The Older Americans Act amended in 1992 is authorized for three-years and contains seven distinct and significant Titles.

• Title I: Declaration of Objectives; Definitions
  
  
• Title II: Administration on Aging
  
  
• Title III: Grants for State and Community Programs on Aging ---
  • Part A -- General Provisions
  • Part B -- Supportive Services and Senior Centers
  • Part C -- Nutrition Services
    • Subpart 1 -- Congregate Nutrition Services
    • Subpart 2 -- Home Delivered Nutrition Services
    • Subpart 3 -- School-Based Meals for Volunteer Older Individuals & Multigenerational Programs
  • Part D -- In home Services for Frail
  • Part E -- Additional Assistance for Special Needs
  • Part F -- Disease Prevention and Health Promotion
  • Part G -- Supportive Activities for Caretakers
    
    
• Title IV: Training, Research, and Discretionary Projects and Programs
  • Part A -- Education and Training
  • Part B -- Research, Development, and Demonstrations
  • Part C -- Centers
  • Part D -- Information Dissemination and Related Activities
    
    
• Title V: Community Service Employment for Older Americans
  
  
• Title VI: Grants for Native Americans
  • Part A -- Indian Program
  • Part B -- Native Hawaiian Program
  • Part C -- General Provisions
    
    
• Title VII: Vulnerable Elder Rights Protection Activities
  • SubTitle A -- State Provisions
    • Chapter 1 -- General State Provisions
    • Chapter 2 -- Ombudsman Programs
    • Chapter 3 -- Programs for the Prevention of Elder Abuse, Neglect, and Exploitation
    • Chapter 4 -- State Elder Rights and Legal Assistance Development Program
    • Chapter 5 -- Outreach, Counseling, and Assistance Program
  • SubTitle B -- Native American Organization Provisions
  • SubTitle C -- General Provisions
    
    

This bill is for a five-year reauthorization and maintains the seven distinct Titles, consolidates subparts, and adds new programs.

• Title I: Declaration of Objectives; Definitions
  
  
• Title II: Administration on Aging
  
  
• Title III: Grants for State and Community Programs on Aging
  • Part A -- General Provisions
  • Part B -- Supportive Services and Senior Centers
  • Part C -- Nutrition Services
    • Subpart 1 -- Congregate Nutrition Services
    • Subpart 2 -- Home Delivered Nutrition Services
  • Part D -- Disease Prevention and Health Promotion Services
  • Part E -- National Family Caregiver Support Program
    
    
• Title IV: Training, Research, and Discretionary Projects and Programs
  • Part A -- Grant Programs
  • Part B -- General Provisions
    
    
• Title V: Community Service Employment Program for Older Americans
  
  
• Title VI: Grants for Native Americans
  • Part A -- Indian Program
  • Part B -- Native Hawaiian Program
  • Part C -- Native American Caregiver Support Program
    
    
• Title VII: Vulnerable Elder Rights Protection Activities
  • SubTitle A -- State Provisions
    • Chapter 1 - General State Provisions
    • Chapter 2 - Ombudsman Programs
    • Chapter 3 - Prevention of Elder Abuse, Neglect, and Exploitation
    • Chapter 4 - State Legal Assistance Development Program
  • SubTitle B - Native American Organization Provisions
  • SubTitle C - General Provisions

Title I - Declaration of Objectives; Definitions

The Act contains 10 objectives that address the inherent dignity of older people, and the duty and responsibility of the governments of the United States to assist older Americans in attaining those objectives.

Title I - Declaration of Objectives; Definitions C

The bill retains the objectives in the Act.

Title II C - Administration on Aging

Establishes the Administration on Aging (AoA), the functions of the Assistant Secretary for Aging and authorizes the review of policies affecting aging. It also provides for the periodic evaluation of programs under the Act.

White House Conference on Aging

The Act provides for the convening of the White House Conference on Aging in order to develop recommendations for additional research and action in the field of aging.

Federal Council on Aging

Section 204 establishes a Federal Council on Aging to advise and assist the President and Assistant Secretary on matters relating to the special needs of older individuals.

