Order Code RL33660
CRS Report for Congress
Received through the CRS Web
Older Americans Act Reauthorization:
Side-by-Side Comparison of Current Law,
H.R. 5293, and S. 3570
August 24, 2006
Carol O’Shaughnessy
Specialist in Social Legislation
Domestic Social Policy Division
Kirsten Jennie Black
Analyst in Gerontology
Domestic Social Policy Division
Sarah C. Kaufman
Research Associate
Domestic Social Policy Division
Congressional Research Service ˜ The Library of Congress

Older Americans Act Reauthorization: Side-by-Side
Comparison of Current Law, H.R. 5293, and S. 3570
Summary
Authorization of appropriations for the Older Americans Act expired at the end
of FY2005, though appropriations legislation has continued funding of the act’s
programs. Legislation to reauthorize the act is being considered by the 109th
Congress. H.R. 5293, the Senior Independence Act of 2006, was passed by the
House on June 21, 2006; S. 3570, the Older Americans Act Amendments of 2006,
was ordered reported by the Senate Committee on Health, Education, Labor, and
Pensions on June 28, 2006. A compromise version of the House and Senate bills
may be taken up before the end of the 109th Congress.
The Older Americans Act (OAA) is the major vehicle for the delivery of social
and nutrition services for older persons. Originally enacted in 1965, the act supports
a wide range of social services and programs for older persons. These include
supportive services, congregate and home-delivered nutrition services, community
service employment, the long-term care ombudsman program, and services to prevent
the abuse, neglect, and exploitation of older persons. The act also supports grants
to Native Americans and research, training, and demonstration activities.
H.R. 5293 and S. 3570 would authorize all titles of the act through FY2011. A
number of provisions contained in both bills would require state and area agencies
on aging to focus attention on planning comprehensive and coordinated systems of
home and community-based services to assist older persons with long-term care
needs to remain in their own homes, rather than entering institutions; require states
to conduct increased planning efforts related to the growing number of older people
in coming decades; and would focus attention on the needs of older people with
limited English proficiency and those at risk of institutional placement. In addition,
both bills would allow family caregiver services authorized under Title III to assist
older people caring for their adult children with disabilities.
Both H.R. 5293 and S. 3570 make changes to the Title V community service
employment program, but take different approaches. The House bill proposals are
wider in scope than those in the Senate committee’s bill, and many of its proposed
changes emanate from the view that the program should place more emphasis on
training of participants for unsubsidized employment than what exists under the
current program.
S. 3570 would authorize new elder justice grant programs and a national study
on the incidence of elder abuse, neglect, and exploitation. It would also require the
Administration on Aging (AoA) to set up a method to collect national uniform data
on elder abuse, neglect, and exploitation.
This report highlights major selected provisions of the bills and provides a
section-by-section comparison of most provisions of H.R. 5293 and S. 3570. A
shortened version of this report will be issued when final legislation is approved.

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Highlights of Selected Provisions of H.R. 5293 and S. 3570 . . . . . . . . . . . . . . . . 2
Home and Community-Based Long-Term Care Services . . . . . . . . . . . . . . . 2
Role of AoA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Role of State and Area Agencies on Aging . . . . . . . . . . . . . . . . . . . . . . 2
Aging and Disability Resource Centers (ADRCs) . . . . . . . . . . . . . . . . . 3
State and Area Agency on Aging Planning
for the Baby Boom Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Nutrition Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
National Academy of Sciences Study of Nutrition . . . . . . . . . . . . . . . . 4
Other Nutrition Program Proposals . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
National Family Caregiver Support Program . . . . . . . . . . . . . . . . . . . . . . . . 5
Senior Community Service Employment Program
for Older Americans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Limit on Time of Participant Enrollment . . . . . . . . . . . . . . . . . . . . . . . 6
Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Elder Justice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
AoA Responsibility for Elder Justice Issues . . . . . . . . . . . . . . . . . . . . . 8
National Incidence Study and Data Collection Efforts . . . . . . . . . . . . . 8
Grants to States and Tribal Organizations
for Elder Justice Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Research and Demonstration Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Model Projects for Aging in Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Demonstration Efforts to Address Mental Illness
in Older People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
TITLE I, DECLARATION OF OBJECTIVES; DEFINITIONS . . . . . . . . . . . . . 10
DEFINITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Assistive device, assistive technology,
and assistive technology service . . . . . . . . . . . . . . . . . . . . . . . . . 10
Health promotion program/evidence-based health promotion . . . . . . 10
Information and assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Aging and Disability Resource Center (ADRC) . . . . . . . . . . . . . . . . 11
At risk of institutional placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Long-term care facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Elder justice
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Exploitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Neglect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Self-neglect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Hispanic serving institution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Long-term care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Multivitamin-mineral supplement . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Self-directed care
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
State system for long-term care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

