Text of US SB 2763 (2014)

II 113TH CONGRESS 2D SESSION S. 2763 To amend the Older Americans Act of 1965 to create a collaborative network with a single point of entry for services and supports, to improve pro- grams to prevent elder financial exploitation, to create a community care wrap-around support demonstration program, and to create a na- tional campaign to raise awareness of the aging network and promote advance integrated long-term care planning, and for other purposes. IN THE SENATE OF THE UNITED STATES JULY 31, 2014 Mr. MERKLEY introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Older Americans Act of 1965 to create a collaborative network with a single point of entry for services and supports, to improve programs to prevent elder financial exploitation, to create a community care wrap-around support demonstration program, and to cre- ate a national campaign to raise awareness of the aging network and promote advance integrated long-term care planning, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 2 •S 2763 IS SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Older Americans Com- 2 munity Access Revitalization and Education Act’’ or the 3 ‘‘Older Americans CARE Act’’. 4 SEC. 2. DEFINITIONS. 5 (a) AGING AND DISABILITY RESOURCE CENTER.— 6 (1) IN GENERAL.—Section 102(4) of the Older 7 Americans Act of 1965 (42 U.S.C. 3002(4)) is 8 amended to read as follows: 9 ‘‘(4) The term ‘Aging and Disability Resource 10 Center’ means a collaborative network that has a no 11 wrong door single entry point system (as described 12 in section 10202(c)(5)(A) of the Patient Protection 13 and Affordable Care Act (42 U.S.C. 1396d note; re- 14 ferred to individually in this Act as a ‘no wrong door 15 system’)) and a comprehensive and integrated pro- 16 gram that— 17 ‘‘(A) is established by the State agency 18 and administered as identified by the State in 19 the State plan described in section 307 as part 20 of a State system of integrated long-term care 21 for individuals with disabilities and older indi- 22 viduals; 23 ‘‘(B) is planned and implemented in a 24 manner that involves formal partnerships, es- 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 3 •S 2763 IS tablished between aging and disability agencies 1 and organizations— 2 ‘‘(i) that are established so that indi- 3 viduals of all ages with needs for inte- 4 grated long-term care, can be properly 5 reached and served within their commu- 6 nities, while maximizing self-direction; and 7 ‘‘(ii) each of which is comprised of— 8 ‘‘(I) the State agency and area 9 agencies on aging at the State and 10 local levels, respectively; and 11 ‘‘(II) State and local disability 12 agencies and organizations, including 13 State independent living councils and 14 centers for independent living, entities 15 serving individuals with develop- 16 mental, physical, mental, or cognitive 17 disabilities, consumers, advocates, and 18 other entities and individuals; 19 ‘‘(C) provides a coordinated system for 20 providing— 21 ‘‘(i) an approach for providing access, 22 information, referrals, and assistance that 23 is person-centered, is a no wrong door sys- 24 tem, goes beyond providing access, infor- 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 4 •S 2763 IS mation, referrals, and assistance available 1 under or coordinated through this Act, and 2 serves all individuals regardless of age, in- 3 come, disability, or state of long-term care 4 services and supports planning; 5 ‘‘(ii) comprehensive information on 6 the full range of available public and pri- 7 vate programs of health and integrated 8 long-term care, and options counseling, 9 service providers, and resources for such 10 programs, within a community and within 11 a State, including information on the avail- 12 ability of integrated long-term care; 13 ‘‘(iii) personal and peer counseling to 14 assist individuals in assessing their existing 15 or anticipated needs and goals for inte- 16 grated long-term care, and assisting the in- 17 dividuals in developing and implementing a 18 plan for integrated long-term care, con- 19 sistent with their desires and designed to 20 meet their specific priorities, goals, needs, 21 and circumstances; and 22 ‘‘(iv) an approach that supplements 23 consumer access to the full range of pub- 24 licly supported programs of integrated 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 5 •S 2763 IS long-term care, including home-based and 1 community-based options, for which con- 2 sumers may be eligible; and 3 ‘‘(D) builds on but does not replace the 4 roles and responsibilities of entities in the State 5 aging network to support people seeking access 6 to community living opportunities, as specified 7 in this Act, or of other aging and disability 8 agencies and organizations.’’