Title II C - Administration on Aging

The provisions are streamlined, while retaining the authorities for AoA and the Assistant Secretary. Specific authority is added for continuing the Eldercare Locator and Pension Counseling. Authority is also provided to accept gifts (in cash or in kind) which may be used for the design of demonstrations and best practices; planning of conferences; and development and dissemination of informational materials. Provisions are added for the development of performance outcome measures by December 31, 2001, for planning, managing, and evaluating activities performed and services provided under the Act.

White House Conference on Aging

The bill retains authority for a White House Conference on Aging to be convened not later than December 31, 2005.

Federal Council on Aging

The authority for a Federal Council on Aging is repealed.

Title III authorizes funds to State and area agencies for a broad array of in-home and supportive services, including nutrition services. The Act under Sec. 341(a) authorizes states to provide in-home services to frail older individuals, including in-home supportive services for older individuals who are victims of Alzheimer's disease and related disorders with neurological and organic brain dysfunction, and to the families of such victims. Additional assistance for the special needs of older individuals is also authorized in Sec. 351. Supportive activities for caretakers who provide in-home services to frail older individuals (including older individuals who are victims of Alzheimer's disease or related disorders with neurological and organic brain dysfunction) is authorized under Sec. 381. Also, these services are authorized under Part B - Supportive Services and Senior Centers. States award funds to area agencies on aging under an intrastate funding formula. Part F-Disease Prevention & Health Promotion Services, unlike other Title III service components, requires state agencies to give funding priority to areas of the state that are medically underserved and where there are large numbers of economically needy older individuals.

The Act sets forth numerous requirements for area plans and enumerates assurances for state plans as conditions for receiving funds.

Title III - Grants for State and Community Programs on Aging

Enhanced flexibility is provided to State and Area Agencies on Aging to respond to differing and changing local needs. The bill eliminates the following categorical programs and places the authority for them under Part B-Supportive Services:

D - In Home Services for Frail Older Individuals

E - Additional Assistance for Special Needs of Older Individuals

G - Supportive Activities for Caretakers Who Provide In-Home Services to Frail Older Individuals.

The bill eliminates some of the items which States and Area Agencies must specify in their plans, or which are categorized as the federal government prescribing "how to" achieve certain national goals. The bill proposes to enhance the efficiency and effectiveness of administration at the local level, while balancing the distinct interests of the partners in the aging network. Additional flexibility is granted through enhanced waiver authority. Authority is granted to permit cost-sharing for selected services.

As a priority service, AAAs are required to expend an adequate amount, unless they ask for and receive a waiver based on their assurance that an adequate amount of service is available from other sources.

Legal Services

Retained as a priority service to be provided by States and AAAs with the protections of the current statute.

Multigenerational Services

Encouraged and expected as part of providing comprehensive and coordinated service delivery systems.

Multigenerational Services

Plan shall provide assurances that efforts will be made to coordinate services with agencies and organizations that provide intergenerational activities and programs.

Services to Non-Elderly

No specific provisions exist.

Provisions are added to clarify that nothing in Title III shall be construed as prohibiting the provision of services by using funds from other sources.

Cost Sharing

Programs and services authorized under Title III of the Act are established on an individual basis with age being the sole criterion. Section 102(38) defines the term "older individual" as an individual who is 60 years of age or older. The purpose of Title III of the Act is "...the development and implementation of comprehensive and coordinated systems to serve older individuals [section 301(a)(1)]. Thus, all persons 60 years of age or older can participate in Title III programs and services. The Act does, however, require state and area agencies to develop state and area plans based on needs assessments which take into account the needs of those older persons in greatest social and economic need with particular attention to low-income minority individuals. The Act and current regulations require that recipients be given an opportunity to contribute voluntarily to expand the availability of services.

