' and inserting the following:
``(g) Limitation on Funding.--From the total amount''.
(b) Reports.--Section 207 (42 U.S.C. 3018) is amended--
(1) in subsection (a)(2), by striking ``section
202(a)(16)'' and inserting ``sections 202(a)(16) and
206(a)(2)''; and
(2) by adding at the end the following:
``(d) The Assistant Secretary shall, as part of the annual report
submitted under subsection (a), prepare and submit a report on
activities carried out under section 206(a)(2) and title IV.''.
(c) Innovation, Demonstration, and Evaluation Activities Within
Aging Programs.--
(1) Heading.--Title IV (42 U.S.C. 3031 et seq.) is amended
in the title heading by striking ``ACTIVITIES FOR HEALTH,
INDEPENDENCE, AND LONGEVITY'' and inserting ``INNOVATION,
DEMONSTRATION, AND EVALUATION WITHIN AGING PROGRAMS''.
(2) Purposes.--Section 401 (42 U.S.C. 3031) is amended--
(A) by amending paragraph (1) to read as follows:
``(1) to gain a better understanding and knowledge base
for--
``(A) appraising services and facilities for older
individuals; and
``(B) developing new and more effective and
efficient ways of improving the lives of older
individuals;'';
(B) in paragraph (2), by striking the semicolon at
the end and inserting ``; and'';
(C) in paragraph (3), by striking ``; and'' and
inserting a period; and
(D) by striking paragraph (4).
(3) Program authorized.--Section 411(a)(3) (42 U.S.C.
3032(a)(3)) is amended by striking ``this section'' and
inserting ``this Act''.
TITLE II--IMPROVING GRANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING
SEC. 201. DETERMINANTS OF HEALTH.
Section 301(a)(1) (42 U.S.C. 3021(a)(1)) is amended--
(1) in subparagraph (C), by striking ``and'' at the end;
(2) in subparagraph (D), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(E) measure impacts related to determinants of
health of older individuals.''.
SEC. 202. YOUNGER ONSET ALZHEIMER'S DISEASE.
The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is
amended--
(1) in section 302(3) (42 U.S.C. 3022(3)), by inserting
``of any age'' after ``an individual''; and
(2) in section 711(6) (42 U.S.C. 3058f(6)), by inserting
``of any age'' after ``individual''.
SEC. 203. REAUTHORIZATION.
(a) Grants for State and Community Programs on Aging.--Subsections
(a) through (e) of section 303 (42 U.S.C. 3023) are amended to read as
follows:
``(a)(1) There are authorized to be appropriated to carry out part
B (relating to supportive services) $413,011,586 for fiscal year 2020,
$437,792,281 for fiscal year 2021, $464,059,818 for fiscal year 2022,
$491,903,407 for fiscal year 2023, $521,417,612 for fiscal year 2024,
$552,702,669 for fiscal year 2025, and $585,864,829 for fiscal year
2026.
``(2) Funds appropriated under paragraph (1) shall be available to
carry out section 712.
``(b)(1) There are authorized to be appropriated to carry out
subpart 1 of part C (relating to congregate nutrition services)
$531,279,663 for fiscal year 2020, $563,156,443 for fiscal year 2021,
$596,945,830 for fiscal year 2022, $632,762,580 for fiscal year 2023,
$670,728,334 for fiscal year 2024, $710,972,034 for fiscal year 2025,
and $753,630,356 for fiscal year 2026.
``(2) There are authorized to be appropriated to carry out subpart
2 of part C (relating to home delivered nutrition services)
$269,577,167 for fiscal year 2020, $285,751,797 for fiscal year 2021,
$302,896,905 for fiscal year 2022, $321,070,719 for fiscal year 2023,
$340,334,963 for fiscal year 2024, $360,755,061 for fiscal year 2025,
and $382,400,364 for fiscal year 2026.
``(c) Grants made under part B, and subparts 1 and 2 of part C, of
this title may be used for paying part of the cost of--
``(1) the administration of area plans by area agencies on
aging designated under section 305(a)(2)(A), including the
preparation of area plans on aging consistent with section 306
and the evaluation of activities carried out under such plans;
and
``(2) the development of comprehensive and coordinated
systems for supportive services, and congregate and home
delivered nutrition services under subparts 1 and 2 of part C,
the development and operation of multipurpose senior centers,
and the delivery of legal assistance.
``(d) There are authorized to be appropriated to carry out part D
(relating to disease prevention and health promotion services)
$26,650,753 for fiscal year 2020, $28,249,798 for fiscal year 2021,
$29,944,786 for fiscal year 2022, $31,741,473 for fiscal year 2023,
$33,645,961 for fiscal year 2024, $35,664,718 for fiscal year 2025, and
$37,804,601 for fiscal year 2026.
``(e) There are authorized to be appropriated to carry out part E
(relating to family caregiver support) $194,331,264 for fiscal year
2020, $205,991,140 for fiscal year 2021, $218,350,609 for fiscal year
2022, $231,451,645 for fiscal year 2023, $245,338,744 for fiscal year
2024, $260,059,069 for fiscal year 2025, and $275,662,613 for fiscal
year 2026.''.
(b) Nutrition Services Incentive Program.--Section 311(e) of the
Older Americans Act of 1965 (42 U.S.C. 3030a(e)) is amended to read as
follows:
``(e) There are authorized to be appropriated to carry out this
section (other than subsection (c)(1)) $171,682,200 for fiscal year
2020, $181,983,132 for fiscal year 2021, $192,902,120 for fiscal year
2022, $204,476,247 for fiscal year 2023, $216,744,822 for fiscal year
2024, $229,749,511 for fiscal year 2025, and $243,534,482 for fiscal
year 2026.''.