. 9 (2) TECHNICAL AMENDMENT.—Section 102(1) 10 of the Older Americans Act of 1965 (42 U.S.C. 11 3002(1)) is amended by inserting ‘‘, except when 12 used as part of the term ‘financial abuse’,’’ before 13 ‘‘means’’. 14 (b) LGBT INDIVIDUALS.— 15 (1) IN GENERAL.—Section 102 of the Older 16 Americans Act of 1965 (42 U.S.C. 3002) is amend- 17 ed— 18 (A) in paragraph (24)— 19 (i) in subparagraph (B), by striking 20 ‘‘and’’ at the end; 21 (ii) in subparagraph (C), by striking 22 the period and inserting ‘‘; and’’; and 23 (iii) by adding at the end the fol- 24 lowing: 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 6 •S 2763 IS ‘‘(D) status as an LGBT individual.’’; 1 (B) by redesignating— 2 (i) paragraphs (36) through (54) as 3 paragraphs (38) through (56), respectively; 4 and 5 (ii) paragraphs (34) and (35) as para- 6 graphs (35) and (36), respectively; 7 (C) by inserting after paragraph (33) the 8 following: 9 ‘‘(34) The term ‘LGBT’, used with respect to 10 an individual, means a lesbian, gay, bisexual, or 11 transgender individual.’’; and 12 (D) by inserting after paragraph (36), as 13 so redesignated, the following: 14 ‘‘(37) The term ‘minority’, used with respect to 15 an individual, includes a lesbian, gay, bisexual, or 16 transgender individual.’’. 17 (2) CONFORMING AMENDMENT.—Section 18 215(e)(1)(J) of the Older Americans Act of 1965 19 (42 U.S.C. 3020e–1(e)(1)(J)) is amended by strik- 20 ing ‘‘minorities’’ and inserting ‘‘minority individ- 21 uals’’. 22 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 7 •S 2763 IS SEC. 3. CREATION OF NATIONAL CAMPAIGN TO RAISE 1 AWARENESS OF THE AGING NETWORK AND 2 PROMOTE ADVANCE INTEGRATED LONG- 3 TERM CARE PLANNING. 4 (a) IN GENERAL.—Section 202(b) of the Older 5 Americans Act of 1965 (42 U.S.C. 3012(b)) is amended 6 by striking paragraph (6) and inserting the following: 7 ‘‘(6) promote, through a coordinated public 8 education and outreach campaign carried out by the 9 National Eldercare Locator Service described in sub- 10 section (a)(21) and in coordination with other appro- 11 priate Federal agencies— 12 ‘‘(A) enhanced awareness by the public of 13 the importance of planning in advance for inte- 14 grated long-term care; and 15 ‘‘(B) the availability of national, State, and 16 local information and resources to assist in such 17 planning, as well as the existence of area agen- 18 cies on aging and other aging service providers 19 to provide direct assistance with such plan- 20 ning;’’. 21 (b) AUTHORIZATION OF APPROPRIATIONS.—Section 22 216 of the Older Americans Act of 1965 (42 U.S.C. 23 3020f) is amended— 24 (1) by redesignating subsection (c) as sub- 25 section (d); and 26 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 8 •S 2763 IS (2) by inserting after subsection (b) the fol- 1 lowing: 2 ‘‘(c) NATIONAL CAMPAIGN.—There is authorized to 3 be appropriated to carry out section 202(b)(6), 4 $3,000,000 for each of fiscal years 2015 through 2019.’’. 5 SEC. 4. NO WRONG DOOR NETWORKS. 6 Section 202(b)(8) of the Older Americans Act of 7 1965 (42 U.S.C. 2012(b)(8)) is amended— 8 (1) in the matter preceding subparagraph (A), 9 by striking ‘‘Aging and Disability Resource Cen- 10 ters—’’ and inserting ‘‘networks, such as Aging and 11 Disability Resource Centers, that are built on infor- 12 mation, referral, and assistance programs run by 13 aging and disability agencies and are collaborative 14 networks with no wrong door systems—’’; 15 (2) in subparagraphs (A), (C), and (D), by 16 striking ‘‘long-term care’’ each place it appears and 17 inserting ‘‘integrated long-term care’’; 18 (3) in subparagraph (A), by striking ‘‘commu- 19 nity-based care’’ and inserting ‘‘community-based 20 care services and supports’’; and 21 (4) in subparagraph (B), by striking ‘‘their 22 care’’ and inserting ‘‘their care services and sup- 23 ports’’. 