Bill summaries are authored by CRS.

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Passed House amended (06/21/2006)

Senior Independence Act of 2006 - (Sec. 2) Reauthorizes the Older Americans Act of 1965.

Revises the definition of "information and assistance service" to include such a service for older individuals at risk for institutional placement. Defines the term "elder justice" to mean effort to prevent, detect, treat, intervene in, and respond to elder abuse, neglect, and exploitation and to protect elders with diminished capacity while maximizing their autonomy.

(Sec. 3) Authorizes the Assistant Secretary for Aging to designate within the Administration on Aging responsibility for elder abuse prevention and services. Assigns to the Assistant Secretary the duty of developing objectives, priorities, policy, and a plan for: (1) carrying out elder justice programs; (2) collecting and disseminating data relating to the abuse, neglect, and exploitation of older individuals (abuse); (3) disseminating information concerning best practices regarding, and providing training on, activities related to such abuse; (4) researching such abuse; (5) providing technical assistance to states and other entities; (6) assisting states and other entities in developing strategic plans to better coordinate elder justice activities, research, and training; and (7) promoting collaborative efforts and diminishing duplicative efforts in elder justice programs in all levels of government.

Authorizes the Assistant Secretary to designate an officer to be responsible for the administration of mental health services authorized under this Act. Establishes the duty of the Assistant Secretary to develop objectives, priorities, and a long-term plan for supporting state and local efforts involving education, prevention, detection, and treatment of mental disorders, including age-related dementia, depression, and Alzheimer's disease and related neurological disorders.

(Sec. 4) Adds as functions of the Administration on Aging: (1) providing assistance in the establishment and implementation of assistive technology services programs for older individuals; (2) coordinating activities with the Centers for Medicare and Medicaid Services and other federal entities to implement and build awareness of programs for older individuals; (3) providing technical assistance to service providers in informing older individuals with greatest economic need of the eligibility requirements for supplemental security income benefits, medical assistance, and benefits under the Food Stamp Act of 1977; (4) providing technical assistance and support for efforts to inform and enroll older individuals in programs for which they are eligible; (5) designing and implementing procedures for collecting information about services needed by older individuals, including services that would permit such individuals to receive long-term care in home and community-based settings; and (6) providing information and technical assistance to states, area agencies on aging, and service providers to support the effort to make available evidence-based disease prevention and health promotion services.

Authorizes the Administration on Aging to establish a National Center on Senior Benefits Outreach and Enrollment that shall: (1) maintain and update web-based decision support and enrollment tools and integrated, person-centered systems to inform older individuals about the full range of benefits for which they may be eligible; (2) utilize cost-effective strategies to find and enroll those with greatest economic need; (3) create and support efforts for Aging and Disability Resource Centers and other organizations and coalitions to serve as enrollment benefit centers; (4) develop and maintain an information clearinghouse on best practices and cost-effective methods for identifying and enrolling limited income older Americans in benefits; and (5) provide training and technical assistance on effective outreach, screening, enrollment and follow-up strategies.

Requires the Assistant Secretary to: (1) coordinate with other federal agencies responsible for formulating and implementing programs, benefits, and services related to providing long-term care; (2) conduct research and demonstration projects to identify strategies for modifying state long-term care systems to respond to the needs of older individuals and family caregivers and to target services to individuals at risk for institutional placement; (3) establish criteria and promote the implementation of evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability; (4) facilitate, in coordination with the Centers for Medicare and Medicaid Services, the Cash and Counseling National Program Office, and other appropriate federal entities, the provision of long-term care in home and community-based settings, including self-directed care models to help individuals avoid unnecessary nursing home placement and depletion of income and assets to qualify for Medicaid eligibility and to assist older individuals to develop a plan for long-term support; (5) provide for the Administration on Aging to play a lead role with respect to issues concerning home and community-based long-term care; (6) promote public awareness of the importance of, and resources available for, planning for long-term care; (7) implement in all states Aging and Disability Resource Centers; (8) establish a national technical assistance program to assist state agencies, area agencies on aging, and community-based service providers that receive funding under this Act in implementing such home and community-based long-term care systems and such evidence-based health promotion and disease prevention programs; and (9) develop performance standards and measures for use by states to determine the extent to which their systems of long-term care fulfill objectives of this Act.

