US Codex
Pub. L.
Notes

Title II — Improving Grants for State and Community Programs on Aging

116th Congress · Approved Mar 25, 2020 · 131 Stat. 240

TITLE II Improving Grants for State and Community Programs on Aging

SEC. 201. Social Determinants of Health.

Section 301(a)(1) (42 U.S.C. 3021(a)(1)) is amended—
(1)
in subparagraph (C), by striking “ and” at the end;
(2)
in subparagraph (D), by striking the period at the end and inserting “ ; and”; and
(3)
by adding at the end the following:

“(E) measure impacts related to social determinants of health of older individuals.”

SEC. 203. Reauthorization.

(a)
Grants for State and Community Programs on Aging.— Subsections (a) through (e) of section 303 (42 U.S.C. 3023) are amended to read as follows:

“(a)

(1) There are authorized to be appropriated to carry out part B (relating to supportive services) $412,029,180 for fiscal year 2020, $436,750,931 for fiscal year 2021, $462,955,987 for fiscal year 2022, $490,733,346 for fiscal year 2023, and $520,177,347 for fiscal year 2024.

“(2) Funds appropriated under paragraph (1) shall be available to carry out section 712.

“(b)

(1) There are authorized to be appropriated to carry out subpart 1 of part C (relating to congregate nutrition services) $530,015,940 for fiscal year 2020, $561,816,896 for fiscal year 2021, $595,525,910 for fiscal year 2022, $631,257,465 for fiscal year 2023, and $669,132,913 for fiscal year 2024.

“(2) There are authorized to be appropriated to carry out subpart 2 of part C (relating to home delivered nutrition services) $268,935,940 for fiscal year 2020, $285,072,096 for fiscal year 2021, $302,176,422 for fiscal year 2022, $320,307,008 for fiscal year 2023, and $339,525,428 for fiscal year 2024.

“(c) Grants made under part B, and subparts 1 and 2 of part C, of this title may be used for paying part of the cost of—

“(1) the administration of area plans by area agencies on aging designated under section 305(a)(2)(A), including the preparation of area plans on aging consistent with section 306 and the evaluation of activities carried out under such plans; and

“(2) the development of comprehensive and coordinated systems for supportive services, and congregate and home delivered nutrition services under subparts 1 and 2 of part C, the development and operation of multipurpose senior centers, and the delivery of legal assistance.

“(d) There are authorized to be appropriated to carry out part D (relating to disease prevention and health promotion services) $26,587,360 for fiscal year 2020, $28,182,602 for fiscal year 2021, $29,873,558 for fiscal year 2022, $31,665,971 for fiscal year 2023, and $33,565,929 for fiscal year 2024.

“(e) There are authorized to be appropriated to carry out part E (relating to family caregiver support) $193,869,020 for fiscal year 2020, $205,501,161 for fiscal year 2021, $217,831,231 for fiscal year 2022, $230,901,105 for fiscal year 2023, and $244,755,171 for fiscal year 2024.”

(b)
Nutrition Services Incentive Program.— Section 311(e) (42 U.S.C. 3030a(e)) is amended to read as follows:

“(e) There are authorized to be appropriated to carry out this section (other than subsection (c)(1)) $171,273,830 for fiscal year 2020, $181,550,260 for fiscal year 2021, $192,443,275 for fiscal year 2022, $203,989,872 for fiscal year 2023, and $216,229,264 for fiscal year 2024.”

SEC. 204. Hold Harmless Formula.

(a)
In General.— Section 304(a)(3)(D) (42 U.S.C. 3024(a)(3)(D)) is amended to read as follows:

“(D)

(i) In this subparagraph and paragraph (5)—

“(I) the term ‘allot’ means allot under this subsection from a sum appropriated under section 303(a) or 303(b)(1), as the case may be; and

“(II) the term ‘covered fiscal year’ means any of fiscal years 2020 through 2029.