SEC. 204. HOLD HARMLESS FORMULA.
(a) In General.--Section 304(a)(3)(D) (42 U.S.C. 3024(a)(3)(D)) is
amended to read as follows:
``(D)(i) In this subparagraph and paragraph (5)--
``(I) the term `allot' means allot under
this subsection from a sum appropriated under
section 303(a) or 303(b)(1), as the case may
be; and
``(II) the term `covered fiscal year' means
any of fiscal years 2020 through 2029.
``(ii) If the sum appropriated under section 303(a)
or 303(b)(1) for a particular covered fiscal year is
less than or equal to the sum appropriated under
section 303(a) or 303(b)(1), respectively, for fiscal
year 2019, amounts shall be allotted to States from the
sum appropriated for the particular year in accordance
with paragraphs (1) and (2), and subparagraphs (A)
through (C) as applicable, but no State shall be
allotted an amount that is less than--
``(I) for fiscal year 2020, 99.75 percent
of the corresponding sum appropriated for
fiscal year 2019;
``(II) for fiscal year 2021, 99.50 percent
of that sum;
``(III) for fiscal year 2022, 99.25 percent
of that sum;
``(IV) for fiscal year 2023, 99.00 percent
of that sum;
``(V) for fiscal year 2024, 98.75 percent
of that sum;
``(VI) for fiscal year 2025, 98.50 percent
of that sum;
``(VII) for fiscal year 2026, 98.25 percent
of that sum;
``(VIII) for fiscal year 2027, 98.00
percent of that sum;
``(IX) for fiscal year 2028, 97.75 percent
of that sum; and
``(X) for fiscal year 2029, 97.50 percent
of that sum.
``(iii) If the sum appropriated under section
303(a) or 303(b)(1) for a particular covered fiscal
year is greater than the sum appropriated under section
303(a) or 303(b)(1), respectively, for fiscal year
2019, the allotments to States from the sum
appropriated for the particular year shall be
calculated as follows:
``(I) From the portion equal to the
corresponding sum appropriated for fiscal year
2019, amounts shall be allotted in accordance
with paragraphs (1) and (2), and subparagraphs
(A) through (C) as applicable, but no State
shall be allotted an amount that is less than
the percentage specified in clause (ii), for
that particular year, of the corresponding sum
appropriated for fiscal year 2019.
``(II) From the remainder, amounts shall be
allotted in accordance with paragraph (1),
subparagraphs (A) through (C) as applicable,
and paragraph (2) to the extent needed to meet
the requirements of those subparagraphs.''.
(b) Repeal.--Section 304(a)(3)(D) (42 U.S.C. 3024(a)(3)(D) is
repealed, effective October 1, 2029.
SEC. 205. OUTREACH EFFORTS.
Section 306(a)(4)(B)(i)(VII) (42 U.S.C. 3026(a)(4)(B)(i)(VII)) is
amended by inserting ``, specifically including survivors of the
Holocaust'' after ``placement''.
SEC. 206. MAINTENANCE OF EFFORT FOR STATE LONG-TERM CARE OMBUDSMAN
PROGRAM.
(a) Area Agency on Aging.--Section 306(a)(9) (42 U.S.C. 3026(a)(9))
is amended by striking ``Act and expended by the agency in fiscal year
2000'' and inserting ``Act and expended by the agency in fiscal year
2019''.
(b) State Agency.--Section 307(a)(9) (42 U.S.C. 3027(a)(9)) is
amended by striking ``not less than'' and all that follows and
inserting ``not less than the total amount expended by the State agency
with funds received under this title and title VII for fiscal year
2019.''.
SEC. 207. COORDINATION WITH RESOURCE CENTERS.
(a) Area Plans.--Section 306(a) (42 U.S.C. 3026(a)) is amended--
(1) in paragraph (16), by striking ``and'' at the end;
(2) in paragraph (17), by striking the period at the end
and inserting a semicolon; and
(3) by adding at the end the following:
``(18) provide assurances that the area agency on aging
will collect data to determine--
``(A) the services that are needed by older
individuals whose needs were the focus of all centers
funded under title IV in fiscal year 2019; and
``(B) the effectiveness of the programs, policies,
and services provided by such area agency on aging in
assisting such individuals; and
``(19) provide assurances that the area agency on aging
will use outreach efforts that will identify individuals
eligible for assistance under this Act, with special emphasis
on those individuals whose needs were the focus of all centers
funded under title IV in fiscal year 2019.''.
(b) State Plans.--Section 307(a) (42 U.S.C. 3027(a)) is amended by
adding at the end the following:
``(31) The plan shall contain an assurance that the State
shall prepare and submit to the Assistant Secretary annual
reports that describe--
``(A) data collected to determine the services that
are needed by older individuals whose needs were the
focus of all centers funded under title IV in fiscal
year 2019;
``(B) data collected to determine the effectiveness
of the programs, policies, and services provided by
area agencies on aging in assisting such individuals;
and
``(C) outreach efforts and other activities carried
out to satisfy the assurances described in paragraphs
(18) and (19) of section 306(a).''.
SEC. 208. SENIOR LEGAL HOTLINES.
Not later than 4 years after the date of enactment of this Act, the
Assistant Secretary shall prepare and submit to Congress a report
containing--
(1) information on which States or localities operate
senior legal hotlines;
(2) information on how such hotlines operated by States or
localities are funded;
(3) information of the usefulness of senior legal hotlines
in the coordination and provision of legal assistance; and
(4) recommendations on additional actions that should be
taken related to senior legal hotlines.