Requires the Assistant Secretary to: (1) encourage and permit voluntary groups active in supportive services and civic engagement to participate in such programs or activities; (2) develop a comprehensive strategy for utilizing older individuals to address critical local needs of national concern, including through activities of pubic and nonprofit organizations such as community-based and faith-based organizations; and (3) encourage other community capacity building initiatives involving older individuals, with particular attention to initiatives that demonstrate the effectiveness and cost savings in meeting critical needs.

(Sec. 6) Repeals the authorization for the Assistant Secretary to provide staff and assistance to the Federal Council on the Aging.

Adds as duties of the officer responsible for the administration of nutrition services to: (1) design, implement, and evaluate evidence-based programs to support improved nutrition and regular physical activity for older individuals; (2) conduct outreach and disseminate evidence-based information to nutrition service providers about the benefits of healthful diets and regular physical activity; (3) disseminate guidance that describes strategies for improving the nutritional quality of provided meals; and (4) disseminate guidelines for conducting nutrient analyses of provided meals.

(Sec. 10) Requires the Assistant Secretary to conduct outreach and provide technical assistance to entities that serve older individuals in integrated health promotion and disease prevention programs that include nutrition education, physical activity, and other activities to modify behavior and to improve health literacy.

(Sec. 11) Revises requirements for pension counseling and information grant applications to include older individuals with limited English proficiency among those given particular emphasis in an outreach plan concerning retirement benefits.

(Sec. 12) Authorizes appropriations for: (1) administration salaries and expenses of the Administration on Aging; (2) the Eldercare Locator Service; (3) pension counseling and information programs; (4) supportive services; (5) congregate nutrition services; (6) home delivered nutrition services; and (7) disease prevention and health promotion services for FY2007-FY2011.

(Sec. 15) Includes among state eligibility requirements for grants for programs on aging assurance that preference will be given to providing services to older individuals, including low-income minority individuals, individuals with limited English proficiency, and individuals living in rural areas (currently particular attention is given to low-income minority individuals and older individuals residing in rural areas). Revises requirements for state grant applications to include the promotion of the development and implementation of a comprehensive, coordinated system for providing long-term care in home and community-based settings by: (1) coordinating with other state agencies responsible for providing such care; (2) participating in any state government activities concerning long-term care; (3) conducting analyses, making recommendations, and implementing programs and strategies to modify the state's system of long-term care; and (4) providing information on the need to plan for long-term care and the range of available long-term care resources.

(Sec. 16) Requires area plans to: (1) determine the extent of need for supportive services, nutrition services, and multipurpose senior centers by considering, among other things, the number of older individuals with low incomes residing in such area, the number at risk for institutional placement, and the number who have greatest economic need (with particular attention to low-income older individuals, low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); (2) provide assurance that the area agency on aging will set objectives, consistent with state policy, for providing services to older individuals with greatest economic need, greatest social need, and at risk for institutional placement; (3) include specific objectives for providing services to low-income minority older individuals and older individuals residing in rural areas; (4) include methods to achieve specific service objectives; (5) emphasize in outreach efforts older individuals at risk for institutional placement (6) provide assurance that the area agency on aging will coordinate planning, identification, assessment of needs, and provision of services for older individuals with disabilities, with particular attention to individuals at risk for institutional placement; (7) provide that the area agency will make use of trained volunteers in providing services and work in coordination with volunteer programs (including Corporation for National Services programs) designed to provide training, placement, and stipends for volunteers in community service settings; (8) provide that the area agency will include family caregivers, service providers, and the business community on its advisory council; and (9) increase public awareness of mental health disorders, remove barriers to diagnosis and treatment, and coordinate mental health services provided (including mental health screenings) with funds expended by the area agency on aging with mental health services provided by community health centers and by other public agencies and nonprofit private organizations.