“(ii) If the sum appropriated under section 303(a) or 303(b)(1) for a particular covered fiscal year is less than or equal to the sum appropriated under section 303(a) or 303(b)(1), respectively, for fiscal year 2019, amounts shall be allotted to States from the sum appropriated for the particular year in accordance with paragraphs (1) and (2), and subparagraphs (A) through (C) as applicable, but no State shall be allotted an amount that is less than—

“(I) for fiscal year 2020, 99.75 percent of the State’s allotment from the corresponding sum appropriated for fiscal year 2019;

“(II) for fiscal year 2021, 99.50 percent of that allotment;

“(III) for fiscal year 2022, 99.25 percent of that allotment;

“(IV) for fiscal year 2023, 99.00 percent of that allotment;

“(V) for fiscal year 2024, 98.75 percent of that allotment;

“(VI) for fiscal year 2025, 98.50 percent of that allotment;

“(VII) for fiscal year 2026, 98.25 percent of that allotment;

“(VIII) for fiscal year 2027, 98.00 percent of that allotment;

“(IX) for fiscal year 2028, 97.75 percent of that allotment; and

“(X) for fiscal year 2029, 97.50 percent of that allotment.

“(iii) If the sum appropriated under section 303(a) or 303(b)(1) for a particular covered fiscal year is greater than the sum appropriated under section 303(a) or 303(b)(1), respectively, for fiscal year 2019, the allotments to States from the sum appropriated for the particular year shall be calculated as follows:

“(I) From the portion equal to the corresponding sum appropriated for fiscal year 2019, amounts shall be allotted in accordance with paragraphs (1) and (2), and subparagraphs (A) through (C) as applicable, but no State shall be allotted an amount that is less than the percentage specified in clause (ii), for that particular year, of the State’s allotment from the corresponding sum appropriated for fiscal year 2019.

“(II) From the remainder, amounts shall be allotted in accordance with paragraph (1), subparagraphs (A) through (C) as applicable, and paragraph (2) to the extent needed to meet the requirements of those subparagraphs.”

(b)
Repeal.— Section 304(a)(3)(D) (42 U.S.C. 3024(a)(3)(D)) is repealed, effective October 1, 2029.
(c)
Conforming Amendment.— Section 304(a)(5) (42 U.S.C. 3024(a)(5)) is amended by striking “ of the prior year” and inserting “ as required by paragraph (3)”.

SEC. 205. Outreach Efforts.

Section 306(a)(4)(B) (42 U.S.C. 3026(a)(4)(B)) is amended—
(1)
in clause (i)(VII), by inserting “ , specifically including survivors of the Holocaust” after “ placement”; and
(2)
in clause (ii), by striking “ (VI)” and inserting “ (VII)”.

SEC. 206. State Long-Term Care Ombudsman Program Minimum Funding and Maintenance of Effort.

The Act (42 U.S.C. 3001 et seq.) is amended—
(1)
by amending section 306(a)(9) (42 U.S.C. 3026(a)(9)) to read as follows:

“(9) provide assurances that—

“(A) the area agency on aging, in carrying out the State Long-Term Care Ombudsman program under section 307(a)(9), will expend not less than the total amount of funds appropriated under this Act and expended by the agency in fiscal year 2019 in carrying out such a program under this title; and

“(B) funds made available to the area agency on aging pursuant to section 712 shall be used to supplement and not supplant other Federal, State, and local funds expended to support activities described in section 712;”

; and

(2)
by amending section 307(a)(9) (42 U.S.C. 3027(a)(9)) to read as follows:

“(9) The plan shall provide assurances that—

“(A) the State agency will carry out, through the Office of the State Long-Term Care Ombudsman, a State Long-Term Care Ombudsman program in accordance with section 712 and this title, and will expend for such purpose an amount that is not less than the amount expended by the State agency with funds received under this title for fiscal year 2019, and an amount that is not less than the amount expended by the State agency with funds received under title VII for fiscal year 2019; and

“(B) funds made available to the State agency pursuant to section 712 shall be used to supplement and not supplant other Federal, State, and local funds expended to support activities described in section 712.”

SEC. 207. Coordination with Resource Centers.

(a)
Area Plans.— Section 306(a) (42 U.S.C. 3026(a)) is amended—
(1)
in paragraph (16), by striking “ and” at the end;
(2)
in paragraph (17), by striking the period at the end and inserting a semicolon; and
(3)
by adding at the end the following:

“(18) provide assurances that the area agency on aging will collect data to determine—

“(A) the services that are needed by older individuals whose needs were the focus of all centers funded under title IV in fiscal year 2019; and

“(B) the effectiveness of the programs, policies, and services provided by such area agency on aging in assisting such individuals; and

“(19) provide assurances that the area agency on aging will use outreach efforts that will identify individuals eligible for assistance under this Act, with special emphasis on those individuals whose needs were the focus of all centers funded under title IV in fiscal year 2019.”