TITLE II, ADMINISTRATION ON AGING (AoA) . . . . . . . . . . . . . . . . . . . . . . 15
FUNCTIONS OF THE ASSISTANT SECRETARY ON AGING . . . . . . . 15
Elder abuse prevention services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Mental health services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Assistive technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Coordination with Centers for Medicare
and Medicaid Services (CMS) regarding new benefits . . . . . . . . 18
Technical assistance regarding benefits outreach
and establishment of a National Center on Senior Benefits . . . . . 18
Data collection on home and community-based care . . . . . . . . . . . . . 19
Evidence-based disease prevention and health promotion . . . . . . . . . 19
AoA role in long-term care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Involvement of older individuals
in voluntary community activities . . . . . . . . . . . . . . . . . . . . . . . . 23
AoA collaboration with other federal agencies:
reference to impact on persons
with limited English proficiency . . . . . . . . . . . . . . . . . . . . . . . . . 24
Assistive Technology Act . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Coordinating committee on aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Functions of nutrition program officer . . . . . . . . . . . . . . . . . . . . . . . . 29
Expertise of the nutrition officer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Set aside of funds for evaluation projects . . . . . . . . . . . . . . . . . . . . . . 30
Reports on the activities under the act . . . . . . . . . . . . . . . . . . . . . . . . 30
Contracting and grant authority; commercial and
private pay relationships; appropriate use of act funds . . . . . . . . 30
Nutrition education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Pension counseling and information programs . . . . . . . . . . . . . . . . . . 32
Authorization of appropriations for Title II activities . . . . . . . . . . . . . 33
TITLE III, GRANTS FOR STATE AND
COMMUNITY PROGRAMS ON AGING . . . . . . . . . . . . . . . . . . . . . . . . 33
Purpose of Title III: coordination with volunteer services . . . . . . . . . . . . . 33
Authorization of appropriations: supportive, nutrition,
and disease prevention and health promotion services . . . . . . . . 33
Authorization of appropriations: National Family
Caregiver Support Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Area agency administrative funds to be use
for needs assessment of growing elder population . . . . . . . . . . . 34
State plans on aging: focus on older individuals
with limited English proficiency . . . . . . . . . . . . . . . . . . . . . . . . . 34
State long-term care systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Puerto Rico, single planning and service area . . . . . . . . . . . . . . . . . . . 35
AREA PLANS ON AGING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Area plans on aging: focus on older individuals
with limited English proficiency . . . . . . . . . . . . . . . . . . . . . . . . . 35
Area plans on aging: focus on persons at risk
of institutional placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Area plans on aging: mental health services . . . . . . . . . . . . . . . . . . . . 36
Area plans on aging: information and assistance . . . . . . . . . . . . . . . . 36
Area plans on aging: specific objectives for serving
older individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Area plans on aging: provider agreement regarding serving
older individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Area plans on aging: outreach efforts . . . . . . . . . . . . . . . . . . . . . . . . . 37
Area plans on aging: use of trained volunteers . . . . . . . . . . . . . . . . . . 38
Area plans on aging: advisory council membership . . . . . . . . . . . . . . 38
Area plans on aging: increasing public awareness
of mental health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Area plans on aging: comprehensive coordinated system
for home and community-based long-term care . . . . . . . . . . . . . 38
Area plans on aging: area agency costs to carry out
commercial relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Area plans on aging: priority for use of funds
for specified older individuals; maintaining
public purpose mission and disclosure of information
on contractual relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Area plans on aging: self-directed care . . . . . . . . . . . . . . . . . . . . . . . . 40
Area plans on aging: emergency preparedness . . . . . . . . . . . . . . . . . . 40
Area plans on aging: area agency planning
for demographic changes in the older population
in planning and service areas . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
STATE PLANS ON AGING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
State plans on aging: focus on older individuals
with limited English proficiency . . . . . . . . . . . . . . . . . . . . . . . . . 42
State plans on aging: identifying service needs
of low-income minority older individuals
with limited English proficiency . . . . . . . . . . . . . . . . . . . . . . . . . 42
State plans on aging: outreach to individuals
with limited English proficiency . . . . . . . . . . . . . . . . . . . . . . . . . 42
State plans on aging: self-directed care . . . . . . . . . . . . . . . . . . . . . . . . 42
State plans on aging: planning for demographic changes
in the older population in the state . . . . . . . . . . . . . . . . . . . . . . . 43
State plans on aging: emergency preparedness . . . . . . . . . . . . . . . . . . 43
State plans on aging: Aging and Disability Resource Centers
(ADRCs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
State plans on aging: non-federal share
for Title III services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
NUTRITION SERVICES INCENTIVE PROGRAM . . . . . . . . . . . . . . . . . 45
Disbursement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Bonus of commodities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
High protein foods; terms and conditions . . . . . . . . . . . . . . . . . . . . . . 45
Cash used to buy commodities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Authorization of appropriations for nutrition service
incentive program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Distribution of information regarding
federal commodity processing programs . . . . . . . . . . . . . . . . . . . 46
VOLUNTARY CONTRIBUTIONS FOR TITLE III SERVICES . . . . . . . . 46
Solicitation of voluntary contributions . . . . . . . . . . . . . . . . . . . . . . . . 46
Voluntary contributions are to supplement not supplant
Title III funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Mandatory cost-sharing: participation of older individuals
with limited English proficiency . . . . . . . . . . . . . . . . . . . . . . . . . 47
AoA study of cost-sharing
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

ALLOWABLE TITLE III SUPPORTIVE SERVICES . . . . . . . . . . . . . . . . 47
NUTRITION SERVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Nutrition services: purpose of nutrition services
. . . . . . . . . . . . . . . . 48
Nutrition services: nutrition education . . . . . . . . . . . . . . . . . . . . . . . . 48
Nutrition services: multivitamin-mineral supplements . . . . . . . . . . . . 49
Nutrition services: home-delivered nutrition services
. . . . . . . . . . . 49
Consultation with nutrition experts . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
State responsibility to obtain expertise of a dietician . . . . . . . . . . . . . 49
Dietary Guidelines for Americans
. . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Intergenerational meals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Nutrition screening, education and assessment . . . . . . . . . . . . . . . . . . 50
Influenza and other vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Evaluation of the Nutrition Program . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Improving indoor air quality in building
where seniors congregate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
CAREGIVER SUPPORT PROGRAM . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Support services for caregivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Priority to caregivers providing care to older individuals . . . . . . . . . . 52
Coordination with volunteer services . . . . . . . . . . . . . . . . . . . . . . . . . 52
Reports on caregiver program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Limitation on federal and non-federal funds
for relative caregiver services . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Programs of national significance . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Allotment of funds to states . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
TITLE IV, RESEARCH, TRAINING, AND
DEMONSTRATION PROJECTS AND PROGRAMS . . . . . . . . . . . . . . . 54
Grant programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Authorization of appropriations for grant programs . . . . . . . . . . . . . . 55
Career preparation for the field of aging . . . . . . . . . . . . . . . . . . . . . . . 56
Health care service demonstration projects in rural areas . . . . . . . . . . 56
Graduate programs with capability in mental health . . . . . . . . . . . . . . 56
Technical assistance and innovation to improve
transportation for older individuals . . . . . . . . . . . . . . . . . . . . . . . 57
Economically sustainable transportation . . . . . . . . . . . . . . . . . . . . . . . 58
Community planning for the aging population . . . . . . . . . . . . . . . . . . 58
DEMONSTRATION PROJECTS
FOR MULTIGENERATIONAL ACTIVITIES . . . . . . . . . . . . . . . . . 58
Demonstration projects for multigenerational activities:
grants and contracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Demonstration projects for multigenerational activities:
use of funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Demonstration projects for multigenerational activities:
preference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Demonstration projects for multigenerational activities:
application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Demonstration projects for multigenerational activities:
eligible organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Demonstration projects for multigenerational activities:
local evaluation and report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Demonstration projects for multigenerational activities:
report to Congress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
DEFINITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Civic engagement activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Multigenerational activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Multigenerational coordinator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Native American programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
MULTIDISCIPLINARY CENTERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Multidisciplinary centers: grant programs . . . . . . . . . . . . . . . . . . . . . . 62
MULTIDISCIPLINARY HEALTH SERVICES
IN COMMUNITIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Multidisciplinary health services in communities:
grant programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
COMMUNITY INNOVATIONS FOR AGING IN PLACE . . . . . . . . . . . . 66
Community Innovations for Aging in Place: authorization . . . . . . . . . 66
Community Innovations for Aging in Place: definitions . . . . . . . . . . 66
Community Innovations for Aging in Place: grants . . . . . . . . . . . . . . 67
Community Innovations for Aging in Place: eligibility
and application requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Community Innovations for Aging in Place: use of funds . . . . . . . . . . 68
Community Innovations for Aging in Place: required services . . . . . . 69
Community Innovations for Aging in Place: service areas . . . . . . . . . 69
Community Innovations for Aging in Place: supplement
and not supplant federal, state, or other funds . . . . . . . . . . . . . . 69
Community Innovations for Aging in Place: technical assistance . . . 70
Community Innovations for Aging in Place:
eligibility requirements for grants to provide
technical assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Community Innovations for Aging in Place: report to Congress . . . . . 70
CHOICES FOR INDEPENDENCE
DEMONSTRATION PROJECTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Choices for Independence: authorization . . . . . . . . . . . . . . . . . . . . . . . 71
Choices for Independence: definitions . . . . . . . . . . . . . . . . . . . . . . . . . 71
Choices for Independence: grants to states . . . . . . . . . . . . . . . . . . . . . 72
Choices for Independence: eligibility . . . . . . . . . . . . . . . . . . . . . . . . . 72
Choices for Independence: use of funds . . . . . . . . . . . . . . . . . . . . . . . 72
Choices for Independence: public education . . . . . . . . . . . . . . . . . . . . 73
Choices for Independence: ADRCs . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Choices for Independence: Healthy Lifestyle Choices . . . . . . . . . . . . 74
Choices for Independence: Community Living Incentives (CLI) . . . . 75
Choices for Independence: technical assistance . . . . . . . . . . . . . . . . . 77
Choices for Independence: evaluation
. . . . . . . . . . . . . . . . . . . . . . . . 77
Choices for Independence: responsibilities
of the Assistant Secretary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
TITLE V, COMMUNITY SERVICE EMPLOYMENT
FOR OLDER AMERICANS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Title V, Community Service Employment
for Older Americans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Program authorized: purposes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Agreements/grants to public and private non-profit
organizations/state agencies/tribal organizations . . . . . . . . . . . . 79

