N4A's side-by-side comparison of changes to the OAA.

Full text of 2006 reauthorization of OAA.

The following is taken from the "ALERT", published by the East Central Illinois Area Agency on Aging October 2006

CONGRESS REAUTHORIZES THE OLDER AMERICANS ACT

Congress has passed the Older Americans Act Amendments of 2006 (H.R. 6197), as of September 30, 2006. The bill reauthorizes the Act for another five years and represents a victory for aging advocates nationwide. The bill now goes to the President for his signature. ECIAAA thanks all Members of the Illinois Congressional Delegation for their unanimous support. The following is a brief summary of new provisions in the bill.

1. Weaves the principles of the Choices for Independence initiative undertaken by the Administration on Aging (AoA) throughout the Act reflecting the appropriate role of the aging network at all levels;
2. Raises authorization levels for the National Family Caregiver Support Program to $187 million, and for the Native American Caregiver Support Program to $7.9 million by 2011;
3. Authorizes State Units on Aging and Area Agencies on Aging to assess the preparedness of their states and communities for the aging of the population, and make recommendations to government officials in the areas of health and human services, land use, housing, transportation, public safety, workforce and economic development, recreation, education, civic engagement, and emergency preparedness.
4. Specifies the functions of Aging and Disability Resource Centers within the Older Americans Act;
5. Expands targeted populations to include older individuals with limited English proficiency;
6. Voluntary contributions for services provided under the Older Americans Act would be encouraged for individuals with self-declared incomes above 185 percent of the Federal Poverty Level;
7. Senior Nutrition Programs would be required to comply with the most recent Dietary Guidelines for Americans including the dietary reference intakes (DRIs);
8. Authorizes the Administration on Aging to contract with the Institute of Medicine to conduct an evidence-based study of nutrition projects funded under the Older Americans Act;
9. Expands the definitions of caregivers to include older adults caring for an adult child with mental retardation or a related developmental disability, caregivers of an individual with Alzheimer's disease or a related disorder who is fifty years of age or older, grandparents over the age of 55 who are raising grandchildren; and adds adoption as one of the ways a grandparent may be related to a child.
10. Title V was renamed the Older American Community Service Employment Program. The bill maintains the current eligibility age of 55 or older; establishes an overall grantee average participation cap of 27 months with a waiver that allows up to a 36-month average participation rate; reinforces the integral role of the program in community services; and increases incrementally the required minimum percentage of participants in unsubsidized placements from 21 to 25 percent over the next five years;
11. Many of the Senates provisions were included, such as grants to improve senior transportation and mental health screening and treatment services for older individuals, support for community innovations for aging in place, and multigenerational and civic engagement activities.
12. Creates a new Section 752 in Title VII Elder Justice entitled, Grants to Promote Comprehensive State Elder Justice Systems defined as an integrated, multi-disciplinary, and collaborative system for preventing, detecting, and addressing elder abuse, neglect and exploitation.

New definitions

1. Aging & Disability Resource Center (ADRC).
2. Assistive Devices/Assistive Technology.
3. Hispanic-serving institution.
4. Long Term Care (LTC).
5. State System of Long Term Care.
6. Self-Directed Care.
7. Health Promotion Programs.
8. Expanded definition of Nutrition Education.
9. Title IV Civic Engagement Activity & Multigenerational Activity.
10. Title III-E expanded definitions of Child and Family Caregiver.
11. Elder, Elder Justice, Exploitation, Caregiver, Direct Care, Fiduciary, Law Enforcement, Neglect, and Self-Neglect.
12. Title V Senior Community Employment Program (SCSEP) definitions for Supportive Services and Unemployed Individual.

