PART D-IN-HOME SERVICES FOR FRAIL OLDER INDIVIDUALS

PROGRAM AUTHORIZED

SEC. 341. (a) The Commissioner shall carry out a program for making grants to States under State plans approved under section 307 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.

(b) In carrying out the provisions of this part, each area agency on aging shall coordinate with other community agencies and voluntary organizations providing counseling and training for family caretakers and support service personnel in management of care, functional and needs assessment services, assistance with locating, arranging for, and coordinating services, case management, and counseling prior to admission to nursing home to prevent premature institutionalization.

(42 U.S.C. 3030h)

DEFINITION OF IN-HOME SERVICES

SEC. 342. For purposes of this part, the term "in-home services" includes―

(1) homemaker and home health aides;

(2) visiting and telephone reassurance;

(3) chore maintenance;

(4) in-home respite care for families, and adult day care as a respite service for families;

(5) minor modification of homes that is necessary to facilitate the ability of older individuals to remain at home and that is not available under other programs, except that not more than $150 per client may be expended under this part for such modification;

(6) personal care services; and

(7) other in-home services as defined

(A) by the State agency in the State plan submitted in accordance with section 307; and

(B) by the area agency on aging in the area plan submitted in accordance with section 306.

(42 U.S.C. 3030i)

STATE CRITERIA

SEC. 343. The State agency shall develop eligibility criteria for providing in-home services to frail older individuals which shall take into account

(1) age;

(2) greatest economic need;

(3) noneconomic factors contributing to the frail condition; and

(4) noneconomic and nonhealth factors contributing to the need for such services.

(42 U.S.C. 3030j)

MAINTENANCE OF EFFORT

SEC. 344. Funds made available under this part shall be in addition to, and may not be used to supplant, any funds that are or would otherwise be expended under any Federal, State, or local law by a State or unit of general purpose local government (including area agencies on aging which have in their planning and services areas existing services which primarily serve older individuals who are victims of Alzheimer's disease and related disorders with neurological and organic brain dysfunction, and the families of such victims).

(42 U.S.C. 3030k)

PART E-ADDITIONAL ASSISTANCE FOR SPECIAL NEEDS OF OLDER INDIVIDUALS

PROGRAM AUTHORIZED

SEC. 351. The Commissioner shall carry out a program for making grants to States under State plans approved under section 307 to provide services, consistent with the purpose of this title, designed to satisfy special needs of older individuals. Such services include

(1) transportation associated with services provided under this title;

(2) outreach regarding such services;

(3) targeting such services to older individuals with greatest economic need or greatest social need;

(4) services under the ombudsman program established under titles III and VII in accordance with section 712; and (5) any other service under this title

(A) for which the State demonstrates to satisfaction of the Commissioner that there is unmet need; and

(B) which is appropriate to improve the quality of life of older individuals, particularly those with greatest economic need and those with greatest social need.

(42 U.S.C. 30301)

PART F-DISEASE PREVENTION AND HEALTH PROMOTION SERVICES

PROGRAM AUTHORIZED

SEC. 361. (a) The Commissioner shall carry out a program for making grants to States under State plans approved under section 307 to provide disease prevention and health promotion services and information at multipurpose senior centers, at congregate meal sites, through home delivered meals programs, or at other appropriate sites. In carrying out such program, the Commissioner shall consult with the Directors of the Centers for Disease Control and the National Institute on Aging.

(b) The Commissioner shall, to the extent possible, assure that services provided by other community organizations and agencies are used to carry out the provisions of this part.

(42 U.S.C. 3030m)

DISTRIBUTION TO AREA AGENCIES ON AGING

SEC. 362. The State agency shall give priority, in carrying out this part, to areas of the State

(1) which are medically underserved; and

(2) in which there are a large number of older individuals who have the greatest economic need for such services.

(42 U.S.C. 3030n)

SEC. 363. DEFINITION.

As used in this part, the term "disease prevention and health promotion services" means

(1) health risk assessments;

(2) routine health screening, which may include hypertension, glaucoma, cholesterol, cancer, vision, hearing, diabetes, and nutrition screening;

(3) nutritional counseling and educational services for individuals and their primary caregivers;

(4) health promotion programs, including programs relating to chronic disabling conditions (including osteoporosis and cardiovascular disease) prevention and reduction of effects, alcohol and substance abuse reduction, smoking cessation, weight loss and control, and stress management;

(5) programs regarding physical fitness, group exercise, and music, art, and dance-movement therapy, including programs for multigenerational participation that are provided by

(A) an institution of higher education;

(B) a local educational agency, as defined in section. 1471 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 2891); or