PROGRAM REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Provision of employment for eligible individuals . . . . . . . . . . . . . . . . 79
50% of hours worked to be in community service
employment-based training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Employment in communities where eligible individuals
reside; no less than 50% of hours worked to be
in community service employment-based training
. . . . . . . . . . 80
Employment for individuals, including Indians
residing on Indian reservations . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Prohibition of participation by eligible individuals
exceeding a specified period . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Employment in public and private non-profit
organizations/for-profit organizations . . . . . . . . . . . . . . . . . . . . . 81
Result in unsubsidized employment . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Contribution to the community . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Provision of employment for eligible individuals . . . . . . . . . . . . . . . . 82
Increase in employment opportunities . . . . . . . . . . . . . . . . . . . . . . . . 82
Prohibition of Title V enrollees performing work
of a person who is on layoff . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Coordination with the Workforce Investment system
. . . . . . . . . . . . 82
Training and payment of trainees’ expenses . . . . . . . . . . . . . . . . . . . . 82
Safe and healthy conditions
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Wages of enrollees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Projects to be established with advice of experienced persons . . . . . . 83
Payment for transportation costs/supportive services . . . . . . . . . . . . . 83
Special needs individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Activities with WIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Sufficient administrative funds for entities . . . . . . . . . . . . . . . . . . . . 84
Innovative work modes and job opportunities . . . . . . . . . . . . . . . . . . 84
Reciprocity of assessments of individuals
under Title V and WIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Non-federal share . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Definition of administrative costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Programmatic costs: fringe benefits . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Programmatic costs: training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Programmatic costs: supportive services . . . . . . . . . . . . . . . . . . . . . . . 86
Limit on fund for wages and benefits of enrollees . . . . . . . . . . . . . . . 86
Consultation with area agencies on aging . . . . . . . . . . . . . . . . . . . . . . 87
Demonstration projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Evaluation of Title V activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Sense of the Senate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
STATE PLAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
State Plan: submission, timing and comments . . . . . . . . . . . . . . . . . . . 88
State Plan: comments by Governor/state chief executive officer . . . . 90
State Plan: avoidance of participant disruption . . . . . . . . . . . . . . . . . . 90
State Plan: collaboration by grantees that serve older Indians . . . . . . . 90
State Plan: distribution of assistance . . . . . . . . . . . . . . . . . . . . . . . . . . 90
COMPETITION FOR AWARD OF GRANTS . . . . . . . . . . . . . . . . . . . . . . 92
Period of grant awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

Prohibition on competition until implementation
of indicators, or January 1, 2010 . . . . . . . . . . . . . . . . . . . . . . . . . 92
Eligibility criteria for awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
PERFORMANCE MEASURES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Performance measures: establishment . . . . . . . . . . . . . . . . . . . . . . . . . 94
Performance measures: annual requirement . . . . . . . . . . . . . . . . . . . . 94
Performance measures: agreement on expected levels . . . . . . . . . . . . 94
Performance measures: composition
. . . . . . . . . . . . . . . . . . . . . . . . . 95
Performance measures: indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Performance measures: additional indicators . . . . . . . . . . . . . . . . . . . 95
Performance measures: issuance of rules on indicators . . . . . . . . . . . . 96
Performance measures: adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Performance measures:
annual publication of grantee performance . . . . . . . . . . . . . . . . . 96
Performance measures:
placement into unsubsidized employment . . . . . . . . . . . . . . . . . . 96
Performance measures: retention in employment . . . . . . . . . . . . . . . . 97
Performance measures:
exemption when a grantee extends time for participation . . . . . . 98
CORRECTIVE ACTION AND TECHNICAL ASSISTANCE
BASED ON PERFORMANCE, AND REQUIREMENTS
FOR COMPETITION BASED ON PERFORMANCE . . . . . . . . . . . 98
National organizations: technical assistance
and corrective action based on performance . . . . . . . . . . . . . . . . 98
National organizations: second year of failure in meeting
performance standards — reduction of 25% of funds . . . . . . . . . 99
National organizations: third year of failure in meeting
performance standards — withdrawal of all funds . . . . . . . . . . . 99
National organizations: additional competition requirements
where national organizations have performance levels
20% or more below the national performance standards . . . . . . . 99
Performance measures: request by the Governor . . . . . . . . . . . . . . . . 100
States: technical assistance and corrective action
based on performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
States: second year of failure — reduction of 25% of funds . . . . . 101
States: third year of failure — withdrawal of all funds . . . . . . . . . . 101
Grantees serving individuals with barriers to employment . . . . . . . . 101
Prohibition on promulgation of rules negatively affecting
minority serving grantees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Authorization of Appropriations . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Unexpended funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
DEFINITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Community service/community service
employment-based training . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Eligible individuals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Individuals to have priority for work opportunities . . . . . . . . . . . . . . 103
Exclusion of individuals who have participated
in Title V projects for a specified period . . . . . . . . . . . . . . . . . 104
Income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Supportive services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Unemployed individual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105