Requires area plans to provide that the area agency on aging shall facilitate the area-wide development and implementation of a comprehensive, coordinated system to provide long-term care in home and community-based settings, in a manner responsive to the needs and preferences of older individuals and their family caregivers by: (1) coordinating with other local public and private agencies and organizations responsible for administering long-term care programs, benefits, and services; (2) analyzing, making recommendations, and implementing programs with respect to strategies for modifying the local system of long-term care; (3) implementing evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability; and (4) providing for the availability and distribution of information on the need to plan for long-term care and the range of available long-term care resources.

Requires area plans to provide: (1) assurances that funds received will be used in a manner that gives priority in furnishing benefits and services to older individuals with greatest economic need, greatest social need, and at risk for institutional placement; and (2) the furnishing of services under this Act consistent with self-directed care.

Authorizes area agencies to: (1) include in each such plan an assessment of how prepared the planning and service area is for a change in the number of older individuals during the next 10 years; and (2) make recommendations to government officials regarding actions by the area agency to build the area's capacity to meet the needs of older individuals for health and human services, land use, housing, transportation, public safety, workforce and economic development, recreation, education, civic engagement, and other services.

(Sec. 17) Requires state plans to provide that the state agency will conduct evaluations of the effectiveness of services provided to individuals with greatest economic need, greatest social need, or disabilities, low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas. Requires the plan, with respect to the preceding fiscal year, to: (1) identify the number of low-income minority older individuals in the state, including the number with limited English proficiency; and (2) describe the methods used to satisfy the service needs of such individuals, including individuals with limited English proficiency. Requires the plan to provide assurance that the state agency will require outreach efforts that will identify eligible individuals, with special emphasis on older individuals with greatest economic need and greatest social need, with particular attention to low-income minority individuals, individuals with limited English proficiency, and individuals residing in rural areas.

Requires that each such plan: (1) provide assurances that the area agencies on aging will provide for the furnishing of services under this Act consistent with self-directed care; and (2) include, at the election of the state, an assessment of how prepared the state is, under its service delivery model, for a change in the number of older individuals during the next 10 years. Allows such assessment to include: (1) the projected change in the number of older individuals in the state; (2) an analysis of how such change may affect such individuals; (3) an analysis of how the state programs, policies, and services can be improved, including by coordinating with area agencies on aging, and how resource levels can be adjusted to meet the needs of the changing population; and (4) an analysis of how the change in number of individuals 85 years of age and older is expected to affect the need for supportive services.

(Sec. 19) Requires the Secretary of Agriculture to give special emphasis to high protein foods in the commodities delivered under the nutrition services incentive program. Authorizes the Secretary to prescribe the terms and conditions respecting the donation of commodities under such program.

Limits amounts provided to state grantees and contractors for the purchase of U.S. agricultural commodities and other foods for their nutrition projects. Authorizes such entities to use part of their allocation to pay a school food authority to obtain such commodities and provides that such payments may cover transporting, distributing, processing, storing, and handling costs.

Authorizes appropriations for FY2007-FY2011 to carry out the nutrition services incentive program.

Requires the Assistant Secretary and the Secretary of Agriculture (currently the Secretary of Agriculture and the Secretary of Health and Human Services) to jointly disseminate to state agencies, area agencies on aging, and providers of nutrition services information concerning: (1) school food authorities participating in programs authorized under Richard B. Russell National School Lunch Act; and (2) available donated foods.

(Sec. 21) Adds as supportive services that the Assistant Secretary may fund through grants: (1) assistive technology devices and services to meet the needs of older individuals who are disabled and other individuals who provide uncompensated care to their adult children with disabilities; (2) services to support states, area agencies on aging, and local service providers in carrying out and coordinating mental health services activities including outreach, education, screening, and referral for treatment of older individuals; and (3) services to facilitate interaction between students (currently, school age children) and older individuals, including individuals with limited English proficiency and in long-term care settings.