Office of Elder Abuse Prevention and Services

1. Authorizes the Department of Health & Human Services Secretary to establish or designate within the Administration on Aging (AoA) an Office of Elder Abuse
2. Prevention Services to carry out elder justice programs and activities related to elder abuse prevention, detection, treatment, intervention, and response; training; and improvement of the elder justice system
3. Collect, maintain, and disseminate data
4. Disseminate information
5. Conduct research
6. Provide technical assistance
7. Determine national incidence and prevalence of abuse.
8. Implement the overall policy and strategy
9. Provide advice to the Secretary on elder justice issues

Functions of Assistant Secretary on Aging

1. Adds: Consult and coordinate activities with the Administrator of CMS to implement and build awareness of programs providing new benefits affecting older individuals.
2. Adds: Provide other services (including technology and internet-based decision support tools) to assist consumers to learn about, receive benefits under, and participate in, programs for which the consumers may be eligible.

Federal Agency Consultation

1. The HHS Secretary shall establish an interagency coordinating committee including representation from DOL, HUD, DOT, Treasury, CMS, CDC, NIH, etc.
2. HHS Secretary serves as Chair.
3. The Committee shall guide policy and program development across the Federal Government with respect to aging and among demographic changes among older individuals.

Authorization of Appropriations

1. Extends existing authorizations for years 2007, 2008, 2009, 2010, and 2011.
2. Adds new language to Sec. 15 Allotments: For any year among FY 2007 through 2011 for which the amount appropriated under subsections (a) through (d) of section 303 is not less than 110 of that appropriated amount for FY 2006, an amount equal to 1 percent of the States allotment shall be used by AAAs in the state to carry out the assessment described in Sec. 306(b), i.e., demographics.

Choices for Independence

1. House and Senate bills include principles of AoA's Choices for Independence proposal, including implementation of ADRCs in all states.
2. Adds language on providing HCBS to support older adults at risk of institutionalization, including self-directed care models.
3. Promotes evidence-based health promotion and disease prevention with emphasis on healthy behaviors.

Mental Health Services

1. Expands health services to include mental health services.
2. Expands health screening to include mental health screening.
3. Adds Paragraph (23) to Supportive Services: services designed to support States, AAA, and local service providers carry out and coordinate with respect to mental health services, activities including outreach, education, screening, and referral for treatment of older individuals.

Community Preparedness

1. Area Agencies on Aging (AAAs) to assess area preparedness for aging of the population over next 10 years.
2. Build capacity of communities to meet needs of older adults in the areas of:
   health & human services, land use, housing, transportation, public safety, workforce & economic development, recreation, education, civic engagement and any other service determined by AAA.

New Targeting Language

1. Expands targeting to include: with particular attention to low income older individuals, low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas.
2. Adds language: and individuals at risk for institutional placement after severe disabilities.

Targeting Objectives & Methods

1. AAAs will set specific objectives for providing services to older individuals with GEN, GSN, and older individuals at risk for institutional placement.
2. AAAs will include specific objectives for providing services to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas.
3. Include in the area plan proposed methods to achieve such objectives.

Targeting Funding

1. AAAs shall provide assurances that funding under OAA Title III gives priority in furnishing benefits and services to older individuals with greatest economic need, older individuals with greatest social need, and older individuals at risk for institutional placement, and to the extent feasible for furnishing services under this Act consistent with self-directed care.

Evidence-Based Programs

1. AAAs shall implement through the agency or service providers, evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals.

AAAs and Long Term Care Development

AAAs shall:

1. Conduct analyses and making recommendations for strategies to modify the local system of LTC
2. Provide for availability and distribution of information related to the need to plan in advance for LTC and the range of available public and private LTC program, options and resources

Consumer Contributions

1. Such contributions shall be encouraged for individuals whose self-declared income is at or above 125% (H.R. 5293)/ 200% (Senate Bill) of the poverty line and may be requested at contribution levels based on actual cost of services
2. Such contributions shall supplement (not supplant) funds received under this Act.

Nutrition Services Incentive Program (NSIP)

1. Amends language regarding Cash Only Program.
2. Authorizes use of program funds to purchase food commodities through School Food Authorities.

Section 330. Purpose

1. H.R. 5293: To promote socialization and the health and well-being of older individuals by assisting such individuals to gain access to disease prevention and health promotion services (including information, nutrition services, and programs of physical activity) to delay the onset of health conditions resulting from poor nutritional health and sedentary behavior.
2. Senate Bill: To promote socialization and the health and well-being of older individuals by assisting such individuals to gain access to nutrition services to delay the onset of adverse health conditions.