TITLE VI, GRANTS FOR NATIVE AMERICANS . . . . . . . . . . . . . . . . . . . . 105
Distribution of funds among tribal organizations . . . . . . . . . . . . . . . 105
Native Americans caregiver support program . . . . . . . . . . . . . . . . . . 106
TITLE VII, ALLOTMENTS FOR VULNERABLE ELDER RIGHTS
PROTECTION ACTIVITIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Vulnerable elder rights protection activities:
ombudsman program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Native American organization provisions . . . . . . . . . . . . . . . . . . . . . 106
Elder abuse, neglect, and exploitation prevention . . . . . . . . . . . . . . . 106
ELDER JUSTICE PROGRAMS: PURPOSES . . . . . . . . . . . . . . . . . . . . . 107
DEFINITIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Caregiver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Direct care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Elder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Elder justice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Eligible entity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Fiduciary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Grant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Law enforcement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Long-term care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Loss of capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Long-term care facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Nursing facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
State legal assistance developer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
State long-term care ombudsman . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
STATE AND TRIBAL GRANTS TO STRENGTHEN
LONG-TERM CARE AND PROVIDE ASSISTANCE
FOR ELDER JUSTICE PROGRAMS . . . . . . . . . . . . . . . . . . . . . . . 111
State and tribal grants: authorization . . . . . . . . . . . . . . . . . . . . . . . . . 111
State and tribal grants: application for eligibility . . . . . . . . . . . . . . . . 111
State and tribal grants: use of funds . . . . . . . . . . . . . . . . . . . . . . . . . . 111
State and tribal grants: administrative expenses . . . . . . . . . . . . . . . . 115
State and tribal grants: supplement not supplant . . . . . . . . . . . . . . . . 115
State and tribal grants: maintenance of effort . . . . . . . . . . . . . . . . . . 115
State and tribal grants: accountability measures . . . . . . . . . . . . . . . . 116
State and tribal grants: evaluating programs . . . . . . . . . . . . . . . . . . . 116
State and tribal grants: compliance with applicable laws . . . . . . . . . 116
State and tribal grants: eligible partnerships . . . . . . . . . . . . . . . . . . . 116
State and tribal grants: authorization of appropriations . . . . . . . . . . . 117
COLLECTION OF UNIFORM NATIONAL DATA
ON ELDER ABUSE, NEGLECT, AND EXPLOITATION . . . . . . . 117
Collection of uniform national data: authorization . . . . . . . . . . . . . . 117
Collection of uniform national data: purpose . . . . . . . . . . . . . . . . . . 117
Collection of uniform national data: phase I — development
of methods of collection and reporting . . . . . . . . . . . . . . . . . . . 117
Collection of uniform national data: phase I — forms
and protection of privacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Collection of uniform national data: phase II — pilot test . . . . . . . . 119
Collection of uniform national data: phase II — adjustments
to form and methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119

Collection of uniform national data: phase III — distribution
of national data reporting forms . . . . . . . . . . . . . . . . . . . . . . . . . 119
Collection of uniform national data: phase III — data collection
grants, authorization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Collection of uniform national data: phase III — data collection
grants, application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Collection of uniform national data: phase III — data collection
grants, requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Collection of uniform national data: phase III — data collection
grants, funding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Collection of uniform national data: phase III — required
information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Collection of uniform national data: report . . . . . . . . . . . . . . . . . . . . 121
Collection of uniform national data: authorization
of appropriations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Rule of construction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
List of Tables
Table 1. Side-by-Side Comparison of Current Law,
H.R. 5293, and S. 3570 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Older Americans Act Reauthorization:
Side-by-Side Comparison of Current Law,
H.R. 5293, and S. 3570
Introduction
Authorization of appropriations for the Older Americans Act of 1965 expired
at the end of FY2005. The 109th Congress is considering legislation to reauthorize
the act. H.R. 5293, the Senior Independence Act of 2006, was reported by the House
Education and Workforce Committee on June 8, 2006,1 and was passed by the House
on June 21, 2006. S. 3570, the Older Americans Act Amendments of 2006, was
ordered reported by the Senate Committee on Health, Education, Labor and Pensions
on June 28, 2006. A compromise version of the House and Senate bills may be taken
up before the end of the 109th Congress.
The Older Americans Act (OAA) is the major vehicle for the delivery of a wide
range of supportive services, as well as nutrition services and community service
employment opportunities for older people. Title II of the act authorizes activities
of the Administration on Aging (AoA). The Title III nutrition program is the major
single service funded by the act, and provides meals to older people in congregate
settings and in their homes. Title III supportive services include information and
assistance about accessing services, a range of home and community-based long-term
care, transportation, and family caregiver support services, among many others. Title
IV
supports a wide range of research, training, and demonstration activities in the
field of aging. The Title V community service employment program supports
subsidized jobs for low-income people aged 55 and over. Title VI funds supportive
and nutrition services for Native American older people, and Title VII supports the
long-term care ombudsman program and services to prevent the abuse, neglect, and
exploitation of older persons. For a description of Older Americans Act programs
and funding, see CRS Report RL31336, The Older Americans Act: Programs and
Funding
, by Carol O’Shaughnessy.
This report highlights selected provisions of H.R. 5293 and S. 3570, and
provides a section-by-section comparison of current law with the bills.
1 Senior Independence Act of 2006, Comm. on Education and the Workforce, House of
Representatives, H.Rept. 109-493, June 8, 2006. 109th Cong., 2nd sess.

CRS-2
Highlights of Selected Provisions
of H.R. 5293 and S. 3570
Home and Community-Based Long-Term Care Services
Title III supports a wide range of home and community-based long-term care
services, including personal care, homemaker and chore services, home-delivered
nutrition services, and assisted transportation. Beyond these Title III-funded
services, many state and area agencies administer home and community-based long-
term care services not funded by Title III. These include those funded by the
Medicaid Section 1915(c) home and community-based services waiver program and
by the Social Services Block Grant program (Title XX of the Social Security Act).
Some state and area agencies on aging are responsible for administering and
managing case management and assessment of the long-term care needs of older
persons and have made great strides in expanding and coordinating a variety of
services to help older persons remain at home and avoid entry into institutions. In
recent years, AoA has supported a wide range of projects that focus on home and
community-based long-term care, including Aging and Disability Resource Centers
(ADRCs).
Program planning and service delivery initiatives by states, as well as research
and demonstration initiatives by AoA and the Centers for Medicare and Medicaid
Services (CMS), have focused on what many believe to be an institutional bias in
federal program support for long-term care. (The primary federal program that
finances long-term care services is Medicaid, and most of its long-term care spending
for the elderly is for nursing home care.)
In the Older Americans Act reauthorization legislation, both the Senate
Committee and House bills define the roles of AoA and state and area agencies on
aging with respect to home and community-based services for older people.
Role of AoA . The bills would require the Assistant Secretary on Aging within
the Department of Health and Human Services (HHS) to promote the development
and implementation of comprehensive, coordinated systems at federal, state, and
local levels for providing long-term care in home and community-based settings, in
a manner responsive to the needs and preferences of older individuals and their
family caregivers. In doing so, the Assistant Secretary would be required to, among
other things, conduct research and demonstration projects to identify innovative,
cost-effective strategies for modifying state systems of long-term care; and target
services to individuals at risk for institutional placement in order to permit them to
remain in home and community-based care settings.
Role of State and Area Agencies on Aging. Likewise, the bills would
require that state and area agencies on aging develop and implement a
comprehensive, coordinated system, at their respective levels, to develop home and
community-based services. They would accomplish this by, among other things,
collaborating, coordinating and consulting with other agencies responsible for
formulating, implementing and administering long-term care programs; and making
recommendations regarding strategies to modify the state’s long-term care system in