24 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 9 •S 2763 IS SEC. 5. SUPPORTIVE SERVICES AND SENIOR CENTERS PRO- 1 GRAM. 2 Section 321(b)(1) of the Older Americans Act of 3 1965 (42 U.S.C. 3030d(b)(1)) is amended by inserting 4 ‘‘or modernization’’ after ‘‘construction’’. 5 SEC. 6. PILOT PROJECT ON SERVICES FOR RECIPIENTS OF 6 FEDERALLY ASSISTED HOUSING. 7 Part A of title IV of the Older Americans Act of 1965 8 (42 U.S.C. 3032 et seq.) is amended by adding at the end 9 the following: 10 ‘‘SEC. 423. PILOT PROJECT ON SERVICES FOR RECIPIENTS 11 OF FEDERALLY ASSISTED HOUSING. 12 ‘‘(a) DEFINITION.—In this section, the term ‘feder- 13 ally assisted housing’ means— 14 ‘‘(1) multifamily housing financed, insured, or 15 subsidized by the Rural Housing Service of the De- 16 partment of Agriculture or by the Department of 17 Housing and Urban Development; or 18 ‘‘(2) housing provided under the Low Income 19 Housing Tax Credit program carried out under sec- 20 tion 42 of the Internal Revenue Code of 1986. 21 ‘‘(b) FUNDING.—The Assistant Secretary may pro- 22 vide funding for a service provided under this Act (includ- 23 ing title V) packaged and targeted for residents of feder- 24 ally assisted housing. The Assistant Secretary may provide 25 such funding for a period of 2 years. 26 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 10 •S 2763 IS ‘‘(c) RECIPIENTS.—The Assistant Secretary shall 1 provide funding made available under subsection (b) 2 through area agencies on aging, other entities approved 3 by the Assistant Secretary, or designees of the agencies 4 or entities, to not-for-profit owners or managers of the 5 housing. 6 ‘‘(d) EVALUATIONS AND REPORTS.— 7 ‘‘(1) EVALUATIONS.—Each agency, entity, or 8 designee that receives funding under this section 9 shall evaluate the effectiveness of the services pro- 10 vided through the funding. 11 ‘‘(2) REPORTS.—The agency, entity, or des- 12 ignee shall, not later than 90 days after the end of 13 the funding period, prepare and submit to the As- 14 sistant Secretary a report containing the results of 15 the evaluation. 16 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 17 are authorized to be appropriated to carry out this section 18 such sums as may be necessary for each of fiscal years 19 2015 through 2017. Such sums shall remain available 20 through fiscal year 2018 for the purpose of carrying out 21 the evaluations and reports under subsection (d).’’. 22 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 11 •S 2763 IS SEC. 7. COMMUNITY CARE WRAP-AROUND SUPPORT DEM- 1 ONSTRATION PROGRAM. 2 Part A of title IV of the Older Americans Act of 1965 3 (42 U.S.C. 3032 et seq.), as amended by section 6, is fur- 4 ther amended by adding at the end the following: 5 ‘‘SEC. 424. COMMUNITY CARE WRAP-AROUND SUPPORT 6 DEMONSTRATION PROGRAM. 7 ‘‘(a) DEFINITIONS.— 8 ‘‘(1) COMMUNITY CARE WRAP-AROUND SUP- 9 PORT PARTNERSHIP.—The term ‘community care 10 wrap-around support partnership’ means a partner- 11 ship that— 12 ‘‘(A) carries out a program that serves not 13 fewer than 30 eligible older individuals; 14 ‘‘(B) includes— 15 ‘‘(i) a designated care coordinator, 16 who may be a nurse, registered dietitian, 17 case manager, health coach, or social work- 18 er, from an eligible entity and who, in con- 19 sultation with a primary care physician or 20 another relevant specialist described in 21 clause (ii), will be responsible for coordi- 22 nating services and supports offered under 23 title III for an older individual; and 24 ‘‘(ii) a consulting primary care physi- 25 cian, or other relevant specialist, receiving 26 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 12 •S 2763 IS compensation for participation in the part- 1 nership in a manner determined by the As- 2 sistant Secretary; and 3 ‘‘(C) may include an individual— 4 ‘‘(i) who is listed in the plan for the 5 community care wrap-around support part- 6 nership described in subsection (c)(2); 7 ‘‘(ii) for whom the eligible older indi- 8 vidual gives consent to participate in the 9 community care wrap-around support part- 10 nership, as that partnership relates to the 11 eligible older individual; and 12 ‘‘(iii) whose relationship to the older 13 individual is that of— 14 ‘‘(I) a family member, close per- 15 sonal friend, or unpaid designated 16 caregiver; 17 ‘‘(II) a legal or financial advisor; 18 ‘‘(III) a home care provider; 19 ‘‘(IV) a provider of transpor- 20 tation; 21 ‘‘(V) a registered dietitian; or 22 ‘‘(VI) a rehabilitation profes- 23 sional. 