(Sec. 22) States that the purpose of the nutrition projects grant program is to promote socialization and the health and well-being of older individuals by helping them gain access to disease prevention and health promotion services to delay the onset of health conditions resulting from poor nutrition or sedentary behavior. Requires states to provide nutrition education, counseling, and services to recipients of meals delivered by state nutrition projects.

(Sec. 23) Includes among nutrition projects for which states may receive grants: (1) congregate setting and home-delivered projects that provide nutrition education, nutrition counseling, and other nutrition services; and (2) congregate setting projects that provide a multivitamin-mineral supplement in addition to a daily meal.

(Sec. 26) Requires states to: (1) ensure their nutrition projects comply with the most recent Dietary Guidelines for Americans; and (2) encourage joint arrangements with facilities serving meals to children. Requires that such projects: (1) provide nutrition assessment; and (2) encourage professionals who distribute nutrition assistance to provide information to homebound seniors on how to get an influenza vaccination in their local areas.

(Sec. 27) Directs the Assistant Secretary for Aging to use allocated funds to contract with the Food and Nutrition Board of the Institute of Medicine to establish an independent panel of experts to conduct an evidence-based evaluation of nutrition projects.

(Sec. 28) Requires the Assistant Secretary to work in consultation with qualified experts to provide information on methods of improving indoor air quality in buildings where seniors congregate.

(Sec. 29) Amends the National Family Caregiver Support Act to include within the definition of "child" an individual who has a disability. Expands the definition of "family caregiver" to include an informal provider of in-home and community care to individuals with Alzheimer's disease or a related disorder with neurological and organic brain dysfunction. Decreases the specified age for a "grandparent or older individual who is a relative caregiver" to 55.

(Sec. 30) Includes in area agency on aging services providing assistance to caregivers in addressing issues related to health, nutrition, and financial literacy and in making decisions and solving problems related to their caregiving roles.

Requires each area agency to encourage the use of trained volunteers to expand available services and to coordinate with volunteer programs to provide training, placement, and stipends for volunteers in community services settings.

Requires the reports submitted by a state to the Assistant Secretary to include descriptions of any mechanisms used to provide family caregivers of an older individual and relative caregivers of a child or an adult with disability information about, and access to, services to better carry out their responsibilities.

(Sec. 32) Authorizes the Assistant Secretary to make grants for: (1) planning activities to prepare communities for the aging of the population; (2) developing, implementing, and assessing technology-based service models and best practices to support the use of health monitoring and assessment technology, communication devices, assistive technologies, and other technologies that may remotely connect family and professional caregivers to frail elderly residing in home and community-based settings or rural areas; (3) conducting activities of national significance to promote quality and continuous improvement in the support provided to family and other informal caregivers of older individuals through activities that include program evaluation, training, technical assistance, and research; (4) building public awareness of cognitive impairment such as Alzheimer's disease, related disorders with neurological and organic brain dysfunction, depression, and mental disorders; and (5) developing and enhancing multidisciplinary systems for the delivery of mental health screening and treatment referral services to improve access to community-based mental health services for older individuals. Authorizes appropriations for FY2007-FY2011.

(Sec. 33) Includes Hispanic serving institutions among institutions of higher education to which the Assistant Secretary shall make grants for career preparation for the field of aging.

(Sec. 34) Includes mental health care services among the services that receive support from the grant program for health care service demonstration projects in rural areas.

(Sec 35) Requires the Assistant Secretary, in awarding grants to demonstration projects for multigenerational activities, to give particular attention to low-income older individuals, including minority individuals, individuals with limited English proficiency, and individuals residing in rural areas.

(Sec. 36) Includes mental health care as a priority area of concern for the Resource Centers on Native American Elders for Native American programs.