SEC. 209. INCREASE IN LIMIT ON USE OF ALLOTTED FUNDS FOR STATE
ADMINISTRATIVE COSTS.
Section 308(b)(2)(A) (42 U.S.C. 3028(b)(2)(A)) is amended by
striking ``$500,000'' and inserting ``$750,000''.
SEC. 210. IMPROVEMENTS TO NUTRITION PROGRAMS.
Section 308(b)(4) (42 U.S.C. 3028(b)(4)) is amended by adding at
the end the following:
``(D) The State, in consultation with area agencies on aging, shall
ensure the process used by the State in transferring funds under this
paragraph (including requirements relating to the authority and timing
of such transfers) is simplified and clarified to reduce administrative
barriers and direct limited resources to the greatest nutrition service
needs at the community level. Such process shall be modified to attempt
to lessen the administrative barriers of such transfers, and help
direct limited resources to where they are needed the most as the unmet
need for nutrition services grows.''.
SEC. 211. REVIEW OF REPORTS.
Section 308(b) (42 U.S.C. 3028(b)) is amended by adding at the end
the following:
``(8) The Assistant Secretary shall review the reports submitted
under section 307(a)(31) and include aggregate data in the report
required by section 207(a), including data on--
``(A) the effectiveness of the programs, policies, and
services provided by area agencies on aging in assisting older
individuals whose needs are the focus of all centers funded
under title IV in fiscal year 2019; and
``(B) outreach efforts and other activities carried out to
satisfy the assurances described in paragraphs (18) and (19) of
section 306(a), to identify such older individuals and their
service needs.''.
SEC. 212. OTHER PRACTICES.
(a) Evaluation.--Section 315(d) (42 U.S.C. 3030c-2(d)) is amended
by inserting ``, by State,'' after ``a comprehensive evaluation''.
(b) GAO Study.--Not later than 2 years after the date of enactment
of this Act, the Comptroller General of the United States shall conduct
a study and issue a report that includes--
(1) information--
(A) about, and a list of, contracts (implemented by
States or area agencies on aging) with health care
organizations, and State-implemented cost-sharing
policies by area agencies on aging, waiver use and
waiver use policies, and voluntary contribution
policies, by State, under title III of the Older
Americans Act of 1965 (42 U.S.C. 3021 et seq.); and
(B) about any negative impacts on low-income
individuals resulting from the policies and uses
described in subparagraph (A), and annual evaluation
methods and corrective action that the Assistant
Secretary is taking to rectify such an impact;
(2) information about the policies described in
subparagraph (A), such as payment rates (including sliding
scales based solely on individual income and the cost of
delivering services and whether low-income individuals or other
populations are excluded from cost sharing or whether specific
demographic groups are targeted with cost sharing), procedures
to account for cost-sharing payments, written or other
educational materials to inform recipients about cost sharing
and voluntary contributions in a way that protects access to
services, and the extent to which stakeholders' views are
solicited regarding cost-sharing policies;
(3) information on the number of older individuals paying
for services under the Older Americans Act of 1965 (42 U.S.C.
3001 et seq.);
(4) policies that ensure that--
(A) low-income individuals are not burdened by
cost-sharing policies; and
(B) cost-sharing policies do not result in the
denial of services due to the individual's income or
the individual's failure to make a cost-sharing
payment; and
(5) recommendations to Congress and various stakeholders
about ways to clarify or improve cost sharing or voluntary
contribution policies and implementation.
SEC. 213. CULTURALLY APPROPRIATE, MEDICALLY TAILORED MEALS.
Section 339(2)(A)(iii) (42 U.S.C. 3030g-21(2)(A)(iii)) is amended
by inserting ``, including meals adjusted for cultural considerations
and preferences and medically tailored meals'' before the comma at the
end.
SEC. 214. NUTRITION SERVICES STUDY.
Subpart 3 of part C of title III (42 U.S.C. 3030g-21 et seq.) is
amended by adding at the end the following:
``SEC. 339B. NUTRITION SERVICES IMPACT STUDY.
``(a) Study.--
``(1) In general.--The Assistant Secretary shall perform a
study to assess how to measure and evaluate the discrepancy
between available services and the demand for such services in
the home delivered nutrition services program and the
congregate nutrition services program under this part, which
shall include assessing various methods (such as those that
States use) to measure and evaluate the discrepancy (such as
measurement through the length of waitlists).
``(2) Contents.--In performing the study, the Assistant
Secretary shall--
``(A) consider means of obtaining information in
rural and underserved communities; and
``(B) consider using existing tools (existing as of
the date the Assistant Secretary begins the study) such
as the tools developed through the Performance Outcome
Measurement Project.
``(3) Analysis.--The Assistant Secretary shall analyze and
determine which methods are the least burdensome and most
effective for measuring and evaluating the discrepancy
described in paragraph (1).
``(b) Recommendations.--
``(1) Preparation.--Not later than 3 years after the date
of enactment of this Act, the Assistant Secretary shall prepare
recommendations--
``(A) on how to measure and evaluate, with the
least burden and the most effectiveness, the
discrepancy described in subsection (a)(1) (such as
measurement through the length of waitlists); and
``(B) about whether studies similar to the study
described in subsection (a) should be carried out for
programs carried out under this Act, other than this
part.
``(2) Issuance.--The Assistant Secretary shall issue the
recommendations, and make the recommendations available as a
notification pursuant to section 202(a)(34) and to the
committees of the Senate and of the House of Representatives
with jurisdiction over this Act, and the Special Committee on
Aging of the Senate.''.
SEC. 215. NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM.