24 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 13 •S 2763 IS ‘‘(2) ELIGIBLE ENTITY.—The term ‘eligible en- 1 tity’ means— 2 ‘‘(A) an area agency on aging; 3 ‘‘(B) a home or community-based provider 4 of the activities described in subsection (d) 5 (such as a home care agency, or entity oper- 6 ating a senior center or adult day care facility); 7 or 8 ‘‘(C) another qualified entity the Assistant 9 Secretary determines to be appropriate to carry 10 out the activities described in subsection (d). 11 ‘‘(3) ELIGIBLE OLDER INDIVIDUAL.—The term 12 ‘eligible older individual’ means an older individual 13 who— 14 ‘‘(A) is age 65 or older; 15 ‘‘(B) who is eligible to receive assistance 16 under this Act; 17 ‘‘(C) who elects to enroll in the demonstra- 18 tion program, as described in subsection (e); 19 and 20 ‘‘(D) who— 21 ‘‘(i) has difficulty completing 2 or 22 more activities of daily living; 23 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 14 •S 2763 IS ‘‘(ii) has had at least one nonelective 1 hospital admission within the past 12 2 months; 3 ‘‘(iii) has received acute or subacute 4 rehabilitation services within the past 12 5 months; or 6 ‘‘(iv) meets such other criteria as the 7 Assistant Secretary determines to be ap- 8 propriate. 9 ‘‘(b) PROGRAM AUTHORIZED.— 10 ‘‘(1) IN GENERAL.—The Assistant Secretary 11 shall establish a demonstration program (referred to 12 in this section as the ‘demonstration program’ and 13 to be commonly known as the ‘community care ini- 14 tiative’) through which the Assistant Secretary shall 15 make grants to eligible entities in order to enable 16 such eligible entities to— 17 ‘‘(A) establish community care wrap- 18 around support partnerships; and 19 ‘‘(B) support the partnerships, enabling 20 the partnerships to carry out the activities de- 21 scribed in subsection (d). 22 ‘‘(2) DURATION.—Each grant awarded under 23 this section shall be for a period of 2 years. 24 ‘‘(c) APPLICATION.— 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 15 •S 2763 IS ‘‘(1) IN GENERAL.—Each eligible entity desir- 1 ing a grant under this section shall submit an appli- 2 cation to the Assistant Secretary at such time, in 3 such manner, and accompanied by such information 4 as the Assistant Secretary may reasonably require. 5 ‘‘(2) CONTENTS.—The application described in 6 this subsection shall include, at a minimum— 7 ‘‘(A) a plan describing the individuals, as 8 listed in subsection (a)(1)(C), that will, upon 9 consent of an eligible older individual, partici- 10 pate in the community care wrap-around sup- 11 port partnership as that partnership relates to 12 the eligible older individual; 13 ‘‘(B) a clear description of— 14 ‘‘(i) the protocols the eligible entity 15 will implement to identify the needs of 16 older individuals receiving services and 17 supports through the partnership; 18 ‘‘(ii) the range of intervention and 19 supportive services and supports that the 20 eligible entity will implement; and 21 ‘‘(iii) preliminary evidence of the effi- 22 cacy or effectiveness of the approach the 23 eligible entity proposes to use in providing 24 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 16 •S 2763 IS services and supports through the partner- 1 ship; and 2 ‘‘(C) an assurance that the partnership will 3 collect the information determined by the As- 4 sistant Secretary under subsection (h)(1). 5 ‘‘(d) USE OF FUNDS.—An eligible entity that receives 6 a grant under this section shall use the grant funds to 7 establish a community care wrap-around support partner- 8 ship and support the partnership, including requiring the 9 partnership to— 10 ‘‘(1) connect each participant with the commu- 11 nity care wrap-around support partnership; 12 ‘‘(2) assess each eligible older individual using 13 a standardized assessment instrument, such as a 14 comprehensive assessment reporting evaluation; 15 ‘‘(3) establish longitudinal care plans for each 16 eligible older individual; and 17 ‘‘(4) provide comprehensive, coordinated, and 18 continuous virtual or in-person access to the services 19 and supports offered under this Act, tailored to the 20 specific needs of the older individual involved, which 21 may include one or more of the following: 22 ‘‘(A) Medication management. 