S. 1562 — what changed
Older Americans Act Reauthorization Act of 2013
From Introduced in Senate to Reported in Senate. 8 sections amended between Introduced in Senate and Reported in Senate.
Section 1 Short title
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This Act may be cited as the “Older Americans Act Reauthorization Act of 2013”.2014”.
Sec. 2 Definitions
Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is amended—
“(1) The term abuse means the knowing infliction of physical or psychological harm or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm.”
added “(3) The term adult protective services means such services provided to adults as the Secretary may specify and includes services such as—
added “(A) receiving reports of adult abuse, neglect, or exploitation;
added “(B) investigating the reports described in subparagraph (A);
added “(C) case planning, monitoring, evaluation, and other casework and services; and
added “(D) providing, arranging for, or facilitating the provision of medical, social service, economic, legal, housing, law enforcement, or other protective, emergency, or support services.”
“(4) The term Aging and Disability Resource Center means an entity, network, or consortium established by a State as part of the State system of long-term care, to provide a coordinated and integrated system for older individuals and individuals with disabilities (as defined in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102)), and the caregivers of older individuals and individuals with disabilities, that provides—
“(A) comprehensive information on the full range of available public and private long-term care programs, options, service providers, and resources within a community, including information on the availability of integrated long-term care services, and Federal or State programs that provide long-term care services and supports through home and community-based service programs;
“(B) person-centered counseling to assist individuals in assessing their existing or anticipated long-term care needs and goals, and developing and implementing a person-centered plan for long-term care that is consistent with the desires of such an individual and designed to meet the individual's specific needs, goals, and circumstances;
added “(C) access for individuals to the full range of publicly-supported long-term care services and supports for which the individuals may be eligible, including home and community-based service options, by serving as a convenient point of entry for such programs and supports; and
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“(C) access for individuals to the full range of publicly supported long-term care services and supports for which the individuals may be eligible, including home and community-based service options, by serving as a convenient point of entry for such programs and supports; and
“(D) in cooperation with area agencies on aging, centers for independent living described in part C of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f et seq.), and other community-based entities, information and referrals regarding available home and community-based services for individuals who are at risk for residing in, or who reside in, institutional settings, so that the individuals have the choice to remain in or to return to the community.”
“(17) The term elder justice means—
“(A) from a societal perspective, efforts to—
“(i) prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation; and
“(ii) protect older individuals with diminished capacity while maximizing their autonomy; and
“(B) from an individual perspective, the recognition of an older individual’s rights, including the right to be free of abuse, neglect, and exploitation.”
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“(55) The term adult protective services means such services provided to adults as the Secretary may specify and includes services such as—
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“(A) receiving reports of adult abuse, neglect, or exploitation;
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“(B) investigating the reports described in subparagraph (A);
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“(C) case planning, monitoring, evaluation, and other casework and services; and
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“(D) providing, arranging for, or facilitating the provision of medical, social service, economic, legal, housing, law enforcement, or other protective, emergency, or support services.”
Sec. 3 Administration on Aging
“(M) collect and analyze best practices related to responding to elder abuse, neglect, and exploitation in long-term care facilities, and publish a report of such best practices.”
“(29) provide information and technical assistance to States, area agencies on aging, and service providers, in collaboration with relevant Federal agencies, on providing efficient, person-centered transportation services, including across geographic boundaries;
“(30) identify model programs and provide information and technical assistance to States, area agencies on aging, and service providers (including providers operating multipurpose senior centers), to support the modernization of multipurpose senior centers; and
“(31) provide technical assistance to and share best practices with States, area agencies on aging, and Aging and Disability Resource Centers, on how to collaborate and coordinate services with health care entities, such as Federally-qualified health centers, as defined in section 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1396d(l)(2)(B)), in order to improve care coordination for individuals with multiple chronic illnesses.”
“(D) when feasible, developing, in consultation with States and national organizations, a consumer-friendly tool to assist older individuals and their families in choosing home and community-based services, with a particular focus on ways for consumers to assess how providers protect the health, safety, welfare, and rights, including the rights provided under section 314, of older individuals;”
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“(F) to provide information and referrals regarding available home and community-based services for individuals who are at risk for residing in, or who reside in, institutional settings, so that the individuals have the choice to remain in or to return to the community.”community;”
“(g) The Assistant Secretary shall, as appropriate, ensure that programs authorized under this Act include appropriate training in the prevention of abuse, neglect, and exploitation and provision of services that address elder justice and the exploitation of older individuals.”