Cost Sharing

The bill permits States to implement cost sharing for certain services. It exempts I&A, outreach, benefits counseling, case management, ombudsman, elder abuse, legal assistance, consumer protection services, congregate and home-delivered meals, services delivered through tribal organizations and low-income individuals at or below the Federal poverty line. It provides for sliding fee scales based on income and the cost of delivering services and income to be determined by self-declaration, without verification. If implemented, States and AAAs must protect the privacy and confidentiality of older individuals, establish appropriate procedures to safeguard and account for payments, use payments to expand the service, and not consider assets, savings or other property owned in determining whether cost sharing is permitted. In addition, there can be no denial of service for an individual’s failure to pay. Materials must be widely distributed in languages reflecting the reading abilities of older individuals.

AAAs may request a waiver if a significant proportion of persons have incomes below the threshold established or if cost sharing would be an unreasonable administrative or financial burden.

State and AAAs shall develop plans designed to ensure that the participation of low-income individuals (with particular attention to low-income minority individuals) will not decrease with the implementation of cost sharing. In addition, in conducting public hearings on state and area plans, they shall solicit the views of older individuals, providers, and other stakeholders on the implementation of cost-sharing.

AoA shall conduct annually, a comprehensive evaluation of cost-sharing practices to determine the impact on participation rates. If a disparate impact upon low-income or minority older individuals is found, corrective action is authorized to be taken.

Voluntary Contributions

The bill makes provisions related to the current voluntary contributions system. It clarifies that the method of solicitation must be non-coercive. It requires AAAs to consult with service providers and older individuals about the best method for accepting voluntary contributions. It prohibits means tests and the denial of service to any individual who does not contribute to the cost of the service. Contributions are to be used to expand the service for which the contribution is given.

Provides waiver authority of up to 30 percent (and a phased down additional amount of 10%) for transfers between congregate and home delivered meal programs, and a phased down amount of up to 20 percent between supportive and nutrition programs (with an additional 8% option upon application).

The bill retains and increases the authority for transfers of up to 40% between congregate and home-delivered meal programs (with the ability to get an additional 10%), and for up to 30% between supportive services and nutrition programs.

Provides waiver authority for mandatory services, use of State plan administration funds to increase area plan ceilings and services, and transfers between Parts B and C upon application.

The bill provides authority to grant waivers in the areas of statewide uniformity and state and area plan requirements to permit demonstrations and to promote innovations or improve service delivery if granting the waiver will not diminish services already provided. In addition, waiver authority is extended to the restrictions on transfers between Parts B and C; and the maintenance of effort levels down to the minimum match required under a State plan.

To qualify for a waiver, a State must demonstrate that approval of the State legislature has be obtained or is not necessary; there has been collaboration with AAAs and other affected organizations; the proposal has been subject to public review and comment, including the opportunity for public hearing upon request; and that the benefits can reasonably be expected to outweigh negative consequences.

Prohibits the direct provision of service, unless in the judgment of the state, one of three elements is demonstrated: 1) that it is necessary to assure an adequate supply of services; 2) the services are directly related to administrative functions; or 3) such services can be provided more economically and with comparable quality.

The prohibition against direct services and the elements necessary for demonstration are retained; however, additional provisions are added. If the state agency or AAA is already providing case management under a state program, the state plan may specify that such agency is allowed to continue. In addition, the state plan may specify that a AAA is allowed to directly provide I&A and outreach services.

Provides that case management services provided through area agencies not duplicate, and be coordinated with case management services provided through other federal and state programs. Further, case management services must be provided by a public agency; or a nonprofit private agency that does not provide, and does not have a direct or indirect ownership or controlling interest in, or a direct or indirect affiliation or relationship with, an entity that provides, services other than case management services under Title III; or is located in a rural area and obtains a waiver.

Provides that case management services provided through area agencies not duplicate, and be coordinated with case management services provided through other federal and state programs. Further, case management services must be provided by a public agency; or a nonprofit private agency that gives each older individual seeking services a list of agencies that provide similar services within the jurisdiction of the AAA, a statement specifying that the individual has a right to make an independent choice of service providers and has case managers acting as agents for the service recipients and not as promoters for the agency providing the service; or is located in a rural area and obtains a waiver of the requirements related to providing a list of agencies that provide similar services and case managers serving as agents for the service recipient as opposed to promoters for service provider agencies.

The Act contains three factors for allocations under Title III among the States: the amount each state received in 1987 (hold harmless); a minimum amount each state receives; and the population based ratio each state represents to the total population of older individuals.