23 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 17 •S 2763 IS ‘‘(B) Medical nutrition therapy with a reg- 1 istered dietitian for individuals requiring dietary 2 modification for chronic disease management. 3 ‘‘(C) Limited environmental modifications, 4 such as safety equipment for showering, bath- 5 ing, or toileting or installation of safety, health, 6 and wellness monitoring technologies for an eli- 7 gible older individual. 8 ‘‘(D) Nutritional and dietary supports, 9 which may include nutrition counseling, edu- 10 cation, and the delivery of meals to the home or 11 assistance with purchasing groceries in order 12 to— 13 ‘‘(i) assure an appropriate diet con- 14 sistent with the medical needs, cultural 15 background, and faith traditions of an eli- 16 gible older individual; and 17 ‘‘(ii) identify opportunities for social- 18 ization within the home or the community 19 of an eligible older individual in order to 20 enhance the ability to participate in 21 healthy nutritional habits. 22 ‘‘(E) Transportation in order to meet the 23 medical and social needs of an eligible older in- 24 dividual. 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 18 •S 2763 IS ‘‘(F) Psychosocial supports to prevent iso- 1 lation and the potential for depression and cog- 2 nitive decline, which often accompany the lack 3 of human interaction. 4 ‘‘(G) Opportunities for exercise, as toler- 5 able and appropriate, to prevent further phys- 6 ical decline that may lead to preventable dis- 7 ability. 8 ‘‘(H) Opportunities for enjoyment through 9 activities or interactions, in person or virtually, 10 that enhance an eligible older individual’s life, 11 relationships, well-being, or sense of produc- 12 tivity, including providing the opportunities 13 through the use of technology products. 14 ‘‘(e) ELECTION TO PARTICIPATE.—The Assistant 15 Secretary shall determine and carry out an appropriate 16 method of ensuring that eligible older individuals have 17 agreed to enroll in a community care wrap-around support 18 partnership program. Enrollment in the demonstration 19 program shall be voluntary. 20 ‘‘(f) COMPLIANCE WITH OTHER LAWS.— 21 ‘‘(1) REGULATIONS.—Notwithstanding any pro- 22 vision of this section, each eligible entity receiving a 23 grant under this section shall ensure that the activi- 24 ties carried out under the grant comply with the reg- 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 19 •S 2763 IS ulations promulgated pursuant to section 264(c) of 1 the Health Insurance Portability and Accountability 2 Act of 1996 (42 U.S.C. 1320d–2 note), the Health 3 Information Technology for Economic and Clinical 4 Health Act (title XIII of division A and title IV of 5 division B of Public Law 111–5), and the amend- 6 ments made by such Act. 7 ‘‘(2) GUIDANCE.—The Assistant Secretary shall 8 ensure that the activities carried out under this sec- 9 tion are consistent with the guidance issued by the 10 Secretary on June 6, 2014, for implementing stand- 11 ards for person-centered planning and self-direction 12 in home and community-based services programs, 13 under section 2402(a) of the Patient Protection and 14 Affordable Care Act (42 U.S.C. 1396n note). 15 ‘‘(g) PARTNERSHIP INFORMATION COLLECTION.— 16 ‘‘(1) DURING THE FIRST YEAR OF THE DEM- 17 ONSTRATION PROGRAM.— 18 ‘‘(A) IN GENERAL.—During the first year 19 of the demonstration program, the community 20 care wrap-around support partnership, through 21 the designated care coordinator described in 22 subsection (a)(1)(B)(i), shall maintain a record 23 for each eligible older individual who is served 24 through the demonstration program. Such 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 20 •S 2763 IS record shall include detailed information about 1 the services and supports provided to the eligi- 2 ble older individual through the demonstration 3 program and shall be incorporated into the elec- 4 tronic health record of the eligible older indi- 5 vidual. 6 ‘‘(B) CONTENTS.