(b)
State Plans.— Section 307(a) (42 U.S.C. 3027(a)), as amended by section 118(c), is further amended by adding at the end the following:

“(30) The plan shall contain an assurance that the State shall prepare and submit to the Assistant Secretary annual reports that describe—

“(A) data collected to determine the services that are needed by older individuals whose needs were the focus of all centers funded under title IV in fiscal year 2019;

“(B) data collected to determine the effectiveness of the programs, policies, and services provided by area agencies on aging in assisting such individuals; and

“(C) outreach efforts and other activities carried out to satisfy the assurances described in paragraphs (18) and (19) of section 306(a).”

SEC. 208. Senior Legal Hotlines.

Not later than 4 years after the date of enactment of this Act, the Assistant Secretary shall prepare and submit to Congress a report containing—
(1)
information on which States or localities operate senior legal hotlines;
(2)
information on how such hotlines operated by States or localities are funded;
(3)
information on the usefulness of senior legal hotlines in the coordination and provision of legal assistance; and
(4)
recommendations on additional actions that should be taken related to senior legal hotlines.

SEC. 209. Increase in Limit on Use of Allotted Funds for State Administrative Costs.

Section 308 (42 U.S.C. 3028) is amended—
(1)
in subsection (a), in paragraphs (1) and (2), by striking “ subsection (b)(1)” and inserting “ subsection (b)”; and
(2)
in subsection (b)—
(A)
in each of paragraphs (1) and (2)—
(i)
in subparagraph (A)—
(I)
by striking “ clause (ii)” and inserting “ subparagraph (B)”; and
(II)
by striking “ greater of” and all that follows through “ or” and inserting the following:

“(i) 5 percent of the total amount of the allotments made to a State under sections 304(a)(1) and 373(f); or

“(ii) ”

; and

(ii)
in subparagraph (B), by striking “ such allotment” and inserting “ such total amount”; and
(B)
in paragraph (2)(A), by striking “ $500,000” and inserting “ $750,000”.

SEC. 210. Improvements to Nutrition Programs.

Section 308(b)(4) (42 U.S.C. 3028(b)(4)) is amended by adding at the end the following:

“(D) The State, in consultation with area agencies on aging, shall ensure the process used by the State in transferring funds under this paragraph (including requirements relating to the authority and timing of such transfers) is simplified and clarified to reduce administrative barriers and direct limited resources to the greatest nutrition service needs at the community level. Such process shall be modified to attempt to lessen the administrative barriers of such transfers, and help direct limited resources to where they are needed the most as the unmet need for nutrition services grows.”

SEC. 211. Review of Reports.

Section 308(b) (42 U.S.C. 3028(b)) is amended by adding at the end the following:

“(8) The Assistant Secretary shall review the reports submitted under section 307(a)(30) and include aggregate data in the report required by section 207(a), including data on—

“(A) the effectiveness of the programs, policies, and services provided by area agencies on aging in assisting older individuals whose needs were the focus of all centers funded under title IV in fiscal year 2019; and

“(B) outreach efforts and other activities carried out to satisfy the assurances described in paragraphs (18) and (19) of section 306(a), to identify such older individuals and their service needs.”

SEC. 212. Other Practices.

Section 315 (42 U.S.C. 3030c–2) is amended by adding at the end the following:

“(e) Response to Area Agencies on Aging.—

“(1) In general.—Upon request from an area agency on aging, the State shall make available any policies or guidance pertaining to policies established under this section.

“(2) Rule of construction.—Nothing in paragraph (1) shall require a State to develop policies or guidance pertaining to policies established under this section.”

SEC. 213. Screening for Negative Health Effects Associated with Social Isolation and Traumatic Brain Injury.

Section 321(a)(8) (42 U.S.C. 3030d(a)(8)) is amended—
(1)
by striking “ screening and” and inserting “ screening, screening for negative health effects associated with social isolation,”; and
(2)
by inserting “ , and traumatic brain injury screening” after “ falls prevention services screening”.

SEC. 214. Supportive Services and Senior Centers.

(a)
In General.— Section 321(a) (42 U.S.C. 3030d(a)) is amended—
(1)
in paragraph (24), by striking “ and” at the end;
(2)
by redesignating paragraph (25) as paragraph (26); and
(3)
by inserting after paragraph (24) the following:

“(25) services that promote or support social connectedness and reduce negative health effects associated with social isolation; and”

(b)
Supportive Services.— Section 321(a)(7) (42 U.S.C. 3030d(a)(7)) is amended by inserting “ cultural experiences (including the arts),” after “ art therapy,”.

