Older Americans Act Reauthorization Act of 2016
An Act
To reauthorize the Older Americans Act of 1965, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SEC. 2. Definitions.
“(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.”
“(3) The term ‘adult protective services’ means such services provided to adults as the Secretary may specify and includes services such as—
“(A) receiving reports of adult abuse, neglect, or exploitation;
“(B) investigating the reports described in subparagraph (A);
“(C) case planning, monitoring, evaluation, and other casework and services; and
“(D) providing, arranging for, or facilitating the provision of medical, social service, economic, legal, housing, law enforcement, or other protective, emergency, or support services.”
“(4) The term ‘Aging and Disability Resource Center’ means an entity, network, or consortium established by a State as part of the State system of long-term care, to provide a coordinated and integrated system for older individuals and individuals with disabilities (as defined in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102)), and the caregivers of older individuals and individuals with disabilities, that provides—
“(A) comprehensive information on the full range of available public and private long-term care programs, options, service providers, and resources within a community, including information on the availability of integrated long-term care services, and Federal or State programs that provide long-term care services and supports through home and community-based service programs;
“(B) person-centered counseling to assist individuals in assessing their existing or anticipated long-term care needs and goals, and developing and implementing a person-centered plan for long-term care that is consistent with the desires of such an individual and designed to meet the individual’s specific needs, goals, and circumstances;
“(C) access for individuals to the full range of publicly-supported long-term care services and supports for which the individuals may be eligible, including home and community-based service options, by serving as a convenient point of entry for such programs and supports; and
“(D) in cooperation with area agencies on aging, centers for independent living described in part C of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f et seq.), and other community-based entities, information and referrals regarding available home and community-based services for individuals who are at risk for residing in, or who reside in, institutional settings, so that the individuals have the choice to remain in or to return to the community.”
“(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.”
; and
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.”
; and
“(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;”
“(F) to provide information and referrals regarding available home and community-based services for individuals who are at risk for residing in, or who reside in, institutional settings, so that the individuals have the choice to remain in or to return to the community;”
; and
“(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.”
“(b) There are authorized to be appropriated—
“(1) to carry out section 202(a)(21) (relating to the National Eldercare Locator Service), $2,088,758 for fiscal year 2017, $2,132,440 for fiscal year 2018, and $2,176,121 for fiscal year 2019;
“(2) to carry out section 215, $1,904,275 for fiscal year 2017, $1,944,099 for fiscal year 2018, and $1,983,922 for fiscal year 2019;
“(3) to carry out section 202 (relating to Elder Rights Support Activities under this title), $1,312,904 for fiscal year 2017, $1,340,361 for fiscal year 2018, and $1,367,817 for fiscal year 2019; and
“(4) to carry out section 202(b) (relating to the Aging and Disability Resource Centers), $6,271,399 for fiscal year 2017, $6,402,551 for fiscal year 2018, and $6,533,703 for fiscal year 2019.”
; and
SEC. 4. State and Community Programs on Aging.
“(D)
(i) For each of fiscal years 2017 through 2019, no State shall be allotted an amount that is less than 99 percent of the amount allotted to such State for the previous fiscal year.
“(ii) For fiscal year 2020 and each subsequent fiscal year, no State shall be allotted an amount that is less than 100 percent of the amount allotted to such State for fiscal year 2019.”
; and
“(H) in coordination with the State agency and with the State agency responsible for elder abuse prevention services, increase public awareness of elder abuse, neglect, and exploitation, and remove barriers to education, prevention, investigation, and treatment of elder abuse, neglect, and exploitation, as appropriate;”
; and
“(K) protection from elder abuse, neglect, and exploitation; and”
“(e) In this section, the term ‘adult child with a disability’ means a child who—
“(1) is age 18 or older;
“(2) is financially dependent on an older individual who is a parent of the child; and
“(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.”
“(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 age 59.
“(3) Older relative caregiver.—The term ‘older relative caregiver’ means a caregiver who—
“(A)
(i) is 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—
“(i) is the grandparent, stepgrandparent, or other relative (other than the parent) by blood, marriage, or adoption, of the child;
“(ii) is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling to serve as the primary caregivers of the child; and
“(iii) has a legal relationship to the child, such as legal custody, adoption, or guardianship, or is raising the child informally; and
“(C) in the case of a caregiver for an individual with a disability, is the parent, grandparent, or other relative by blood, marriage, or adoption, of the individual with a disability.”