(a) Definitions for National Family Caregiver Support Program.--
Section 372(a) (42 U.S.C. 3030s(a)) is amended--
(1) by redesignating paragraphs (1) through (3) as
paragraphs (2) through (4), respectively; and
(2) by inserting before paragraph (2), as so redesignated,
the following:
``(1) Caregiver assessment.--The term `caregiver
assessment' means a defined process of gathering information to
identify the specific needs, barriers to support services, and
existing supports of a family caregiver or older relative
caregiver, as identified by the caregiver involved, to
appropriately target recommendations for support services
described in section 373(b). Such assessment shall be
administered through direct contact with the caregiver, which
may include contact through a home visit, the Internet,
telephone or teleconference, or in-person interaction.''.
(b) General Authority.--Section 373 (42 U.S.C. 3030s-1) is
amended--
(1) in subsection (b), in the matter preceding paragraph
(1), by inserting ``which may be informed through the use of
caregiver assessments,'' after ``provided,'';
(2) in subsection (e)(3), in the first sentence, by
inserting ``, including caregiver assessments used in the
State,'' after ``mechanisms'';
(3) by redesignating subsections (e) through (g) as
subsections (f) through (h), respectively;
(4) by inserting after subsection (d) the following:
``(e) Best Practices.--Not later than 1 year after the date of
enactment of the Modernization of the Older Americans Act Amendments
and every 5 years thereafter, the Assistant Secretary shall--
``(1) identify best practices relating to the programs
carried out under this section and section 631, regarding--
``(A) the use of procedures and tools to monitor
and evaluate the performance of the programs carried
out under such sections;
``(B) the use of evidence-based caregiver support
services; and
``(C) any other issue determined relevant by the
Assistant Secretary; and
``(2) make available, including on the website of the
Administration and pursuant to section 202(a)(34), best
practices described in paragraph (1), to carry out the programs
under this section and section 631.''; and
(5) by adding at the end the following:
``(i) Activities of National Significance.--The Assistant Secretary
may award funds authorized under this section to States, public
agencies, private nonprofit agencies, institutions of higher education,
and organizations, including tribal organizations, for conducting
activities of national significance that--
``(1) promote quality and continuous improvement in the
support provided to family caregivers and older relative
caregivers through programs carried out under this section and
section 631; and
``(2) include, with respect to such programs, program
evaluation, training, technical assistance, and research.
``(j) Technical Assistance for Caregiver Assessments.--Not later
than 1 year after the date of enactment of the Modernization of the
Older Americans Act Amendments, the Assistant Secretary, in
consultation with stakeholders with appropriate expertise and, as
appropriate, informed by the strategy developed under the RAISE Family
Caregivers Act (42 U.S.C. 3030s note), shall provide technical
assistance to promote and implement the use of caregiver assessments.
Such technical assistance may include sharing available tools or
templates, comprehensive assessment protocols, and best practices
concerning--
``(1) conducting caregiver assessments (including
reassessments) as needed;
``(2) implementing such assessments that are consistent
across a planning and service area, as appropriate; and
``(3) implementing caregiver support service plans,
including conducting referrals to and coordination of
activities with relevant State services.''.
(c) Report on Caregiver Assessments.--
(1) In general.--Not later than 3 years after the date of
enactment of this Act, the Assistant Secretary shall issue a
report on the use of caregiver assessments by area agencies on
aging, entities contracting with such agencies, and tribal
organizations. Such report shall include--
(A) an analysis of the current use of caregiver
assessments, as of the date of the report;
(B) an analysis of the potential impact of
caregiver assessments on--
(i) family caregivers and older relative
caregivers; and
(ii) the older individuals to whom the
caregivers described in clause (i) provide
care;
(C) an analysis of the potential impact of using
caregiver assessments on the aging network;
(D) an analysis of how caregiver assessments are
being used to identify the specific needs, barriers to
support services, and existing supports of family
caregivers and older relative caregivers, with
particular consideration to supporting--
(i) a caregiver specified in this
subparagraph who is caring for individuals with
disabilities, or, if appropriate, with a
serious illness; and
(ii) caregivers with disabilities;
(E) recommendations for furthering the use of
caregiver assessments, as appropriate, including in
rural or underserved areas; and
(F) recommendations for assisting State agencies
and area agencies on aging, particularly in rural or
underserved areas, in implementing the use of caregiver
assessments.
(2) Submission.--Not later than 6 months after the issuance
of the report specified in paragraph (1), the Assistant
Secretary shall submit the report to the committees of the
Senate and the House of Representatives with jurisdiction over
this Act, and the Special Committee on Aging of the Senate.
(3) Definitions.--In this subsection--
(A) the terms ``caregiver assessment'' and ``older
relative caregiver'' have the meanings given such terms
in section 372(a) of the Older Americans Act of 1965
(42 U.S.C. 3030s(a));
(B) the term ``family caregiver'' has the meaning
given the term in section 302 of such Act (42 U.S.C.
3022); and
(C) the terms ``State agency'' and ``tribal
organization'' have the meanings given the terms in
section 102 of such Act (42 U.S.C. 3002).
(d) Conforming Amendment.--Section 631(b) of such Act (42 U.S.C.
3057k-11(b)) is amended by striking ``(c), (d), and (e)'' and inserting
``(c), (d), and (f)''.
SEC. 216. NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM CAP.
(a) Federal Share.--Subsection (h)(2), as redesignated by section
215(b)(3) of this Act, of section 373 (42 U.S.C. 3030s-1) is amended by
striking subparagraph (C).
