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The Older Americans Act Reauthorization Act of 2015 is tremendously important for the protection of older people and people living with disabilities.  The Reauthorization Act Bill passed the House with an amendment on March 21, 2016.  The Senate Bill, S. 192, is entitled "An Act to Reauthorize the Older Americans Act of 1965.”  The short title of the Bill as amended and passed is the “Older Americans Act Reauthorization Act of 2016."  See https://www.govtrack.us/congress/bills/114/s192/text (site visited March 29, 2016).

Below, we identify a few of the important features of the Act.

Meeting Essential Needs.  Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is amended to cover goods and services that are necessary to meet essential needs or to avoid physical or psychological harm.  Adult protective services are defined as “services provided to adults as the Secretary may specify,” including “receiving reports of adult abuse, neglect, or exploitation;” investigating such reports; “case planning, monitoring, evaluation, and other casework and services; and providing and arranging for facilitating the provision of medical, social, economic, legal, housing, law enforcement, or other protective, emergency, or support services.”

Aging and Disability Resource Center. Under the new law, 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.  This Center provides 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 provides services to “caregivers of older individuals and individuals with disabilities,” including “comprehensive information on the full range of available public and private long-term care programs, options, service providers, and resources within a community.”  Services include “information on the availability of integrated long-term care services,” Federal or State programs that implement “a person-centered plan for long-term care,” and “oral health.”  Services must be “consistent with the desires of the individual” and must include a designated point of entry, in cooperation with area agencies on aging and centers for independent living described in part C of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f et seq.).

Importantly, services include “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.” 

Expanding Elder Justice. The new law expands the concept of elder justice to mean “from a societal perspective, efforts to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation” and to “protect older individuals with diminished capacity while maximizing their autonomy.”  In addition, exploitation is expanded to include financial exploitation.  The Act expands the applicable agencies’ capacity to incorporate best practices by collecting and analyzing “best practices related to responding to elder abuse, neglect, and exploitation in long-term care facilities,” and by publishing “a report of such best practices.” Applicable agencies must be coordinated with the heads of State adult protective services programs and the Director of the Office of Long-Term Care Ombudsman Programs. 

In addition, the Act is amended to reach the health and economic needs of older individuals and to “provide information and technical assistance to States, area agencies on aging, and service providers, in collaboration with relevant Federal agencies; to provide efficient, person-centered transportation services across geographic boundaries” and to “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 to “provide technical assistance to, and share best practices with, States, area agencies on aging, and Aging and Disability Resource Centers, concerning 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)), including improved care coordination for individuals with multiple chronic illnesses.”

“When feasible,” the Agency is to develop, “in consultation with states and national organizations, a consumer-friendly tool to assist older individuals and their families with 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.”

Appropriations.  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. Appropriations of $40,063,000 are authorized through fiscal year 2019. 

“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. 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.”

Planning and Service Areas.  Section 306 of the Older Americans Act of 1965 (42 U.S.C. 3026) is amended by inserting "establishment, maintenance, modernization, or construction of multipurpose senior centers (including a plan to use the skills and services of older individuals in paid and unpaid work, including multigenerational and older individual to older individual work)," “in coordination with the State agency and with the State agency responsible for elder abuse prevention services,” with the aims of increasing “public awareness of elder abuse, neglect, and exploitation, and removing barriers to education, prevention, investigation, and treatment of elder abuse, neglect, and exploitation, as appropriate” for protection from elder abuse, neglect, and exploitation.  State plans with respect to the nutrition services incentive program, are allocated "$164,055,664 for fiscal year 2017, $167,486,502 for fiscal year 2018, and $170,917,349 for fiscal year 2019.

Supportive Services.  Section 321 of the Older Americans Act of 1965 (42 U.S.C. 3030d) is amended to provide “referral, chronic condition self-care management, or falls prevention services,” and “screening for elder abuse, neglect, and exploitation;” and “pursue opportunities for the development of intergenerational shared site models for programs or projects, consistent with the purposes of this Act, including services for an adult child with a disability.”  An adult child means a person with a disability who “is age 18 or older” and “is financially dependent on an older individual who is a parent of the child.”

Home Delivered Nutrition Services Program.  Section 336(1) of the Older Americans Act of 1965 (42 U.S.C. 3030f (1)) “is amended by striking ‘canned’ and all that follows through ’meals’ and inserting ‘canned, or fresh foods and, as appropriate, supplemental foods, and any additional meals.’"

Nutrition Services.  Section 339 of the Older Americans Act of 1965 (42 U.S.C. 3030g–21) is amended by striking "solicit" and inserting "utilize"; and “where feasible,” this section “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.”

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.”

Older Relative Caregiver. The term older relative caregiver is defined to mean a caregiver who “is age 55 or older” and “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.”  A caregiver for a child is defined as “the grandparent, step-grandparent, or other relative (other than the parent) by blood, marriage, or adoption, of the child; 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 has a legal relationship to the child, such as legal custody, adoption, or guardianship, or is raising the child informally; and 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.

Conclusion

We are pleased with the expansions included in the Reauthorization Act.  We hope these expansions will enhance coordination and service delivery, to advance the important purposes of the Older Americans Act.

 

March 30, 2016 – A. Chiplin

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