; and
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”
“(1) aging network support activities under this section, $6,216,054 for fiscal year 2017, $6,346,048 for fiscal year 2018, and $6,476,043 for fiscal year 2019; and
“(2) elder rights support activities under this section, $10,856,828 for fiscal year 2017, $11,083,873 for fiscal year 2018, and $11,310,919 for fiscal year 2019.”
SEC. 6. Amendments to Community Service Senior Opportunities Act.
“(F) how the activities of grantees in the State under this title will be coordinated with activities carried out in the State under title I of the Workforce Innovation and Opportunity Act (29 U.S.C. 3111 et seq.) and other related programs (referred to in this subparagraph as ‘WIOA and related activities’), and how the State will reduce unnecessary duplication between the activities carried out under this title and the WIOA and related activities.”
; and
“(6) Combined state plan.—In lieu of the plan described in paragraph (1), a State may develop and submit a combined State plan in accordance with section 103 of the Workforce Innovation and Opportunity Act (29 U.S.C. 3113). For a State that obtains approval of such a combined State plan, that section 103 shall apply in lieu of this subsection and a reference in any other provision of this title (other than this subsection) to a State plan shall be considered to be a reference to that combined State plan.”
; and
“(C) Agreement on expected levels of performance.—
“(i) First 2 years.—Each grantee shall reach agreement with the Secretary on levels of performance for each measure described in subparagraph (A)(i), for each of the first 2 program years covered by the grant agreement. In reaching the agreement, the grantee and the Secretary shall take into account the expected levels proposed by the grantee and the factors described in subparagraph (D). The levels agreed to shall be considered to be the expected levels of performance for the grantee for such program years.
“(ii) Third and fourth year.—Each grantee shall reach agreement with the Secretary, prior to the third program year covered by the grant agreement, on levels of performance for each measure described in subparagraph (A), for each of the third and fourth program years so covered. In reaching the agreement, the grantee and the Secretary shall take into account the expected levels proposed by the grantee and the factors described in subparagraph (D). The levels agreed to shall be considered to be the expected levels of performance for the grantee for such program years.
“(D) Factors.—In reaching the agreements described in subparagraph (B), each grantee and the Secretary shall—
“(i) take into account how the levels involved compare with the expected levels of performance established for other grantees;
“(ii) ensure that the levels involved are adjusted, using an objective statistical model based on the model established by the Secretary in accordance with section 116(a)(3)(A)(viii)) of the Workforce Investment and Opportunity Act (29 U.S.C. 3141(a)(3)(A)(viii)); and
“(iii) take into account the extent to which the levels involved promote continuous improvement in performance accountability on the core measures and ensure optimal return on the investment of Federal funds.
“(E) Adjustments based on economic conditions and individuals served during the program year.—The Secretary shall, in accordance with the objective statistical model developed pursuant to subparagraph (D)(ii), adjust the expected levels of performance for a program year for grantees, to reflect the actual economic conditions and characteristics of participants in the corresponding projects during such program year.”
; and
“(B) the percentage of project participants who are in unsubsidized employment during the second quarter after exit from the project;
“(C) the percentage of project participants who are in unsubsidized employment during the fourth quarter after exit from the project;
“(D) the median earnings of project participants who are in unsubsidized employment during the second quarter after exit from the project;
“(E) indicators of effectiveness in serving employers, host agencies, and project participants; and
“(F) the number of eligible individuals served, including the number of participating individuals described in subsection (a)(3)(B)(ii) or (b)(2) of section 518.”
“(iv) Use of core indicators.—For purposes of assessing grantee performance under this subparagraph before program year 2017, the Secretary shall use the core indicators of performance in effect at the time of the award and the most recent corresponding expected levels of performance.”
“(4) Special rule for implementation.—The Secretary shall implement the core measures of performance described in this section not later than December 31, 2017.”
; and
“(e) Impact on Grant Competition.—Effective on January 1, 2018, the Secretary may not publish a notice announcing a grant competition under this title, or solicit proposals for grants, until the day on which the Secretary implements the core measures of performance.”