(b) Monitoring the Impact of the Elimination of the Cap on Funds
for Older Relative Caregivers.--
(1) Report.--Not later than 18 months after the date of
enactment of this Act, and annually thereafter, the Assistant
Secretary shall submit to the Committee on Health, Education,
Labor, and Pensions of the Senate and the Committee on
Education and Labor of the House of Representatives a report on
the impact of the amendment made by subsection (a) to eliminate
the limitation on funds that States may allocate to provide
support services to older relative caregivers in the National
Family Caregiver Support Program established under part E of
title III of the Older Americans Act of 1965 (42 U.S.C. 3030s
et seq.). Each such report shall also be made available to the
public.
(2) Contents.--For purposes of reports required by
paragraph (1), each State that receives an allotment under such
National Family Caregiver Support Program for fiscal year 2020
or a subsequent fiscal year shall report to the Assistant
Secretary for the fiscal year involved the amount of funds of
the total Federal and non-Federal shares described in section
373(h)(2) of the Older Americans Act of 1965 (42 U.S.C. 3030s-
1(h)(2)) used by the State to provide support services for
older relative caregivers and the amount of such funds so used
for family caregivers.
TITLE III--MODERNIZING ACTIVITIES FOR HEALTH, INDEPENDENCE, AND
LONGEVITY
SEC. 301. REAUTHORIZATION.
Section 411(b) (42 U.S.C. 3032(b)) is amended to read as follows--
``(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out--
``(1) aging network support activities under this section,
$14,549,157 for fiscal year 2020, $15,422,107 for fiscal year
2021, $16,347,433 for fiscal year 2022, $17,328,279 for fiscal
year 2023, $18,367,976 for fiscal year 2024, $19,470,054 for
fiscal year 2025, and $20,638,257 for fiscal year 2026; and
``(2) elder rights support activities under this section,
$15,650,667 for fiscal year 2020, $16,589,707 for fiscal year
2021, $17,585,090 for fiscal year 2022, $18,640,195 for fiscal
year 2023, $19,758,607 for fiscal year 2024, $20,944,123 for
fiscal year 2025, and $22,200,770 for fiscal year 2026.''.
SEC. 302. FALLS PREVENTION AND CHRONIC DISEASE SELF-MANAGEMENT
EDUCATION.
Section 411(a) (42 U.S.C. 3032(a)) is amended--
(1) by redesignating paragraphs (13) and (14) as paragraphs
(15) and (16), respectively; and
(2) by inserting after paragraph (12) the following:
``(13) bringing to scale and sustaining evidence-based
falls prevention programs that will reduce the number of falls,
fear of falling, and fall-related injuries in older
individuals, including older individuals with disabilities;
``(14) bringing to scale and sustaining evidence-based
chronic disease self-management programs that empower older
individuals, including older individuals with disabilities, to
better manage their chronic conditions;''.
SEC. 303. TECHNICAL ASSISTANCE AND INNOVATION TO IMPROVE TRANSPORTATION
FOR OLDER INDIVIDUALS.
Section 416(b)(2) (42 U.S.C. 3032e(b)(2)) is amended--
(1) in subparagraph (B), by inserting before the semicolon
``, call center, website or Internet-based portal, mobile
application, or other technological tools'';
(2) in subparagraph (C), by striking ``; and'' and
inserting a semicolon;
(3) by redesignating subparagraph (D) as subparagraph (G);
and
(4) by inserting after subparagraph (C) the following:
``(D)(i) improving the aggregation, availability,
and accessibility of information on options for
transportation services for older individuals,
including information on public transit, on-demand
transportation services, volunteer-based transportation
services, and other private transportation providers;
and
``(ii) providing older individuals with the ability
to schedule trips both in advance and on demand, as
appropriate;
``(E) identifying opportunities to share resources
and reduce costs of transportation services for older
individuals;
``(F) coordinating individualized trip planning
responses to requests from older individuals for
transportation services; and''.
SEC. 304. GRANT PROGRAM FOR MULTIGENERATIONAL COLLABORATION.
Section 417 (42 U.S.C. 3032f) is amended--
(1) by amending subsection (a) to read as follows:
``(a) Grants and Contracts.--The Assistant Secretary shall award
grants to and enter into contracts with eligible organizations to carry
out projects, serving individuals in younger generations and older
individuals, to--
``(1) provide opportunities for older individuals to
participate in multigenerational activities and civic
engagement activities that contribute to the health and
wellness of older individuals and individuals in younger
generations by developing--
``(A) meaningful roles for participants;
``(B) reciprocity in relationship building;
``(C) reduced social isolation and improved
participant social connectedness;
``(D) improved economic well-being for older
individuals;
``(E) increased lifelong learning; or
``(F) support for family caregivers by--
``(i) providing support for older relative
caregivers (as defined in section 372(a))
raising children (such as kinship navigator
programs); or
``(ii) involving volunteers who are older
individuals who provide support and information
to families who have a child with a disability
or chronic illness, or other families in need
of such family support;
``(2) coordinate multigenerational activities and civic
engagement activities, including multigenerational nutrition
and meal service programs;
``(3) promote volunteerism, including by providing
opportunities for older individuals to become a mentor to
individuals in younger generations; and
``(4) facilitate development of, and participation in,
multigenerational activities and civic engagement
activities.'';
(2) by striking subsection (g);
(3) by redesignating subsections (b) through (f) as
subsections (c) through (g), respectively;
(4) by inserting after subsection (a) the following:
``(b) Grant and Contract Periods.--Each grant awarded and contract
entered into under subsection (a) shall be for a period of not less
than 36 months.'';
(5) by amending subsection (c), as so redesignated, to read
as follows:
``(c) Use of Funds.--
``(1) In general.--An eligible organization shall use funds
made available under a grant awarded, or a contract entered
into, under this section to carry out a project described in
subsection (a).