—The Assistant Secretary 7 shall determine the information to be collected 8 in each record described in subparagraph (A), 9 which may include information on the types of 10 services and supports provided, referrals, mem- 11 bers of the community care wrap-around sup- 12 port partnership, and an impact statement on 13 the health of the eligible older individual served. 14 ‘‘(2) DURING THE SECOND YEAR OF THE DEM- 15 ONSTRATION PROGRAM.—During the second year of 16 the demonstration program, in addition to maintain- 17 ing the record described in paragraph (1), the des- 18 ignated care coordinator described in subsection 19 (a)(1)(B)(i) shall ensure that, through the record de- 20 scribed in paragraph (1), the community care wrap- 21 around support partnership is able to— 22 ‘‘(A) determine gaps in the provision of 23 services that can assist in the provision of com- 24 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 21 •S 2763 IS prehensive health and wellness care for the eli- 1 gible older individual; 2 ‘‘(B) connect the eligible older individual to 3 services under this Act that will address any 4 such gaps; and 5 ‘‘(C) subject to the consent of the eligible 6 older individual, make appointments for the eli- 7 gible older individual to receive needed services 8 and ensure that such participant’s primary care 9 physician and caregiver receive notice of the 10 needs. 11 ‘‘(h) DETERMINATION OF THE DEMONSTRATION 12 PROGRAM EFFECT ON PATIENT OUTCOMES.— 13 ‘‘(1) TRANSFER OF INFORMATION.—Each eligi- 14 ble entity shall collect, from each community care 15 wrap-around partnership supported by the eligible 16 entity, and report to the Assistant Secretary (in 17 such form and manner, and at such frequency, as 18 shall be specified by the Assistant Secretary) such 19 data as the Assistant Secretary determines to be ap- 20 propriate to monitor and analyze the demonstration 21 program. 22 ‘‘(2) INDEPENDENT ANALYSIS OF THE DEM- 23 ONSTRATION PROGRAM.—The Assistant Secretary 24 shall enter into an agreement with an entity to con- 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00021 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 22 •S 2763 IS duct an independent analysis, in consultation with 1 the Administrator for the Centers for Medicare & 2 Medicaid Services, and make a determination of 3 whether the activities described in subsection (d) re- 4 sult in— 5 ‘‘(A) a reduced number of hospital days 6 (other than days an eligible older individual 7 elects to remain in the hospital); 8 ‘‘(B) reduced hospital readmissions for eli- 9 gible older individuals; 10 ‘‘(C) reduced emergency room visits for eli- 11 gible older individuals; 12 ‘‘(D) improved health outcomes commensu- 13 rate, in each individual case, with the eligible 14 older individual’s stage of chronic illness; 15 ‘‘(E) improved efficiency of care, such as a 16 reduction of duplicative diagnostic and labora- 17 tory tests, for eligible older individuals; 18 ‘‘(F) a reduced cost of health care services; 19 ‘‘(G) improved or maintained nutrition sta- 20 tus, to manage chronic disease; 21 ‘‘(H) any delay of entry of eligible older in- 22 dividuals into institutional care; and 23 ‘‘(I) any other outcomes measures the As- 24 sistant Secretary determines to be appropriate. 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 23 •S 2763 IS ‘‘(3) IMPACT STUDY.— 1 ‘‘(A) EVALUATION.—The Assistant Sec- 2 retary, in consultation with the Administrator 3 for the Centers for Medicare & Medicaid Serv- 4 ices and using the information and data col- 5 lected under this subsection and subsection (g), 6 shall conduct an evaluation of the demonstra- 7 tion program, including comparing the well- 8 being and costs of care of participants in a 9 community care wrap-around support partner- 10 ship program, to the well-being and such costs 11 for patients who have not participated in such 12 a program, to determine the impact of the addi- 13 tional services and supports provided through 14 such a program and shall prepare findings from 15 the evaluation. 16 ‘‘(B) DETERMINATION ON EXPANSION.