(Sec. 37) Includes "diverse populations of older individuals residing in urban communities" among the areas of special emphasis of gerontology centers for which institutions may receive grants. Requires funded multidisciplinary centers of gerontology to: (1) serve as repositories of information about best practices in long-term care delivery, housing, and transportation; and (2) provide training and technical assistance to support the provision of community-based mental health services for older individuals.

(Sec. 39) Reauthorizes the community service employment-based training program for older Americans. (Changes the title of the rewritten provisions of the Older Americans Act of 1965 from the Older American Community Service Employment Act to the Older American Community Service Employment-Based Training Act.) Authorizes such program to provide vital social and human services to communities by providing work experiences to eligible individuals in public agencies and community- and faith-based organizations. Authorizes the Secretary to make grants to public and nonprofit agencies and organizations, agencies of a state, and tribal organizations to carry out the program. Sets forth requirements for the grant programs.

Repeals provisions that require the Secretary to develop alternatives for innovative work modes and provide technical assistance in creating job opportunities.

Requires not less than 65% (currently 75%) of funds for program grants shall be used to pay wages and benefits for eligible individuals who are employed under funded projects.

Repeals requirements for review and public comment on such projects. Requires the Secretary of Labor to use funds to carry out projects for developing and implementing techniques and approaches, and demonstrating the effectiveness of the specialized methods, in addressing eligible workers' employment and training needs. Sets forth provisions that outline what the projects may include.

Requires a state's chief executive officer, for the state to be eligible for funding, to submit a single state plan that outlines a three-year strategy for the statewide provision of training and related activities (currently, the governor submits the plan). Requires the state plan to be submitted with copies of public comments. Requires the plan to identify and address eligible minority individuals, including individuals who have limited English proficiency.

Authorizes the Secretary to reserve up to 1.5% from sums appropriated to carry out demonstration projects, pilot projects, and evaluation projects. Requires the Secretary to reserve an amount for national grants with public or nonprofit national Indian, Pacific Island, and Asian American aging organizations. Reserves funds to maintain FY2006 activities.

Requires the Secretary and each grantee to reach an agreement on the expected levels of performance for each program year for each of the core performance indicators. Requires the Secretary to establish a specified level of performance for entry into the unsubsidized employment core indicator of performance. Repeals the requirement that directs the Secretary to annually establish performance measures for each state. Requires that core indicators consist of: (1) entry into unsubsidized employment; (2) retention in unsubsidized employment for six months; (3) earnings; and (4) aggregate hours of community service employment-based training. Requires that the additional indicator of performance consist of: (1) retention in unsubsidized employment for a year; and (2) the number of eligible individuals served.

Repeals definitions for "placement into public or private unsubsidized employment" and "retention in public or private unsubsidized employment."

Requires the Secretary to award national grants for a period of three years through a competitive process. Allows the Secretary to award grants to a recipient who satisfies requirements to continue a project beyond such period (not to exceed two successive one-year periods).

Sets forth corrective efforts for national and state grantees that fail to meet the expected levels of performance.

Revises grant criteria to require the Secretary to select applicants that serve individuals over the age of 65 (currently, over age 60). Adds the applicant's prior performance in meeting performance measures as a factor for the Secretary to consider in awarding grants.

Authorizes appropriations.

Excludes unemployment compensation, benefits for the aged, blind, or disabled, veterans payments, or 25% of the survivors insurance benefits from the income of an "eligible individual" for such program.

Includes among uses of state allotments for the prevention of elder abuse, neglect, and exploitation the promotion of financial literacy to prevent identity theft and financial exploitation of older individuals.

(Sec. 40) Authorizes appropriations for: (1) the Native American Caregiver Support Program; (2) vulnerable elder rights protection activities; and (3) eligible Native American entity elder rights activities.

(Sec. 43) Allows state agencies to use allotments for programs for the prevention of elder abuse, neglect, and exploitation to provide for public education and outreach to promote financial literacy and prevent identity theft and financial exploitation.