``(2) Provision of projects through grantees.--In awarding
grants and entering into contracts under this section, the
Assistant Secretary shall ensure that such grants and contracts
are for the activities and projects that satisfy each
requirement under paragraphs (1) through (4) of subsection
(a).'';
(6) in subsection (d), as so redesignated--
(A) in paragraph (1), by inserting ``, intent to
carry out, or intent to partner with local
organizations or multiservice organizations to carry
out,'' after ``record of carrying out'';
(B) in paragraph (3), by striking ``; and'' and
inserting a semicolon;
(C) in paragraph (4), by striking the period and
inserting ``; and''; and
(D) by adding at the end the following:
``(5) eligible organizations proposing multigenerational
activity projects that utilize shared site programs, such as
collocated child care and long-term care facilities.'';
(7) by amending subsections (f) and (g), as so
redesignated, to read as follows:
``(f) Eligible Organizations.--Organizations eligible to receive a
grant or enter into a contract under subsection (a) shall--
``(1) be a State, an area agency on aging, or an
organization that provides opportunities for older individuals
to participate in activities described in such subsection; and
``(2) have the capacity to conduct the coordination,
promotion, and facilitation described in such subsection
through the use of multigenerational coordinators.
``(g) Evaluation.--
``(1) In general.--Not later than 3 years after the date of
enactment of the Modernization of the Older Americans Act
Amendments, the Assistant Secretary shall, through data
submitted by organizations carrying out projects through grants
or contracts under this section, evaluate the activities
supported through such grants and contracts to determine--
``(A) the effectiveness of such activities;
``(B) the impact of such activities on the
community being served and the organization providing
the activities; and
``(C) the impact of such activities on older
individuals participating in such projects.
``(2) Report to congress.--Not later than 6 months after
the Assistant Secretary completes the evaluation under
paragraph (1), the Assistant Secretary shall prepare and submit
to the Speaker of the House of Representatives and the
President pro tempore of the Senate a report that assesses such
evaluation and contains, at a minimum--
``(A) the names or descriptive titles of the
projects funded under subsection (a);
``(B) a description of the nature and operation of
such projects;
``(C) the names and addresses of organizations that
conducted such projects;
``(D) a description of the methods and success of
such projects in recruiting older individuals as
employees and as volunteers to participate in the
projects;
``(E) a description of the success of the projects
in retaining older individuals participating in such
projects as employees and as volunteers;
``(F) the rate of turnover of older individuals who
are employees or volunteers in such projects;
``(G) a strategy for disseminating the findings
resulting from such projects; and
``(H) any policy change recommendations relating to
such projects.''; and
(8) in subsection (h)(2)(B)(i), by striking ``individuals
from the generations with older individuals'' and inserting
``older individuals''.
TITLE IV--SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM
SEC. 401. PRIORITY FOR THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM.
(a) In General.--The Older Americans Act of 1965 (42 U.S.C. 3001 et
seq.) is amended--
(1) in section 503(a)(4)(C) (42 U.S.C. 3056a(a)(4)(C))--
(A) in clause (iii), by striking ``and'' at the
end;
(B) in clause (iv), by adding ``and'' at the end;
and
(C) by adding at the end the following:
``(v) eligible individuals who are
offenders;'';
(2) in section 514(e)(1) (42 U.S.C. 3056l(e)(1)), by
inserting ``eligible individuals who are offenders,'' after
``need,''; and
(3) in section 518 (42 U.S.C. 3056p)--
(A) in subsection (a)(3)(B)(ii)--
(i) in clause (IV), by striking ``or'' at
the end;
(ii) in clause (V), by striking the period
at the end and inserting ``; or''; and
(iii) by adding at the end the following:
``(VI) are offenders.'';
(B) in subsection (a), by adding at the end the
following:
``(9) Offender.--The term `offender' means an eligible
individual--
``(A) who is or has been subject to any stage of
the criminal justice process, and for whom services
under this title may be beneficial; or
``(B) who requires assistance in overcoming
artificial barriers to employment resulting from a
record of arrest or conviction.''; and
(C) in subsection (b)(2)--
(i) in subparagraph (F), by striking ``or''
at the end;
(ii) in subparagraph (G), by striking the
period at the end and inserting ``; or''; and
(iii) by adding at the end the following:
``(H) is an offender.''.
(b) Implementation.--The Secretary of Labor shall implement the
amendments made by this section not later than 12 months after the date
of enactment of this Act.
SEC. 402. AUTHORIZATION OF APPROPRIATIONS.
Section 517(a) (42 U.S.C. 3056o(a)) is amended to read as follows:
``(a) In General.--There are authorized to be appropriated to carry
out this title $429,020,486 for fiscal year 2020, $454,761,715 for
fiscal year 2021, $482,047,418 for fiscal year 2022, $510,970,263 for
fiscal year 2023, $541,628,478 for fiscal year 2024, $574,126,187 for
fiscal year 2025, and $608,573,758 for fiscal year 2026.''.
TITLE V--ENHANCING GRANTS FOR NATIVE AMERICANS
SEC. 501. REAUTHORIZATION.
Title VI (42 U.S.C. 3057 et seq.) is amended--
(1) in part D (42 U.S.C. 3057l et seq.)--
(A) by amending section 643 (42 U.S.C. 3057n) to
read as follows--
``SEC. 643. AUTHORIZATION OF APPROPRIATIONS.