— 17 Based on the evaluation conducted under sub- 18 paragraph (A) and the independent analysis 19 conducted under paragraph (2), the Assistant 20 Secretary, in consultation with the Adminis- 21 trator for the Centers for Medicare & Medicaid 22 Services, shall determine whether expansion of 23 the demonstration program is appropriate. If 24 so, the Assistant Secretary, in consultation with 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 24 •S 2763 IS such Administrator, shall prepare a plan speci- 1 fying— 2 ‘‘(i) whether the expanded program 3 should involve a greater number of grants 4 to eligible entities, for community care 5 wrap-around support partnership programs 6 based on subsections (a) through (g); 7 ‘‘(ii) whether the expanded program 8 should involve grants to regional, state- 9 wide, or multi-State combinations of eligi- 10 ble entities to engage corresponding com- 11 munity care wrap-around support partner- 12 ships in corresponding areas, for such pro- 13 grams based on subsections (a) through 14 (g); and 15 ‘‘(iii) whether the expanded program 16 should be carried out through the Adminis- 17 tration on Aging and the Center for Medi- 18 care and Medicaid Innovation. 19 ‘‘(4) REPORT TO CONGRESS.—Not later than 1 20 year after the end of the demonstration program, 21 the Assistant Secretary shall submit to Congress a 22 report containing the findings, the results of the 23 independent analysis, the determination, and any 24 plan, prepared under paragraphs (1) through (3). 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 25 •S 2763 IS ‘‘(5) EXPANDED PROGRAM.—Subject to the 1 availability of appropriations, if the report contains 2 a plan prepared under paragraph (3)(B), the Assist- 3 ant Secretary may implement the expanded pro- 4 gram, in accordance with the plan, not sooner than 5 6 months after submission of the report. 6 ‘‘(i) IMPLEMENTATION DATE.—Not later than Janu- 7 ary 1, 2015, the Assistant Secretary shall issue a request 8 for proposals to carry out this section. 9 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 10 are authorized to be appropriated to carry out this section 11 such sums as may be necessary for each of fiscal years 12 2015 through 2019.’’. 13 SEC. 8. PREVENTION OF ELDER ABUSE, NEGLECT, AND EX- 14 PLOITATION. 15 (a) INTERVENTION OR DEVICES.—Section 16 712(a)(3)(H) of the Older Americans Act of 1965 (42 17 U.S.C. 3058g(a)(3)(H)) is amended— 18 (1) in clauses (ii) and (iii), by striking ‘‘and’’ 19 at the end; 20 (2) in clause (iii), by striking ‘‘provide technical 21 support for’’ and inserting ‘‘actively encourage and 22 assist in’’; and 23 (3) by adding at the end the following: 24 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 26 •S 2763 IS ‘‘(iv) identify interventions or devices (in- 1 cluding adult bed rails) that affect the rights 2 and safety of residents, including the use of 3 chemical and physical restraints; and 4 ‘‘(v) educate providers, residents, and fam- 5 ilies about the danger of those interventions 6 and devices; and’’. 7 (b) USE OF ALLOTMENTS.—Section 721(e)(2) of the 8 Older Americans Act of 1965 (42 U.S.C. 3058i(e)(2)) is 9 amended, in the matter preceding subparagraph (A), by 10 striking ‘‘report’’ and all that follows through ‘‘subsection 11 (b)(9)(B)(ii),’’ and inserting ‘‘report described in sub- 12 section (b) or a related referral’’. 13 SEC. 9. PREVENTION OF FINANCIAL ABUSE, FRAUD, AND 14 OTHER FINANCIAL EXPLOITATION. 15 (a) AUTHORIZATION OF APPROPRIATIONS.—Section 16 702 of the Older Americans Act of 1965 (42 U.S.C. 17 3058a) is amended— 18 (1) in subsection (c), by striking ‘‘chapter 4’’ 19 and inserting ‘‘chapter 5’’; and 20 (2) by inserting after subsection (b) the fol- 21 lowing: 22 ‘‘(c) PREVENTION OF FINANCIAL ABUSE, FRAUD, 23 AND OTHER FINANCIAL EXPLOITATION.—There are au- 24 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 27 •S 2763 IS thorized to be appropriated to carry out chapter 4, such 1 sums as may be necessary for each fiscal year.’’. 2 (b) PROGRAM.—Subtitle A of title VII of the Older 3 Americans Act of 1965 (42 U.S.C. 3058 et seq.) is amend- 4 ed— 5 (1) by redesignating chapter 4 and section 731 6 as chapter 5 and section 736, respectively; and 7 (2) by inserting after chapter 3 the following: 8 ‘‘CHAPTER 4—PROGRAMS FOR PREVEN- 9 TION OF FINANCIAL ABUSE, FRAUD, 10 AND OTHER FINANCIAL EXPLOI- 11 TATION 12 ‘‘SEC. 731. PREVENTION OF FINANCIAL ABUSE, FRAUD, AND 13 OTHER FINANCIAL EXPLOITATION. 14 ‘‘(a) ESTABLISHMENT.