CRS-3
order to respond to the needs and preferences of older individuals and family
caregivers.
Aging and Disability Resource Centers (ADRCs). In recent years, AoA
has used its Title IV research and demonstration authority to award funds for ADRCs
in 43 states. The ADRC grant program is a cooperative effort between AoA and
CMS and was developed to assist states in their efforts to create a single, coordinated
system of information and access for all persons seeking long term support to assist
them in accessing services, enhance individuals’ choice of services, and support
informed decision-making. Both H.R. 5293 and S. 3570 would provide authority
in the Older Americans Act for the Assistant Secretary to continue this initiative. In
the bills, ADRCs are defined as entities that provide comprehensive information on
available public and private long-term care programs, options, and resources and
provide personal counseling to assist individuals to develop and implement a plan to
meet long-term care needs. ADRCs are to serve as a convenient point of entry for
people needing such assistance for these programs.
State and Area Agency on Aging Planning
for the Baby Boom Population

The increasing numbers of people turning age 65 in the coming decades will
place increasing burdens on aging service providers supported by the Older
Americans Act (the first wave of the baby boom population are turning age 60 in
2006). Groups representing these providers, such as the National Association of
State Units on Aging, and the National Association of Area Agencies on Aging, have
proposed new Older Americans Act initiatives to assist state and area agencies in
their planning efforts to prepare for the growing elderly population across the nation.
While state and area agencies are already responsible for assessing the needs of the
current older population in their states and areas, the baby boom population is
expected to increase the need for resources as well as planning efforts.
Both H.R. 5293 and S. 3570 would require each state agency on aging, at the
election of the state, to include in state plans on aging an assessment of how prepared
the state is for changes in the elderly population over a 10-year period. The
assessment may also include:
! an analysis of how demographic changes may affect older
individuals, including those with low-income, greatest economic
need, minority older individuals, those residing in rural areas, and
those with limited English proficiency;
! an analysis of how the programs, policies, and services provided by
states and area agencies can be improved, and how resource levels
can be adjusted to meet the needs of the changing population of
older individuals in the state; and
! an analysis of how the change in the number of persons age 85 years
and older is expected to affect the need for supportive services.
Both bills would also authorize area agencies on aging to conduct similar
activities and to make recommendations to governmental officials on actions to build

CRS-4
their capacity to respond to the needs of the growing aging population, including
health and human services, land use, housing, transportation, public safety, workforce
and economic development, among others. In addition, S. 3570 would allow an
additional 1% of a state’s allotment for Title III funds to be used for area plan
administration to carry out these activities. This could only occur when
appropriations for Title III supportive, nutrition and disease prevention and health
promotion services exceed 110% of the FY2006 amount.
Nutrition Services
The Title III nutrition program is the largest single program under the Older
Americans Act. Funded at $715.1 million in FY2006, it represents 58% of Title III
funds, and 40% of the act’s total funding. Data for FY2004 (latest available) show
that of the 249 million meals served, 57% were provided to frail older persons (and
their caregivers) at home, and 43% were provided in congregate settings, such as
senior centers and schools.2
The program serves a particularly vulnerable older population. AoA data show
that about 62% of congregate nutrition participants, and 73% of home-delivered
nutrition participants, are age 75 or older. About 52% of congregate nutrition
participants, and 61% of home-delivered participants, live alone. About 56% of
congregate nutrition participants, and 66% of home-delivered participants, report that
the meals they receive through the program provided one-half or more of their daily
food intake.3
National Academy of Sciences Study of Nutrition. Both H.R. 5293 and
S. 3570 would require the Assistant Secretary to use funds set aside for evaluation
to conduct an evidence-based evaluation of the nutrition program. The evaluation
would be conducted by the Food and Nutrition Board of the Institute of Medicine
(IOM) and is to include:
! an evaluation of the effect of nutrition projects on the health and
nutrition status of participants, prevention of hunger and food
insecurity, and ability of participants to remain living independently;
! a cost-benefit analysis of nutrition projects, including their potential
to affect costs of Medicaid; and
! recommendations on how nutrition projects may be modified to
improve outcomes, and nutritional quality of meals.
Other Nutrition Program Proposals. H.R. 5293 and S. 3570 would add
several new services designed to enhance the scope of the services currently
available. The bills would add assessment and counseling as services that may be
available to participants. In addition, H.R. 5293 would allow nutrition projects to
2 U.S. Department of Health and Human Services, Fiscal Year 2007: Administration on
Aging: Justification of Estimates for Appropriations Committees,
pp. 28-29.
3 Administration on Aging. Highlights from the Pilot Study: Second National Survey of
Older Americans Act Title III Service Recipients.
[http://www.aoa.gov/about/results/
Final-Highlights-2nd-natioinal-survey.pdf], accessed Sept. 1, 2006.

CRS-5
provide participants with a multivitamin supplement along with the meal. S. 3570
does not include this provision.
National Family Caregiver Support Program
The National Family Caregiver Support Program, added to Title III by the 2000
amendments to the act, authorizes a number of services to assist caregivers of frail
older persons, including information and assistance to caregivers about available
services; individual counseling; organization of support groups and caregiver
training; respite services to provide families temporary relief from caregiving
responsibilities; and supplemental services (such as adult day care or home care
services, for example), on a limited basis, that complement care provided by family
and other informal caregivers.
Under current law, priority is to be given to older persons and their families who
have the greatest social and economic need, with particular attention to low income
individuals, and to older persons who provide care and support to persons with
mental retardation and developmental disabilities. Under current AoA guidance,
parents of children with disabilities may receive caregiver services if their children
are age 18 or younger. If the child is age 19-59, including, for example, adult
children with developmental disabilities who still need parental care, their parents are
not eligible for the act’s caregiver services. Both bills would clarify that services
may be provided to parents of a child with disabilities regardless of age of the child
(S. 3570 specifically refers to an adult child with a developmental or related
disability, while H.R. 5293 does not limit the disability type).
Under current law, grandparents or other older individuals who are relative
caregivers for children under the age of 18 may receive caregiver support services if
they are age 60 and older. Both H.R. 5293 and S. 3570 would decrease the age of
eligibility for grandparents/relative caregivers to age 55.
Senior Community Service Employment Program
for Older Americans

The community service employment program for older Americans (also known
as the Senior Community Service Employment Program, or SCSEP) has as its
purpose the promotion of useful part-time opportunities in community service
activities for unemployed low-income persons who are 55 years or older and who
have poor employment prospects. The program not only provides opportunities for
part-time employment and income for older persons, but also contributes to the
general welfare of communities by providing a source of labor for various
community service activities. Enrollees work part-time in a variety of community
service activities. The program provides for 61,050 jobs, serving about 92,300
people in FY2006.
Both H.R. 5293 and S. 3570 make changes to the Title V program, but take
different approaches. The House bill proposals are wider in scope than those in the
Senate Committee bill, and many of its proposed changes emanate from the view that
the program should place more emphasis on training of participants for unsubsidized