``There are authorized to be appropriated to carry out this title--
``(1) for parts A and B, $38,524,324 for fiscal year 2020,
$40,835,783 for fiscal year 2021, $43,285,930 for fiscal year
2022, $45,883,086 for fiscal year 2023, $48,636,071 for fiscal
year 2024, $51,554,235 for fiscal year 2025, and $54,647,489
for fiscal year 2026; and
``(2) for part C, $10,785,575 for fiscal year 2020,
$11,432,710 for fiscal year 2021, $12,118,672 for fiscal year
2022, $12,845,792 for fiscal year 2023, $13,616,540 for fiscal
year 2024, $14,433,532 for fiscal year 2025, and $15,299,544
for fiscal year 2026.''; and
(B) by adding at the end the following:
``SEC. 644. FUNDING SET ASIDE.
``Of the funds appropriated under section 643(1) for a fiscal year,
up to 5 percent shall be made available to carry out part D for such
fiscal year, provided that for such fiscal year--
``(1) the funds appropriated for parts A and B are greater
than the funds appropriated for fiscal year 2019; and
``(2) the Assistant Secretary makes available for parts A
and B no less than the amount of resources made available for
fiscal year 2019.'';
(2) by redesignating part D, as so amended, as part E; and
(3) by inserting after part C the following:
``PART D--SUPPORTIVE SERVICES FOR HEALTHY AGING AND INDEPENDENCE
``SEC. 636. PROGRAM.
``(a) In General.--The Assistant Secretary may carry out a
competitive demonstration program for making grants to tribal
organizations or organizations serving Native Hawaiians with
applications approved under part A or B, respectively, to pay for the
Federal share of carrying out programs serving Indians or Native
Hawaiians, to enable the organizations to build their capacity to
provide a wider range of in-home and community supportive services to
enable older individuals who are Indians or Native Hawaiians to
maintain their health and independence and to avoid long-term care
facility placement.
``(b) Supportive Services.--
``(1) In general.--Subject to paragraph (2), supportive
services described in subsection (a) may include any of the
activities described in section 321(a).
``(2) Priority.--The Assistant Secretary, in making grants
under this section, shall give priority to tribal organizations
or organizations serving Native Hawaiians that will use the
grant funds for supportive services described in subsection (a)
that are for in-home assistance, transportation, information
and referral, case management, health and wellness programs,
legal services, family caregiver support services, and other
services that directly support the independence of the older
individuals served.
``(3) Rule of construction.--Nothing in this section shall
be construed or interpreted to prohibit the provision of
supportive services under part A or B.''.
TITLE VI--MODERNIZING ALLOTMENTS FOR VULNERABLE ELDER RIGHTS PROTECTION
ACTIVITIES AND OTHER PROGRAMS
SEC. 601. REAUTHORIZATION; VULNERABLE ELDER RIGHTS PROTECTION
ACTIVITIES.
Section 702 (42 U.S.C. 3058a) is amended by striking subsections
(a) and (b) and inserting the following:
``(a) Ombudsman Program.--There are authorized to be appropriated
to carry out chapter 2, $18,110,027 for fiscal year 2020, $19,196,629
for fiscal year 2021, $20,348,427 for fiscal year 2022, $21,569,332 for
fiscal year 2023, $22,863,492 for fiscal year 2024, $24,235,301 for
fiscal year 2025, and $25,689,419 for fiscal year 2026.
``(b) Other Programs.--There are authorized to be appropriated to
carry out chapters 3 and 4, $5,119,287 for fiscal year 2020, $5,426,444
for fiscal year 2021, $5,752,031 for fiscal year 2022, $6,097,153 for
fiscal year 2023, $6,462,982 for fiscal year 2024, $6,850,761 for
fiscal year 2025, and $7,261,807 for fiscal year 2026.''.
SEC. 602. VOLUNTEER STATE LONG-TERM CARE OMBUDSMAN REPRESENTATIVES.
Section 712(a)(5) (42 U.S.C. 3058g(a)(5)) is amended by adding at
the end the following:
``(E) Rule of construction for volunteer ombudsman
representatives.--Nothing in this paragraph shall be
construed as prohibiting the program from reimbursing
or otherwise providing financial support to an
individual designated under subparagraph (A) as a
volunteer to represent a local Ombudsman entity for any
costs, such as transportation costs, incurred by the
individual in serving as such volunteer.''.
SEC. 603. PREVENTION OF ELDER ABUSE, NEGLECT, AND EXPLOITATION.
Section 721(b)(12) (42 U.S.C. 3058i(b)(12)) is amended--
(1) in subparagraph (C), by inserting ``community outreach
and education,'' after ``technical assistance,''; and
(2) in subparagraph (F)--
(A) by striking ``studying'' and inserting
``implementing''; and
(B) by inserting ``, programs, and materials''
after ``practices''.
SEC. 604. PRINCIPLES FOR PERSON-DIRECTED SERVICES AND SUPPORTS DURING
SERIOUS ILLNESS.
(a) Definitions.--
(1) Administrator.--The term ``Administrator'' means the
Administrator of the Administration for Community Living.
(2) Covered agency.--The term ``covered agency'' means--
(A) a State agency or area agency on aging; and
(B) a Federal agency other than the Department of
Health and Human Services, and a unit of that
Department other than the Administration on Aging, that
the Assistant Secretary determines performs functions
for which the principles are relevant, and the Centers
for Medicare & Medicaid Services.
(3) Principles.--The term ``principles'' means the
Principles for Person-directed Services and Supports during
Serious Illness, issued by the Administration on September 1,
2017, or an updated set of such Principles.