SEC. 215. Culturally Appropriate, Medically Tailored Meals.

Section 339(2)(A)(iii) (42 U.S.C. 3030g–21(2)(A)(iii)) is amended by inserting “ , including meals adjusted for cultural considerations and preferences and medically tailored meals” before the comma at the end.

SEC. 216. Nutrition Services Study.

Subpart 3 of part C of title III (42 U.S.C. 3030g–21 et seq.) is amended by adding at the end the following:

“SEC. 339B. NUTRITION SERVICES IMPACT STUDY.

“(a) Study.—

“(1) In general.—The Assistant Secretary shall perform a study to assess how to measure and evaluate the discrepancy between available services and the demand for such services in the home delivered nutrition services program and the congregate nutrition services program under this part, which shall include assessing various methods (such as those that States use) to measure and evaluate the discrepancy (such as measurement through the length of waitlists).

“(2) Contents.—In performing the study, the Assistant Secretary shall—

“(A) consider means of obtaining information in rural and underserved communities; and

“(B) consider using existing tools (existing as of the date the Assistant Secretary begins the study) such as the tools developed through the Performance Outcome Measurement Project.

“(3) Analysis.—The Assistant Secretary shall analyze and determine which methods are the least burdensome and most effective for measuring and evaluating the discrepancy described in paragraph (1).

“(b) Recommendations.—

“(1) Preparation.—Not later than 3 years after the date of enactment of the Supporting Older Americans Act of 2020, the Assistant Secretary shall prepare recommendations—

“(A) on how to measure and evaluate, with the least burden and the most effectiveness, the discrepancy described in subsection (a)(1) (such as measurement through the length of waitlists); and

“(B) about whether studies similar to the study described in subsection (a) should be carried out for programs carried out under this Act, other than this part.

“(2) Issuance.—The Assistant Secretary shall issue the recommendations, and make the recommendations available as a notification pursuant to section 202(a)(34) and to the committees of the Senate and of the House of Representatives with jurisdiction over this Act, and the Special Committee on Aging of the Senate.”

SEC. 217. National Family Caregiver Support Program.

(a)
Definitions for National Family Caregiver Support Program.— Section 372(a) (42 U.S.C. 3030s(a)) is amended—
(1)
by redesignating paragraphs (1) through (3) as paragraphs (2) through (4), respectively; and
(2)
by inserting before paragraph (2), as so redesignated, the following:

“(1) Caregiver assessment.—The term ‘caregiver assessment’ means a defined process of gathering information to identify the specific needs, barriers to carrying out caregiving responsibilities, and existing supports of a family caregiver or older relative caregiver, as identified by the caregiver involved, to appropriately target recommendations for support services described in section 373(b). Such assessment shall be administered through direct contact with the caregiver, which may include contact through a home visit, the Internet, telephone or teleconference, or in-person interaction.”

(b)
General Authority.— Section 373 (42 U.S.C. 3030s–1) is amended—
(1)
in subsection (b), in the matter preceding paragraph (1), by inserting “ which may be informed through the use of caregiver assessments,” after “ provided,”;
(2)
in subsection (e)(3), in the first sentence, by inserting “ , including caregiver assessments used in the State,” after “ mechanisms”;
(3)
by redesignating subsections (e) through (g) as subsections (f) through (h), respectively;
(4)
by inserting after subsection (d) the following:

“(e) Best Practices.—Not later than 1 year after the date of enactment of the Supporting Older Americans Act of 2020 and every 5 years thereafter, the Assistant Secretary shall—

“(1) identify best practices relating to the programs carried out under this section and section 631, regarding—

“(A) the use of procedures and tools to monitor and evaluate the performance of the programs carried out under such sections;

“(B) the use of evidence-based caregiver support services; and

“(C) any other issue determined relevant by the Assistant Secretary; and

“(2) make available, including on the website of the Administration and pursuant to section 202(a)(34), best practices described in paragraph (1), to carry out the programs under this section and section 631.”

; and

(5)
by adding at the end the following:

“(i) Activities of National Significance.—The Assistant Secretary may award funds authorized under this section to States, public agencies, private nonprofit agencies, institutions of higher education, and organizations, including tribal organizations, for conducting activities of national significance that—

“(1) promote quality and continuous improvement in the support provided to family caregivers and older relative caregivers through programs carried out under this section and section 631; and

“(2) include, with respect to such programs, program evaluation, training, technical assistance, and research.