Sec. 4 State and community programs on aging
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“(H) in coordination with the State agency and with the State agency responsible for elder abuse prevention services, increase public awareness of elder abuse, neglect, and exploitation, and remove barriers to education, prevention, investigation, and treatment of elder abuse abuse, neglect, and exploitation education, exploitation, as appropriate;”
“(K) protection from elder abuse, neglect, and exploitation; and”
added “(e) In this section, the term adult child with a disability means a child who—
added “(1) is age 18 or older;
added “(2) is financially dependent on an older individual who is a parent of the child; and
added “(3) has a disability.”
“(L) where feasible, encourages the use of locally grown foods in meal programs and identifies potential partnerships and contracts with local producers and providers of locally grown foods.”
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“(2) Individual with a disability—The term individual with a disability means an individual with a disability, as defined in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102), who is not less than age 18 and not more than 59 years of age.age 59.
“(3) Older relative caregiver—The term older relative caregiver means a caregiver who—
“(A)
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“(i) is 55 years of age 55 or older; and
“(ii) lives with, is the informal provider of in-home and community care to, and is the primary caregiver for, a child or an individual with a disability;
“(B) in the case of a caregiver for a child—
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“(i) is the grandparent, stepgrandparent, stepgrandparent, or other relative (other than the parent) by blood, marriage, or adoption, of the child;
“(ii) is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling to serve as the primary caregivers of the child; and
“(iii) has a legal relationship to the child, such as legal custody, adoption, or guardianship, or is raising the child informally; and
“(C) in the case of a caregiver for an individual with a disability, is the parent, grandparent, or other relative by blood, marriage, or adoption, of the individual with a disability.”
Sec. 5 Activities for health, independence, and longevity
“(13) continuing support for program integrity initiatives concerning the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) that train senior volunteers to prevent and identify health care fraud and abuse; and”
Sec. 8 Vulnerable elder rights protection activities
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“(i) are made by, or on behalf of, residents, including residents with limited or no decision-making decisionmaking capacity and who have no known legal representative, and if such a resident is unable to communicate consent for an Ombudsman to work on a complaint directly involving the resident, the Ombudsman shall seek evidence to indicate what outcome the resident would have communicated (and, in the absence of evidence to the contrary, shall assume that the resident wishes to have the resident’s health, safety, welfare, and rights protected) and shall work to accomplish that outcome; and”
“(I) when feasible, continue to carry out the functions described in this section on behalf of residents transitioning from a long-term care facility to a home care setting; and”
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“(vii) identify, investigate, and resolve complaints described in clause (iii) that are made by or on behalf of residents with limited or no decision-making decisionmaking capacity and who have no known legal representative, and if such a resident is unable to communicate consent for an Ombudsman to work on a complaint directly involving the resident, the Ombudsman shall seek evidence to indicate what outcome the resident would have communicated (and, in the absence of evidence to the contrary, shall assume that the resident wishes to have the resident’s health, safety, welfare, and rights protected) and shall work to accomplish that outcome; and”
“(3) Health oversight agency—For purposes of section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (including regulations issued under that section) (42 U.S.C. 1320d–2 note), the Ombudsman and a representative of the Office shall be considered a “health oversight agency,” so that release of residents' individually identifiable health information to the Ombudsman or representative is not precluded in cases in which the requirements of clause (i) or (ii) of paragraph (1)(B), or the requirements of paragraph (1)(D), are otherwise met.”
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“(C) notwithstanding subparagraph (B), ensure that the Ombudsman may disclose information as needed in order to best serve residents with limited or no decision-making decisionmaking capacity who have no known legal representative and are unable to communicate consent, in order for the Ombudsman to carry out the functions and duties described in paragraphs (3)(A)(i) (3)(A) and (5)(B)(vi) (5)(B) of subsection (a).”