(4) State agency.--The term ``State agency'' has the
meaning given the term in section 102 of the Older Americans
Act of 1965 (42 U.S.C. 3002).
(b) Dissemination.--The Administrator shall disseminate the
principles to appropriate stakeholders within the aging network, as
determined by the Assistant Secretary, and to covered agencies. The
covered agencies may use the principles in setting priorities for
service delivery and care plans in programs carried out by the
agencies.
(c) Feedback.--The Administrator shall solicit, on an ongoing
basis, feedback on the principles from covered agencies, experts in the
fields of aging and dementia, and stakeholders who provide or receive
disability services.
(d) Report.--Not less often than once, but not more often than
annually, during the 3 years after the date of enactment of this Act,
the Administrator shall prepare and submit to Congress a report
describing the feedback received under subsection (c) and indicating if
any changes or updates are needed to the principles.
SEC. 605. EXTENSION OF THE SUPPORTING GRANDPARENTS RAISING
GRANDCHILDREN ACT.
Section 3(f) of the Supporting Grandparents Raising Grandchildren
Act (Public Law 115-196) is amended by striking ``3'' and inserting
``4''.
SEC. 606. BEST PRACTICES FOR HOME AND COMMUNITY-BASED OMBUDSMEN.
Not later than 3 years after the date of enactment of this Act, the
Assistant Secretary shall issue a report updating the best practices
for home and community-based ombudsmen that were included in the report
entitled ``Best Practices for Home and Community-Based Ombudsmen'',
issued by the National Direct Service Workforce Resource Center of the
Centers for Medicare & Medicaid Services and prepared by the Research
and Training Center at the University of Minnesota and The Lewin Group
(January 2013).
SEC. 607. SENIOR HOME MODIFICATION ASSISTANCE INITIATIVE.
Not later than 2 years after the date of enactment of this Act, the
Comptroller General of the United States shall conduct a study and
issue a report that includes--
(1) an inventory of Federal programs, administered by the
Department of Health and Human Services, the Department of
Housing and Urban Development, or any other Federal agency or
department determined appropriate by the Comptroller General,
that support evidence-based falls prevention, home assessments,
and home modifications for older individuals and individuals
with disabilities;
(2) statistical data, for recent fiscal years, on the
number of older individuals and individuals with disabilities
served by each Federal program described in paragraph (1) and
the approximate amount of Federal funding invested in each such
program;
(3) a demographic analysis of individuals served by each
such program for recent fiscal years;
(4) an analysis of duplication and gaps in populations
supported by the Federal programs described in paragraph (1);
(5) what is known about the impact of the Federal programs
described in paragraph (1) on health status and health outcomes
in populations supported by such programs;
(6) a review of Federal efforts to coordinate Federal
programs existing prior to the date of enactment of this Act
that support evidence-based falls prevention, home assessments,
and home modifications for older individuals and individuals
with disabilities and any considerations for improving
coordination, which may include an indication of the Federal
agency or department that is best suited to coordinate such
Federal programs; and
(7) information on the extent to which consumer-friendly
resources, such as a brochure, are available through the
National Eldercare Locator Service established under section
202(a)(21) of the Older Americans Act of 1965 (42 U.S.C.
3012(a)(21)), are accessible to all area agencies on aging, and
contain information on evidence-based falls prevention, home
assessments, and home modifications for older individuals
attempting to live independently and safely in their homes and
for the caregivers of such individuals.
TITLE VII--MISCELLANEOUS
SEC. 701. TECHNICAL CORRECTIONS.
The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is
amended--
(1) in section 102(37)(A) (42 U.S.C. 3002(37)(A)), by
striking ``paragraph (5)'' and inserting ``paragraph (26)'';
(2) in section 202(a)(23) (42 U.S.C. 3012(a)(23)), by
striking ``sections 307(a)(18) and 731(b)(2)'' and inserting
``sections 307(a)(13) and 731'';
(3) in section 202(e)(1)(A) (42 U.S.C. 3012(e)(1)(A)), by
moving the left margin of clause (i) 2 ems to the left;
(4) in sections 203(c)(7) (42 U.S.C. 3013(c)(7)),
207(b)(2)(B) (42 U.S.C. 3018(b)(2)(B)), and 215(i) (42 U.S.C.
3020e-1(i)), by striking ``Committee on Education and the
Workforce'' each place it appears and inserting ``Committee on
Education and Labor'';
(5) in section 207(b)(3)(A) (42 U.S.C. 3018(b)(3)(A)), by
striking ``Administrator of the Health Care Finance
Administration'' and inserting ``Administrator of the Centers
for Medicare & Medicaid Services'';
(6) in section 304(a)(3)(C) (42 U.S.C. 3024(a)(3)(C)), by
striking ``term'' and all that follows through ``does'' and
inserting ``term `State' does'';
(7) in section 306(a) (42 U.S.C. 3026(a))--
(A) in paragraph (1), by inserting ``the number of
older individuals at risk for institutional placement
residing in such area,'' before ``and the number of
older individuals who are Indians''; and
(B) in paragraph (2)(B), by striking ``who are
victims of'' and inserting ``with'';
(8) in section 339(2)(A)(ii)(I) (42 U.S.C. 3030g-
21(2)(A)(ii)(I)), by striking ``Institute of Medicine of the
National Academy of Sciences'' and inserting ``National
Academies of Sciences, Engineering, and Medicine'';
(9) in section 611 (42 U.S.C. 3057b), by striking ``(a)'';
and
(10) in section 614(c)(4) (42 U.S.C. 3057e(c)(4)), by
striking ``(a)(12)'' and inserting ``(a)(11)''.
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