The provisions for allotting funds under Title III are updated and reorganized (This does not apply to funds under the National Family Caregiver Support Program). The hold harmless level is updated to 2000, and the formula is to be run with population (60+) first, then checking to see if the minimum and hold harmless factors are met. If not, each state is reduced proportionately to meet these two factors. A fourth factor is added as a second hold harmless level, i.e., No state shall receive less than 20% of the percentage increase above the FY 2000 allotments for all states.

The Act requires States, in consultation with AAAs, using best available data, develop and publish for review and comment a formula for distribution within the State of funds that takes into account the geographical distribution of older individuals in the State; and the distribution among PSA of those with greatest economic need and greatest social need, with particular attention to low-income minority older individuals. States must submit their formulas to AoA for approval.

These provisions are retained without change.

This section lists the broad array of home and community-based supportive services to be provided through the network of states, area agencies on aging and service providers.

The provisions are retained, but consolidated, reorganized and streamlined slightly.

Section 311 requires the Secretary of Agriculture to provide support in the form of commodities or cash-in-lieu of commodities to a recipient of a grant or contract to be used for nutrition services in compliance with the provisions of Title III of the Older Americans Act. This support is provided on a per-meal reimbursement basis as the Nutrition Program for the Elderly (NPE) and is administered by the Food and Consumer Services of the United States Department of Agriculture (USDA) through State and Territory distributing agencies as well as Tribes.

The bill consolidates by eliminating the unfunded subpart for school-based meals, but grants authority for States to perform this function under the congregate nutrition services subpart. Additional reordering and consolidation of provisions is done. It modifies the USDA meal reimbursement program to lessen the administrative burdens on States, Tribes and local agencies. The bill retains the connection with the number of meals provided and minimizes any disruptiveness in allocations to States by revising the basis for allocations from an estimate to the actual number of meals served in the prior year.

Consolidates provisions of the current III-D into III-B, and creates a new III-E to establish support networks that provide: information about the availability of support services; assistance in gaining access; individual counseling to help make decisions and solve problems; respite care, and supplemental services. It would establish an infrastructure of program resources and assistance to family caregivers and grandparents and older individuals who are relative caregivers through State and area agencies on aging, service providers and consumer organizations.

Service categories authorized by the statute include: information to caregivers about available services; assistance to caregivers in gaining access to services; individual counseling, organization of support groups, and caregiver training to assist in making decisions and solving problems; respite care to enable caregivers to be temporarily relieved from their caregiving responsibilities; and supplemental services on a limited basis, to complement the care provided by caregivers. Priority is to be given to older individuals and families with the greatest social and economic need, with particular attention to low-income older individuals and older individuals caring for persons with MR/DD (who are not more than 18 years of age or who are 60 years of age and older). A state may not use more than 10% of the funds to provide support services to grandparents and older individuals who are relative caregivers.

Authorization of Appropriations

An authorization of appropriations for $125 million is provided for the first year if the aggregate amount appropriated for supportive services, congregate and home-delivered meals, and disease prevention and health promotion services in FY 2001 is not less than in FY 2000.

Competitive Innovation Grants

It also authorizes a program of competitive grants to foster the development and testing of new evidence-based approaches to sustaining the efforts of families and other informal caregivers. Of the funds appropriated, 4% shall be reserved for these innovation grants. Further, it requires the Assistant Secretary to carry out activities of national significance in relation to the provision of support to family and other informal caregivers. One percent of the appropriations is to be reserved for this purpose. These provisions sunset three fiscal years after the date of enactment.

The funds are to be allotted under a 70+ population-based interstate funding formula. The bill prescribes the order in which the factors are to be taken into account C first, population; then adjusted proportionately to satisfy the minimum amount each state shall receive. Funds can be made available for re-allotment and for the costs of administration of area plans. The required match is 25% from nonfederal sources.

Native American Caregiver Support Program

A similar program for Native Americans is added as Part C of Title VI.

Provides for grants to States to provide disease prevention and health promotion services and information. States shall give priority to areas of the State which are medically underserved and in which there are a large number of older individuals who have the greatest economic need for such services.