(C) a community-based organization;

(6) home injury control services, including screening of high-risk home environments and provision of educational programs on injury prevention (including fall and fracture prevention) in the home environment;

(7) screening for the prevention of depression, coordination of community mental health services, provision of educational activities, and referral to psychiatric and psychological services;

(8) educational programs on the availability, benefits, and appropriate use of preventive health services covered under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.);

(9) medication management screening and education to prevent incorrect medication and adverse drug reactions;

(10) information concerning diagnosis, prevention, treatment, and rehabilitation of age-related diseases and chronic disabling conditions, including osteoporosis, cardiovascular diseases, and Alzheimer's disease and related disorders with neurological and organic brain dysfunction;

(11) gerontological counseling; and

(12) counseling regarding social services and followup health services based on any of the services described in paragraphs (1) through (11).

The term shall not include services for which payment may be made under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).

(42 U.S.C. 30300)

PART G-SUPPORTIVE ACTIVITIES FOR CARETAKERS WHO PROVIDE IN-HOME SERVICES TO FRAIL OLDER INDIVIDUALS

SEC. 381. PROGRAM AUTHORIZED.

The Commissioner shall carry out a program for making grants to States under State plans approved under section 307 to carry out a program to provide 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). Such supportive activities may include

(1) providing training and counseling for such caretakers; (2) technical assistance to such caretakers to assist them to form or to participate in support groups;

(3) providing information—

(A) to frail older individuals and their families regarding how to obtain in-home services and respite services; and

who provide such services,

(B) to caretakers who

regarding

(i) how to provide such services; and

(ii) sources of nonfinancial support available to them as a result of their providing such services; and (4) maintaining lists of individuals who provide respite services for the families of frail older individuals.

(42 U.S.C. 3030p)

SEC. 382. DEFINITIONS.

For purposes of this part, the term "in-home services" has the meaning given such term in section 342.

(42 U.S.C. 3030q)

SEC. 383. MAINTENANCE OF EFFORT.

Section 344 shall apply with respect to funds made available under this part, in the same manner as such section applies to funds made available under part D.

(42 U.S.C. 3030r)

TITLE IV-TRAINING, RESEARCH, AND DISCRETIONARY PROJECTS AND PROGRAMS

STATEMENT OF PURPOSE

SEC. 401. It is the purpose of this title to expand the Nation's knowledge and understanding of aging and the aging process, to design and test innovative ideas in programs and services for older individuals, and publicly disseminate the results of the tests, to replicate such programs and services under this Act, and to help meet the needs for trained personnel in the field of aging through—

(1) placing a priority on the education and training of personnel to work with and on behalf of older individuals, with special emphasis on minority individuals, low-income individuals, frail individuals, and individuals with disabilities;

(2) research and development of effective practices in the field of aging;

(3) demonstration projects directly related to the field of aging; and

(4) dissemination of information on aging and the aging process acquired through such programs to public and private organizations or programs for older individuals.

(42 U.S.C. 3030aa)

ADMINISTRATION

SEC. 402. (a) In order to carry out the provisions of this title effectively, the Commissioner shall administer this title through the Administration.

(b) In carrying out the provisions of this title, the Commissioner may request the technical assistance and cooperation of the Department of Education, the National Institutes of Health, the Department of Veterans Affairs, the Alcohol, Drug Abuse, and Mental Health Administration 1, and such other agencies and departments of the Federal Government as may be appropriate.

(c) The Commissioner shall ensure that grants and contracts under this title are equitably awarded to agencies, organizations, and institutions representing minorities.

(d) The Commissioner shall, in developing priorities, consistent with the requirements of this title, for awarding grants and entering into contracts under this title, consult annually with State agencies, area agencies on aging, recipients of grants under title VI, institutions of higher education, organizations representing beneficiaries of services under this Act, and other organizations, and individuals, with expertise in aging issues.

(e) The Commissioner shall ensure that grants and contracts awarded under this title

(1) are evaluated for their benefit to older individuals, and to programs under this Act; and

(2) comply with the requirements under this Act.

(42 U.S.C. 3030bb)

PART A-EDUCATION AND TRAINING

PURPOSE

SEC. 410. The purpose of this part is to improve the quality of service and to help meet critical shortages of adequately trained personnel for programs in the field of aging by

(1) identifying both short- and long-range manpower needs in the field of aging;

1 Section 163(c)(2)(C) of Public Law 102-321, attempted to amend section 402(b) by striking out "the Alcohol, Drug Abuse, and Mental Health Administration" and inserting "the Substance Abuse and Mental Health Services Administration" but could not be executed because the language to be striken was inaccurrately quoted at that time.