CRS-6
employment than what exists under the current program. (H.R. 5293 would change
the name of the program to Older American Community Service Employment-Based
Training Act.
) While H.R. 5293 would retain the community service nature of the
jobs in which enrollees are placed, it would place more emphasis on training as part
of the program and would allow enrollees to be placed in private, for-profit
employment while serving as Title V enrollees.
Under the current program, participants primarily receive on-the-job training
after they have been placed in a community service position, rather than formal
training before placement. H.R. 5293 would decrease the amount of program funds
that could be spent on wages and fringe benefits in order to allow for an increased
amount to be used for training. Under current law, national and state grantees are to
spend 75% of their grants for wages and fringe benefits for enrollees. The remainder
is to be used for administration (between 13.5% and 15%), and other enrollee costs,
such as supportive services and training (between 10% and 12.5%). H.R. 5293
would decrease the amount to be spent on wages and fringe benefits to 65%. The
House Committee report indicates that this change would allow grantees to spend
more of their funds on classroom training and on-the-job training.4
H.R. 5293 would also allow enrollees to be placed in private, for-profit
organizations while receiving a Title V wage. The Senate bill does not make this
change and would add a provision to underline the community service employment
aspect of the program. It states that it is the sense of the Senate that the older
American community service employment program was created with the intent of
placing older individuals in community service positions to provide job training
placements; and placing older individuals in community service positions strengthens
the ability of individuals to become self-sufficient, provides much-needed volunteer
support to organizations which benefit significantly from increased civic engagement,
and strengthens the communities that are served by such organizations.
Limit on Time of Participant Enrollment. Under the current program,
there is no time limit on how long an enrollee may spend as a Title V participant. The
average length of time participants spend in the program is about 27 months. H.R.
5293 would limit participation by eligible individuals to 24 months (in the
aggregate). Individual participants could stay in the program for up to four years.
S. 3570 would allow an eligible individual to participate for up to 36 months in
the aggregate (and grantees may ask for a waiver of this limit under certain
circumstances). Under the bill, a grantee may extend the period of participation for
up to 20% of the project participants. In selecting participants for the extended
period, the grantee is to give priority to certain groups, including participants age 65
and older, those who are frail older individuals, and individuals who have more than
one barrier to employment, such as a disability, residence in an area of high
employment, or failure to find employment after using services under Title I of the
Workforce Investment Act (WIA), among other things.
4 Senior Independence Act of 2006, Comm. on Education and the Workforce, House of
Representatives, H.Rept. 109-493, June 8, 2006, 109th Cong., 2nd sess., p. 58

CRS-7
Eligibility. The bills make a number of changes to individual eligibility. When
determining an individual’s eligibility, H.R. 5293 and S. 3570 would exclude as
income unemployment compensation, Supplemental Security Income (SSI) benefits,
and 25% of benefits received under Title II of the Social Security Act. In addition,
S. 3570 would also exclude payments made to or on behalf of veterans or former
members of the Armed Forces under laws administered by the Secretary of Veterans
Affairs.
Elder Justice
Title VII authorizes Vulnerable Elder Rights Protection Activities. Two of the
four programs authorized have received funding — the long-term care ombudsman
program (whose purpose is to investigate and resolve complaints of residents of
nursing facilities, board and care facilities, and other adult care homes) and the elder
abuse, neglect and exploitation prevention program.5 Relatively limited resources
have been given to domestic elder abuse issues under Title VII. Most Title VII
funding is directed at the older people residing in institutions through the long-term
care ombudsman program. Of $20.2 million appropriated for FY2006 for Title VII
programs, almost three-quarters was for ombudsman activities.
As older individuals continue to live longer lives, increasing the likelihood of
age-related disability, those who rely on family, friends, or professionals for care
could become vulnerable to abuse, neglect, and exploitation. Given these
demographic trends, it is anticipated that cases of elder abuse, neglect, and
exploitation will increase. It has been difficult to estimate the number of older
people living in institutions and in the community who may be subject to elder abuse,
neglect and exploitation. Efforts to collect data on elder abuse, neglect, and
exploitation at the national level pose several problems, including variation in state
statutory definitions of elder abuse making it difficult to identify actions that
constitute abuse and neglect, and lack of a uniform reporting system across states.
Recognizing the need for a coordinated federal effort with a multidisciplinary
approach that combines law enforcement, public health, and social services to
combat abuse, neglect, and exploitation of the elderly, legislation has been
considered in recent Congresses. Senator John Breaux first introduced the Elder
Justice Act of 2002 (S. 2933) in the 107th Congress. A similar measure (S. 333) was
introduced in the 108th Congress; the bill was approved by the Senate Finance
Committee but never taken up on the Senate floor. On November 15, 2005, Senator
Hatch introduced S. 2010, the Elder Justice Act; the bill was ordered reported by the
Senate Finance Committee on August 3, 2006.
In addition to these efforts, Congress has included provisions related to elder
justice activities in legislation to reauthorize the Older Americans Act. Both H.R.
5293 and S. 3570 focus on efforts to increase attention to elder justice issues, but take
different approaches. In both bills, elder justice is defined as efforts to prevent,
5 Two other programs are authorized, but not funded — legal assistance development and
the Native American elder rights program.

CRS-8
detect, treat, intervene in, and respond to elder abuse, neglect, and exploitation and
to protect elders with diminished capacity while maximizing their autonomy.
AoA Responsibility for Elder Justice Issues. The House bill would
authorize the Assistant Secretary to designate within the AoA responsibility for elder
abuse prevention and services while the Senate Committee bill would authorize the
Secretary of HHS to establish within the AoA an Office of Elder Abuse Prevention
and Services.
National Incidence Study and Data Collection Efforts. S. 3570 would
authorize the Assistant Secretary to carry out a study to determine the national
incidence and prevalence of elder abuse, neglect, and exploitation in all settings. In
addition, the bill would add a provision for the collection of uniform national data on
elder abuse, neglect, and exploitation. The purpose of this provision of the bill is to
improve, streamline, and promote uniform collection, maintenance, and
dissemination of national data relating to the various types of elder abuse, neglect,
and exploitation.
Grants to States and Tribal Organizations for Elder Justice
Programs. S. 3570 would authorize funds for grants to states and Indian tribes to
strengthen long-term care and provide assistance for elder justice programs. Among
other things, state and tribal grants would be used for the following activities:
! prevention, detection, assessment, and treatment of, intervention in,
investigation of, and response to elder abuse, neglect, and
exploitation;
! examination of various types of elder shelters (referred to as “safe
havens”), and to test various safe haven models; and
! support for multidisciplinary elder justice activities.
Research and Demonstration Initiatives
S. 3570 would add authority for the Assistant Secretary on Aging to conduct
several new demonstration programs under Title IV. Among these are demonstration
projects for model projects to assist older people to age in place, including in
Naturally Occurring Retirement Communities (NORCs); and for mental health
services for older people. H.R. 5293, as passed by the House, makes no changes to
the Title IV research, training, and demonstration program.
New research and demonstration programs contained in S. 3570 include the
following.
Model Projects for Aging in Place. Many communities around the country
are experimenting with ways to assist older people who have “aged in place,” that is
who have resided in their own homes independently for many years, and now may
need a variety of supportive services to assist them to continue to do so. In recent
years, House and Senate appropriation legislation has included earmarks for a
number of projects to provide support for organizations that assist these “Naturally
Occurring Retirement Communities” (NORCs). For example, for FY2007, the
House and Senate Appropriations Committees have earmarked funds for,