Congregate Nutrition

1. Provide nutrition education, nutrition counseling, and other services, as appropriate, based on the needs of meal participants, and
2. May provide along with a meal, a multi-vitamin mineral supplement as an addition to such meal.

Home Delivered Nutrition Services

1. Modifies language in Sec. 336 to:
   • at least 1 HDM per day consisting of hot, cold, frozen, dried, canned, fresh, or supplemental foods and any additional meals that the recipient of a grant or contract under this subpart elects to provide
   • nutrition education, nutrition counseling, and other nutrition services as appropriate, based on the needs of the meal recipients.

Flu Shot Information

1. New language: encourages professionals who distribute nutrition assistance under Title III-C-2 to provide information to homebound seniors on how to get a flu shot in their local areas.

General Provisions for Nutrition

1. Solicit the expertise of a dietician or other individual with equivalent education and training in nutrition science.
2. Ensure that projects provide meals that comply with the most recent Dietary Guidelines for Americans published by the Secretary and the Secretary of Agriculture.
3. Replaces daily recommended dietary allowances with dietary reference intakes.
4. Deletes accompany from provision allowing nutrition services to be provided to persons with disabilities who reside at home with older individuals eligible for service.

National Family Caregiver Support Program

1. The term child means any individual who is not more than 18 years of age or an adult child with mental retardation or developmental disability.
2. The term family caregiver means an adult family member, or another individual, who is an informal provider of in-home and community care to an older individual or an adult child with mental retardation or developmental disability.
3. The term Grandparent or older individual who is a relative caregiver means a grandparent or step-grandparent of a child, or a relative of a child by blood, marriage, or adoption, who is 55 years of age or older.
4. Makes caregivers age 50 or older eligible for services if caring for Alzheimer's patients.

Counseling to Caregivers

1. Adds new language to Individual counseling, organization of support groups, and caregiver training to caregivers to assist caregivers in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles.

Use of Volunteers

1. In carrying out Title III-E programs, each AAA shall encourage the use of trained volunteers to expand available services and coordinate, if possible, with volunteer programs administered by the Corporation for National Service.

Activities of National Significance

1. Section 376 of National Family Support Caregiver Act is amended to authorize research including:
   • Intergenerational programs.
   • Programs providing support and information to families who have a child with a disability or chronic illness
   • Unique issues faced by rural caregivers
   • Needs of older persons with Alzheimer's disease and related dementia
   • Supporting caregivers in health promotion and disease prevention.

Title IV Research Grants

1. Authorizes grants for planning activities to prepare communities for the aging of the population.
2. Authorizes grants to institutions of higher education to provide education and training that prepares students for careers in the field of aging.
3. Adds mental health to Health Care Service Demonstration Projects in Rural Areas.
4. Adds demonstration projects for multigenerational activities, and civic engagement, designed to meet critical community needs.

Senior Citizen Senior Employment Program

1. Maintains dual purpose of employment-based job training and community service.
2. Retains participation of national contractors and state sponsors.
3. Retains 55+ for age eligibility, but requires grantees to first serve those with greatest need including workers 65+.
4. Requires grantees to have average time limit for participation not to exceed 2 years, and limits individual participation to 4 years.
5. Moves minimum placement rate for unsubsidized employment from 20 to 30 percent, by phasing in a 2% increase over the next 5 years.

Title VII. Vulnerable Elder Rights Protection Activities

1. Senate Bill adds a new Subtitle B Elder Justice Programs.
2. Adds definitions for caregiver, direct care, elder, elder justice, eligible entity, fiduciary, grant, law enforcement, loss of capacity, LTC facility, etc.
3. Adds State and Tribal Grants to strengthen LTC and provide assistance for elder justice programs including: prevention, detection, assessment, treatment, intervention, investigation, and responses to ANE.
4. Adds grants for elder shelters as safe havens offering M-teams, training, and a variety of services.
5. Adds grants for collection of uniform national data on ANE (authorization of $10 Million in FY2007).