“(5) Local workforce development board; state workforce development board.—The terms ‘local workforce development board’ and ‘State workforce development board’ have the meanings given the terms ‘local board’ and ‘State board’, respectively, in section 3 of the Workforce Innovation and Opportunity Act (29 U.S.C. 3102).”
SEC. 7. Grants for Native Americans.
SEC. 8. Vulnerable Elder Rights Protection Activities.
“(b) Other Programs.—There are authorized to be appropriated to carry out chapters 3 and 4, $4,891,876 for fiscal year 2017, $4,994,178 for fiscal year 2018, and $5,096,480 for fiscal year 2019.”
; and
“(i) are made by, or on behalf of, residents, including residents with limited or no decisionmaking capacity and who have no known legal representative, and if such a resident is unable to communicate consent for an Ombudsman to work on a complaint directly involving the resident, the Ombudsman shall seek evidence to indicate what outcome the resident would have 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”
“(vii) identify, investigate, and resolve complaints described in clause (iii) that are made by or on behalf of residents with limited or no decisionmaking capacity and who have no known legal representative, and if such a resident is unable to communicate consent for an Ombudsman to work on a complaint directly involving the resident, the Ombudsman shall seek evidence to indicate what outcome the resident would have 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.”
“(C) notwithstanding subparagraph (B), ensure that the Ombudsman may disclose information as needed in order to best serve residents with limited or no 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) and (5)(B) of subsection (a).”
; and
“(f) Conflict of Interest.—
“(1) Individual conflict of interest.—The State agency shall—
“(A) ensure that no individual, or member of the immediate family of an individual, involved in the designation of the Ombudsman (whether by appointment or otherwise) or the designation of an entity designated under subsection (a)(5), is subject to a conflict of interest;
“(B) ensure that no officer or employee of the Office, representative of a local Ombudsman entity, or member of the immediate family of the officer, employee, or representative, is subject to a conflict of interest; and
“(C) ensure that the Ombudsman—
“(i) does not have a direct involvement in the licensing or certification of a long-term care facility or of a provider of a long-term care service;
“(ii) does not have an ownership or investment interest (represented by equity, debt, or other financial relationship) in a long-term care facility or a long-term care service;
“(iii) is not employed by, or participating in the management of, a long-term care facility or a related organization, and has not been employed by such a facility or organization within 1 year before the date of the determination involved;
“(iv) does not receive, or have the right to receive, directly or indirectly, remuneration (in cash or in kind) under a compensation arrangement with an owner or operator of a long-term care facility;
“(v) does not have management responsibility for, or operate under the supervision of an individual with management responsibility for, adult protective services; and
“(vi) does not serve as a guardian or in another fiduciary capacity for residents of long-term care facilities in an official capacity (as opposed to serving as a guardian or fiduciary for a family member, in a personal capacity).
“(2) Organizational conflict of interest.—
“(A) In general.—The State agency shall comply with subparagraph (B)(i) in a case in which the Office poses an organizational conflict of interest, including a situation in which the Office is placed in an organization that—
“(i) is responsible for licensing, certifying, or surveying long-term care services in the State;
“(ii) is an association (or an affiliate of such an association) of long-term care facilities, or of any other residential facilities for older individuals;
“(iii) provides long-term care services, including programs carried out under a Medicaid waiver approved under section 1115 of the Social Security Act (42 U.S.C. 1315) or under subsection (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;
“(vii) is responsible for eligibility determinations for the Medicaid program carried out under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.);
“(viii) conducts preadmission screening for placements in facilities described in clause (ii); or
“(ix) makes decisions regarding admission or discharge of individuals to or from such facilities.
“(B) Identifying, removing, and remedying organizational conflict.—
“(i) In general.—The State agency may not operate the Office or carry out the program, directly, or by contract or other arrangement with any public agency or nonprofit private organization, in a case in which there is an organizational conflict of interest (within the meaning of subparagraph (A)) unless such conflict of interest has been—
“(I) identified by the State agency;
“(II) disclosed by the State agency to the Assistant Secretary in writing; and
“(III) remedied in accordance with this subparagraph.
“(ii) Action by assistant secretary.—In a case in which a potential or actual organizational conflict of interest (within the meaning of subparagraph (A)) involving the Office is disclosed or reported to the Assistant Secretary by any person or entity, the Assistant Secretary shall require that the State agency, in accordance with the policies and procedures established by the State agency under 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).”
; and
“(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”
; and