—In order to be eligible to re- 15 ceive an allotment under section 703 from funds appro- 16 priated under section 702 and made available to carry out 17 this chapter, a State agency shall, in accordance with this 18 section, and in consultation with area agencies on aging, 19 develop and enhance programs to address elder abuse, ne- 20 glect, and exploitation (including financial abuse, fraud, 21 and other financial exploitation). 22 ‘‘(b) USE OF ALLOTMENTS.—The State agency shall 23 use an allotment described in subsection (a) to carry out, 24 through the programs described in subsection (a), activi- 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 28 •S 2763 IS ties to develop, strengthen, and carry out programs for 1 the prevention, detection, assessment, and treatment of, 2 intervention in, investigation of, and response to elder 3 abuse, neglect, and exploitation (including financial abuse, 4 fraud, and other financial exploitation), including activi- 5 ties that— 6 ‘‘(1) fund programs that focus on outreach and 7 education to older individuals and their families and 8 support networks, on elder abuse, neglect, and ex- 9 ploitation (including financial abuse, fraud, and 10 other financial exploitation); 11 ‘‘(2) promote and enhance programs, such as 12 the Gatekeeper program, that train postal carriers, 13 financial institutions, firefighters, meter readers, 14 and other community professionals who are in a po- 15 sition to observe an older individual on a daily or 16 regular basis— 17 ‘‘(A) to identify signs of elder abuse, ne- 18 glect, and exploitation (including financial 19 abuse, fraud, and other financial exploitation); 20 and 21 ‘‘(B) to report such signs to the State 22 agency responsible for adult protective services 23 or an area agency on aging; 24 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 29 •S 2763 IS ‘‘(3) create a position for a statewide coordi- 1 nator on elder abuse, neglect, and exploitation (in- 2 cluding financial abuse, fraud, and other financial 3 exploitation), within each State agency responsible 4 for adult protective services or law enforcement, to 5 act as a liaison with various financial institutions in- 6 cluding the State agency responsible for consumer 7 protection; 8 ‘‘(4) provide funding to States and area agen- 9 cies on aging for trainers who are able to conduct 10 outreach and education for older individuals in their 11 natural living environment on— 12 ‘‘(A) identifying signs of elder abuse, ne- 13 glect, and exploitation (including financial 14 abuse, fraud, and other financial exploitation); 15 ‘‘(B) how to respond to practices described 16 in subparagraph (A); and 17 ‘‘(C) how to get help from local resources; 18 ‘‘(5) fund programs that capture data, and per- 19 form data analysis, on the prevalence of elder abuse, 20 neglect, and exploitation (including financial abuse, 21 fraud, and other financial exploitation) at the State 22 and national level; 23 ‘‘(6) provide intake workers or hotlines that are 24 able to take calls directly from older individuals, 25 VerDate Mar 15 2010 02:35 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS 30 •S 2763 IS their family members, and community professionals 1 in their planning and service areas, about elder 2 abuse, neglect, and exploitation (including financial 3 abuse, fraud, and other financial exploitation); 4 ‘‘(7) provide funding to States and area agen- 5 cies on aging for the services of forensic accountants 6 to track and identify elder abuse, neglect, and ex- 7 ploitation (including financial abuse, fraud, and 8 other financial exploitation); 9 ‘‘(8) fund programs and arrangement that will 10 safeguard victims’ or potential victims’ finances, 11 such as daily money management programs and 12 conservatorships; and 13 ‘‘(9) fund pilot programs to test innovative 14 practices in local communities, to develop partner- 15 ships across disciplines for the prevention, investiga- 16 tion, and prosecution of elder abuse, neglect, and ex- 17 ploitation (including financial abuse, fraud, and 18 other financial exploitation).’’. 19 (c) CONFORMING AMENDMENT.—Section 202(a)(23) 20 of the Older Americans Act of 1965 (42 U.S.C. 21 3012(a)(23)) is amended by striking ‘‘sections 307(a)(18) 22 and 731(b)(2)’’ and inserting ‘‘section 307(a)(13) and sec- 23 tion 736’’. 24 Æ VerDate Mar 15 2010 03:34 Aug 14, 2014 Jkt 039200 PO 00000 Frm 00030 Fmt 6652 Sfmt 6301 E:\BILLS\S2763.IS S2763 smartinez on DSK4TPTVN1PROD with BILLS