CRS-9
respectively, 15 and 5 NORC projects as part of the AoA Title IV research and
demonstration program.6
Under current Older Americans Act statute, there is no explicit authority to
carry out NORC projects. S. 3570 would require that the Assistant Secretary award
Title IV funds to carry out model aging in place projects, including NORCs. The aim
of these projects would be to help sustain the independence of older individuals in
communities where the individuals have established personal, family, and
professional supportive networks. The bill defines Naturally Occurring Retirement
Community
as a residential building, a housing complex, an area (including a rural
area) of single family residences, or a neighborhood composed of age-integrated
housing where 40% of the heads of household are older individuals; or a critical mass
of older individuals that exists, based on local factors which, taken in total, allow an
organization to achieve efficiencies in the provision of health and social services to
older individuals living in the community; and that is not an institutional care or
assisted living setting.
Entities that would receive funds under this demonstration would be required
to provide comprehensive and coordinated health and social services, including the
following services: case management, case assistance, and social work services;
health care management and health care assistance; education, socialization, and
recreational activities; volunteer opportunities for project participants; and
coordinating the services provided under Title III for eligible older individuals served
by the project.
Demonstration Efforts to Address Mental Illness in Older People.
S. 3570 would add a new provision requiring the Assistant Secretary to make
competitive grants to states to develop systems for the delivery of mental health
screening and treatment services for older individuals who lack access to such
services and programs. The purpose of the grants would be to
! increase public awareness regarding the benefits of prevention and
treatment of mental disorders in older individuals;
! reduce the stigma associated with mental disorders in older
individuals and other barriers to the diagnosis and treatment of the
disorders; and
! reduce age-related prejudice and discrimination regarding mental
disorders in older individuals.
6 House Committee on Appropriations, Departments of Labor, Health and Human Services,
and Education, and Related Agencies,
H.Rept. 109-515, 109th Cong., 2nd sess., p. 161ff;
Senate Committee on Appropriations, Departments of Labor, Health and Human Services,
and Education and Related Agencies
, S.Rept. 109-287, 109th Cong., 2nd sess., p. 212.

CRS-10
Table 1. Side-by-Side Comparison of Current Law, H.R. 5293, and S. 3570
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

TITLE I, DECLARATION OF OBJECTIVES; DEFINITIONS
DEFINITIONS
Assistive device, assistive
No provision.
Defines assistive device, assistive technology,
No provision.
technology, and assistive
and assistive technology service to have the
technology service
same meaning as section 3 of the Assistive
Technology Act of 1998 (29 U.S.C. 3002).
(p. 3)
Health promotion
Defines health promotion programs as
Changes the term to evidence-based health
Same as H.R. 5293, but would eliminate
program/evidence-based
programs that include, but are not limited
promotion programs which include programs
reference to improving nutrition through the
health promotion
to, programs relating to prevention and
related to the prevention and mitigation of the
consumption of a healthful diet and
reduction of effects of chronic disabling
effects of chronic disease (including
multivitamin-mineral supplementation. (p. 2)
conditions (including osteoporosis and
osteoporosis, hypertension, obesity, diabetes,
cardiovascular disease), alcohol and
and cardiovascular disease), alcohol and
substance abuse reduction, smoking
substance abuse reduction, smoking cessation,
cessation, weight loss and control, and
weight loss and control, stress management,
stress management. These programs are
falls prevention, physical activity, and
part of the broader definitions of disease
improved nutrition through the consumption of
prevention and health promotion services.
a healthful diet and multivitamin-mineral
supplementation. (p. 3)
Information and assistance
Defines information and assistance as
Adds reference to older individuals at risk for
Same as H.R. 5293. (p. 2)
services that, among other things, serve the
institutional placement. (p. 3)
entire community of older individuals,
particularly, older individuals at greatest
social need and with greatest economic
need.

CRS-11
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Aging and Disability
No provision.
Defines ADRCs as a program established by a
Similar to H.R. 5293, except defines ADRCs
Resource Center (ADRC)
state, as part of the state’s system of long-term
as center (rather than program). (p. 4)
care, to provide a coordinated system for —
• comprehensive information on available
Same as H.R. 5293. (p. 4)
public and private long-term care programs,
options, and resources; (p. 5)
• personal counseling to assist individuals in
Same as H.R. 5293. (p. 4)
assessing their existing or anticipated long-
term care needs, and developing and
implementing a plan for long-term care
designed to meet their specific needs and
circumstances; and (p. 5)
• consumer access to the range of publicly-
Similar to H.R. 5293, except refers to
supported long-term care programs for which
consumers (rather than they). (p. 4)
they may be eligible, by serving as a
convenient point of entry for such programs.
(p. 5)
At risk of institutional
No provision.
Defines at risk for institutional placement as an
Same as H.R. 5293, except refers to
placement
older individual who is unable to perform at
substantial assistance (rather than substantial
least two activities of daily living without
human assistance) and does not require, but
substantial human assistance (including verbal
includes an older individual who is
reminding, physical cuing, or supervision) and
determined by state to be in need of
is determined by the state to be in need of
placement in a long-term care facility. (p. 4)
placement in a long-term care facility. (p. 6)
Long-term care facility
Defines long-term care facility as —
No change in current law.
Adds reference to an assisted living facility.
• any skilled nursing facility, as defined in
(p. 3)
section 1819(a) of the Social Security
Act;
• any nursing facility, as defined in section
1919(a) of the Social Security Act;

CRS-12
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

• for the purposes of sections 307(a)(12)
and 712, a board and care facility; and
any other adult care home similar to a
facility or institution.
Elder justice
No provision.
Defines elder justice as efforts to prevent,
No provision in Title II of the act. Elder
detect, treat, intervene in, and respond to elder
justice is defined in Title VII, as efforts to
abuse, neglect, and exploitation and to protect
prevent, detect, treat, intervene in, and
elders with diminished capacity while
respond to elder abuse, neglect, and
maximizing their autonomy. (p. 6)
exploitation and to protect elders with
diminished capacity while maximizing their
autonomy; and from an individual
perspective, the recognition of an elder’s
rights, including the right to be free of abuse,
neglect, and exploitation. (p. 114)
Exploitation
Defines exploitation as the illegal or
Defines exploitation as the fraudulent or
Similar to H.R. 5293, except that reference to
improper act or process of an individual,
otherwise illegal, unauthorized, or improper act
individual includes a caregiver or fiduciary.
including a caregiver, using the resources
or process of an individual who uses the
(p. 2)
of an older individual for monetary or
resources of an older individual for monetary or
personal benefit, profit, or gain.
personal benefit, profit, or gain, or that results
in depriving an older individual of rightful
access to, or use of, benefits, resources,
belongings, or assets. (p. 4)
Neglect
Defines neglect as —
Defines neglect as the failure of a caregiver or
Similar to H.R. 5293, except refers to an
• the failure to provide for oneself the
fiduciary to provide goods or services that are
older individual (rather than elder). (p. 3)
goods or services that are necessary to
necessary to maintain the health or safety of an
avoid physical harm, mental anguish, or
elder; or self-neglect. (p. 4)
mental illness; or
• the failure of a caregiver to provide the
goods or services.