“(f) Conflict of interest
“(1) Individual conflict of interest—The State agency shall—
“(A) ensure that no individual, or member of the immediate family of an individual, involved in the designation of the Ombudsman (whether by appointment or otherwise) or the designation of an entity designated under subsection (a)(5), is subject to a conflict of interest;
“(B) ensure that no officer or employee of the Office, representative of a local Ombudsman entity, or member of the immediate family of the officer, employee, or representative, is subject to a conflict of interest; and
“(C) ensure that the Ombudsman—
“(i) does not have a direct involvement in the licensing or certification of a long-term care facility or of a provider of a long-term care service;
“(ii) does not have an ownership or investment interest (represented by equity, debt, or other financial relationship) in a long-term care facility or a long-term care service;
“(iii) is not employed by, or participating in the management of, a long-term care facility or a related organization, and has not been employed by such a facility or organization within 1 year before the date of the determination involved;
“(iv) does not receive, or have the right to receive, directly or indirectly, remuneration (in cash or in kind) under a compensation arrangement with an owner or operator of a long-term care facility;
“(v) does not have management responsibility for, or operate under the supervision of an individual with management responsibility for, adult protective services; and
“(vi) does not serve as a guardian or in another fiduciary capacity for residents of long-term care facilities in an official capacity (as opposed to serving as a guardian or fiduciary for a family member, in a personal capacity).
“(2) Organizational conflict of interest
“(A) In general—The State agency shall comply with subparagraph (B)(i) in a case in which the Office poses an organizational conflict of interest, including a situation in which the Office is placed in an organization that—
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“(i) is responsible for licensing, certifying certifying, or surveying long-term care services in the State;
“(ii) is an association (or an affiliate of such an association) of long-term care facilities, or of any other residential facilities for older individuals;
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“(iii) provides long-term care services, including programs carried out under a Medicaid waiver approved under section 1115 of the Social Security Act (42 U.S.C. 1315) or under subsection (c) or (b) or (c) of section 1915 of the Social Security Act (42 U.S.C. 1396n), or under a Medicaid State plan amendment under subsection (i), (j), or (k) of section 1915 of the Social Security Act (42 U.S.C. 1396n);
“(iv) provides long-term care case management;
“(v) sets rates for long-term care services;
“(vi) provides adult protective services;
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“(vii) is responsible for eligibility determinations for the Medicaid program carried out under title XIX, XIX of the Social Security Act (42 U.S.C. 1395 et seq., 1396 et seq.);
“(viii) conducts preadmission screening for placements in facilities described in clause (ii); or
“(ix) makes decisions regarding admission or discharge of individuals to or from such facilities.
“(B) Identifying, removing, and remedying organizational conflict
“(i) In general—The State agency may not operate the Office or carry out the program, directly, or by contract or other arrangement with any public agency or nonprofit private organization, in a case in which there is an organizational conflict of interest (within the meaning of subparagraph (A)) unless such conflict of interest has been—
“(I) identified by the State agency;
“(II) disclosed by the State agency to the Assistant Secretary in writing; and
“(III) remedied in accordance with this subparagraph.
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“(ii) Action by Assistant Secretary—In a case in which a potential or actual organizational conflict of interest (within the meaning of subparagraph (A)) involving the Office is disclosed or reported to the Assistant Secretary by any person or entity, the Assistant Secretary shall require that the State agency, in accordance with the policies and procedures established by the State agency under section 705(a)(5)(D)(iii)—subsection (a)(5)(D)(iii)—
“(I) remove the conflict; or
“(II) submit, and obtain the approval of the Assistant Secretary for, an adequate remedial plan that indicates how the Ombudsman will be unencumbered in fulfilling all of the functions specified in subsection (a)(3).”
“(4) strengthen and update”
“(4) ensure that the Ombudsman or a designee participates in training provided by the National Ombudsman Resource Center established in section 202(a)(18);”
“(5) promoting the submission of data on elder abuse, neglect, and exploitation for the appropriate database of the Administration or another database specified by the Assistant Secretary;”
“(F) supporting and studying innovative practices in communities to develop partnerships across disciplines for the prevention, investigation, and prosecution of abuse, neglect, and exploitation; and”
Sec. 9 Behavioral health
The Older Americans Act of 1965 is amended—