“(j) Technical Assistance for Caregiver Assessments.—Not later than 1 year after the date of enactment of the Supporting Older Americans Act of 2020, the Assistant Secretary, in consultation with stakeholders with appropriate expertise and, as appropriate, informed by the strategy developed under the RAISE Family Caregivers Act (42 U.S.C. 3030s note), shall provide technical assistance to promote and implement the use of caregiver assessments. Such technical assistance may include sharing available tools or templates, comprehensive assessment protocols, and best practices concerning—

“(1) conducting caregiver assessments (including reassessments) as needed;

“(2) implementing such assessments that are consistent across a planning and service area, as appropriate; and

“(3) implementing caregiver support service plans, including conducting referrals to and coordination of activities with relevant State services.”

(c)
Report on Caregiver Assessments.—
(1)
In general.— Not later than 3 years after the date of enactment of this Act, the Assistant Secretary shall issue a report on the use of caregiver assessments by area agencies on aging, entities contracting with such agencies, and tribal organizations. Such report shall include—
(A)
an analysis of the current use of caregiver assessments, as of the date of the report;
(B)
an analysis of the potential impact of caregiver assessments on—
(i)
family caregivers and older relative caregivers; and
(ii)
the older individuals to whom the caregivers described in clause (i) provide care;
(C)
an analysis of the potential impact of using caregiver assessments on the aging network;
(D)
an analysis of how caregiver assessments are being used to identify the specific needs, barriers to carrying out caregiving responsibilities, and existing supports of family caregivers and older relative caregivers, with particular consideration to supporting—
(i)
a caregiver specified in this subparagraph who is caring for individuals with disabilities, or, if appropriate, with a serious illness; and
(ii)
caregivers with disabilities;
(E)
recommendations for furthering the use of caregiver assessments, as appropriate, including in rural or underserved areas; and
(F)
recommendations for assisting State agencies and area agencies on aging, particularly in rural or underserved areas, in implementing the use of caregiver assessments.
(2)
Submission.— Not later than 6 months after the issuance of the report specified in paragraph (1), the Assistant Secretary shall submit the report to the committees of the Senate and the House of Representatives with jurisdiction over this Act, and the Special Committee on Aging of the Senate.
(3)
Definitions.— In this subsection—
(A)
the terms “caregiver assessment” and “older relative caregiver” have the meanings given such terms in section 372(a) of the Older Americans Act of 1965 (42 U.S.C. 3030s(a));
(B)
the term “family caregiver” has the meaning given the term in section 302 of such Act (42 U.S.C. 3022); and
(C)
the terms “State agency” and “tribal organization” have the meanings given the terms in section 102 of such Act (42 U.S.C. 3002).
(d)
Conforming Amendment.— Section 631(b) of such Act (42 U.S.C. 3057k–11(b)) is amended by striking “ (c), (d), and (e)” and inserting “ (c), (d), and (f)”.

SEC. 218. National Family Caregiver Support Program Cap.

(a)
Federal Share.— Subsection (h)(2), as redesignated by section 217(b)(3) of this Act, of section 373 (42 U.S.C. 3030s–1) is amended by striking subparagraph (C).
(b)
Monitoring the Impact of the Elimination of the Cap on Funds for Older Relative Caregivers.—
(1)
Report.— Not later than 18 months after the date of enactment of this Act, and annually thereafter, the Assistant Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Education and Labor of the House of Representatives a report on the impact of the amendment made by subsection (a) to eliminate the limitation on funds that States may allocate to provide support services to older relative caregivers in the National Family Caregiver Support Program established under part E of title III of the Older Americans Act of 1965 (42 U.S.C. 3030s et seq.). Each such report shall also be made available to the public.
(2)
Contents.— For purposes of reports required by paragraph (1), each State that receives an allotment under such National Family Caregiver Support Program for fiscal year 2020 or a subsequent fiscal year shall report to the Assistant Secretary for the fiscal year involved the amount of funds of the total Federal and non-Federal shares described in section 373(h)(2) of the Older Americans Act of 1965 (42 U.S.C. 3030s–1(h)(2)) used by the State to provide support services for older relative caregivers and the amount of such funds so used for family caregivers.