Provides authority to develop projects and programs designed to expand the nation=s knowledge and understanding of aging; to design and test innovative ideas in programs and services, and to disseminate the result to replicate such programs and services; and to help meet the needs for trained personnel in the field of aging.

Retains much of the current Title IV. Consolidates the authorities to make grants with States, public agencies, private nonprofit agencies, institutions of higher education, and organizations, including tribal organizations for: education and training; applied social research and analysis; evaluation of performance; development of methods and practices to improve quality and effectiveness; demonstration of new approaches for programs and services; technical assistance; coordination with agencies that provide services to older individuals who are blind; training of graduate level professionals specializing in the mental health needs of older individuals; and any other activities the Assistant Secretary determines.

The authority for Pension Rights Demonstration Projects is moved to Title II. Adds three new projects: Older Individual=s Protection from Violence; Health Care Service Demonstrations in Rural Areas; and Computer Training. Does not include existing authority for Special Projects in Comprehensive Long-Term Care; Supportive Services in Federally Assisted Housing Demonstrations; Neighborhood Senior Care; Information and Assistance Systems Development; Demonstration Programs for Older Individuals with Developmental Disabilities; Housing Demonstrations; and Private Resource Enhancement Projects.

Title V - Community Service Employment for Older Americans

Authorizes the Secretary of Labor to establish an older American community service employment program in order to foster and promote useful part-time opportunities in community service activities for unemployed low-income persons who are fifty-five years old or older and who have poor employment prospects.

Title V - Community Service Employment for Older Americans

Amends the purpose statement to include as one of the program purposes to foster individual economic self-sufficiency and to increase the number of persons who may benefit from unsubsidized employment in both the public and the private sectors. Establishes an enhanced performance accountability system, reinforces connections with the broader workforce investment system established under the Workforce Investment Act, and provides for broad participation in the development of a plan in each State to ensure an equitable distribution of projects and the coordination of services to seniors.

Title VI - Grants for Native Americans

Authorizes grants to promote the delivery of supportive services, including nutrition services to American Indians, Alaskan Natives, and Native Hawaiians that are comparable to services provided under Title III.

Title VI - Grants for Native Americans

The bill retains separate authority for the program while adding provisions to clarify that only one grant per tribal organization is permitted under Part A and local customs and subsistence needs are to be taken into consideration. Other enhancements for Native Americans include authority to receive disaster assistance, the removal of barriers for coordination with Title III, and access to the funds from USDA's NPE program.

Part C - Native American Caregiver Service Program

A service program similar to the one in Title III is provided for American Indian and Alaskan Native grantees under Title VI, Part A and Native Hawaiian grantees under Title VI, Part B. Grantees would apply based on specified requirements including population to be served; service priority; coordination with community organizations; and quality standards and reporting. A separate authorization of appropriations ($5 million for 2001 and such sums for subsequent years) is provided for this grant program.

Title VII - Vulnerable Elder Rights Protection

Provides separate authority for States to develop Elder Rights Protection Systems focused on protecting the rights of vulnerable older individuals who reside in the community and in institutional settings. Funds are allotted through an interstate funding formula administered by initially allotting by 60+ population, and then adjusting to ensure that no state is allotted less than a minimum amount, and for the Ombudsman and Elder Abuse programs, no less than the state was allotted in 1991 to carry out the programs under Title III.

Title VII - Vulnerable Elder Rights Protection

The bill retains separate authority and separate authorizations of appropriations for three of the four program chapters under this Title. There are no provisions for Outreach, Counseling and Assistance Programs. The interstate funding formula is retained, and the hold harmless levels for the Ombudsman and Elder Abuse programs are updated from the 1991 levels to the 2000 levels.

Subtitle B--Native American Organization Provisions

The Act makes available authority to award grants to tribes, public agencies, or nonprofit organizations serving older individuals who are Native Americans for the purpose of carrying out vulnerable elder rights protections activities that are determined to be priorities.

Subtitle B--Native American Organization Provisions

This subtitle is retained with a separate authorization of appropriations.