CRS-13
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Self-neglect
No provision.
Defines self-neglect as an adult’s inability, due
Same as H.R. 5293. (p. 3)
to physical or mental impairment or diminished
capacity, to perform essential self-care tasks
including obtaining essential food, clothing,
shelter, and medical care; obtaining goods and
services necessary to maintain physical health,
mental health, or general safety; or managing
one’s own financial affairs. (p. 9)
Hispanic serving institution
No provision.
Defines Hispanic serving institution to have the
Same as H.R. 5293. (p. 5)
same meaning as in section 502 of the Higher
Education Act of 1965 (20 U.S.C. 1101a).
(p. 6)
Long-term care
No provision.
Defines long-term care as any services, care, or
Same as H.R. 5293, except that the term
items (including assistive devices), including
long-term care does not include disease
disease prevention and health promotion
prevention and health promotion services, in-
services, in-home services, and case
home services, and case management
management services —
services. (p. 5)
• intended to assist individuals in coping with,
Same as H.R. 5293. (p. 5)
and to the extent practicable compensate for,
functional impairments in carrying out
activities of daily living; (p. 7)
• furnished at home, in a community care
Same as H.R. 5293. (p. 5)
setting (including a small community care
setting as defined in subsection (g)(1), and a
large community care setting as defined in
subsection (h)(1), of section 1929 of the
Social Security Act (42 U.S.C. 1396t)), or in
a long-term care facility; and (p. 7)
• not furnished to prevent, diagnose, treat, or
Same as H.R. 5293, except does not include
cure, a medical disease or condition. (p. 7)
the term prevent. (p. 5)

CRS-14
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Multivitamin-mineral
No provision.
Defines multivitamin-mineral supplement as a
No provision.
supplement
dietary supplement that provides at least two-
thirds of the essential vitamins and minerals at
100 percent of the daily value levels as
determined by the Food and Drug
Administration. (p. 7)
Self-directed care
No provision.
Defines self-directed care as an approach to
Same as H.R. 5293 with slightly different
providing services (including programs,
wording. (p. 5)
benefits, supports, and technology) under this
act intended to assist an older individual with
activities of daily living, in which —
• services (including the amount, duration,
• Same as H.R. 5293. (p. 6)
scope, provider, and location of services) are
planned, budgeted, and purchased under the
direction and control of such individual;
(p. 8)
• the individual is provided with information
• Similar to H.R. 5293, except refers to an
and assistance as necessary and appropriate to
individual’s service options (rather than
enable informed decisions about his or her
care options). (p. 6)
care options; (p. 8)
• the individual’s needs, capabilities, and
Similar to H.R. 5293, except that services are
preferences for services and the individual’s
assessed by the area agency on aging
ability to direct and control his or her receipt
involved or the local provider agency (rather
of services, are assessed by the area agency
than an agency designated by the area
on aging (or other agency designated by the
agency on aging). (p. 6)
area agency on aging); (p. 8)
• based on the assessment, the area agency on
Similar to H.R. 5293, except that upon
aging (or other agency designated by the area
request the area agency on aging assists the
agency on aging) together with the
individual and the individual’s family,
individual’s family, caregiver, or legal
caregiver, or legal representative in
representative develops a plan of services that
developing the plan, role of family, and
specifies which services the individual will be
budget. (p. 6)
responsible for directing; a determination of
the role of family members (and others whose
participation is sought by the individual) in

CRS-15
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

providing services under such plan; and a
budget for services; (p. 9)
• the area agency on aging or state agency
Same as H.R. 5293, but refers to the area
provides for oversight of such individual’s
agency on aging or state agency involved.
self-directed receipt of services, including
(p. 7)
steps to ensure the quality of services
provided and the appropriate use of funds
under this act. (p. 9)
State system for long-term
No provision.
Defines state system for long-term care as the
Same as H.R. 5293. (p. 7)
care
federal, state, and local programs and activities
administered by a state that provide, support, or
facilitate access to long-term care to individuals
in such state. (p. 10)
TITLE II, ADMINISTRATION ON AGING (AoA)
FUNCTIONS OF THE ASSISTANT SECRETARY ON AGING
Elder abuse prevention
No provision.
The bill would authorize the Assistant Secretary
The bill would authorize the Secretary of
services
to designate within the AoA responsibility for
Health and Human Services (HHS) to
elder abuse prevention and services. (p. 10)
establish or designate within the AoA an
Office of Elder Abuse Prevention and
Services. (p. 7)
The bill would require the Assistant Secretary,
Same as H.R. 5293. (p. 8)
acting through the person designated with
responsibility for elder abuse prevention and
services, to develop objectives, priorities,
policy and a long-term plan for —
• carrying out elder justice programs and
Same as H.R. 5293. (p. 8)
activities relating to elder abuse prevention,
detection, treatment, intervention, and
response; training of individuals in these
matters; and improvement of the elder justice
system in the U.S.; (p. 10)

CRS-16
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

• collecting and disseminating data relating to
Same as H.R. 5293, would add that collecting
the abuse, neglect, and exploitation of older
and disseminating data will be conducted
individuals; (p. 11)
annually and authorizes the Secretary to
include vulnerable adults (in addition to
older adults). (p. 8)
No provision.
Would also authorize the inclusion of data
under section 753 (as added by the bill) after
consultation with the Attorney General and in
collaboration with experts from the
Department of Justice. (p. 8)
• disseminating information concerning best
• Same as H.R. 5293, but would authorize
practices regarding, and providing training
the Secretary to include vulnerable adults
on, carrying out activities related to abuse,
(in addition to older individuals). (p. 9)
neglect, and exploitation of older individuals;
(p. 11)
• conducting research related to abuse, neglect,
• Same as H.R. 5293, would require the
and exploitation of older individuals; (p. 11)
Assistant Secretary to conduct research in
conjunction with the necessary experts
and
authorizes the Secretary to include
vulnerable adults (in addition to older
individuals
). (p. 9)
• providing technical assistance to states and
• Similar to H.R. 5293 with different
other eligible entities under Title VII; (p. 11)
wording and refers to subtitle B of Title VII
as added by the bill. (p. 9)
• assisting states and other eligible entities
No provision.
under Title VII to develop strategic plans to
better coordinate elder justice activities,
research, and training; and (p. 11)
• promoting collaborative efforts and
No provision.
diminishing duplicative efforts in the
development and carrying out of elder justice
programs at the federal, state, and local
levels. (p. 11)

CRS-17
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

National study on incidence
No provision.
No provision.
Would authorize the Assistant Secretary to:
and prevalence of elder
• carry out a study to determine the national
abuse, neglect, and
incidence and prevalence of elder abuse,
exploitation
neglect, and exploitation in all settings; and
• implement the overall policy and a strategy
to carry out the plan described above; and
provide advice to the Secretary on elder
justice issues and administer such programs
relating to elder abuse, neglect, and
exploitation as the Secretary determines to
be appropriate.
The Secretary, acting through the Assistant
Secretary, may issue such regulations as may
be necessary to carry out this subsection and
subtitle B of Title VII as added by the bill.
(p. 9)
Mental health services
No provision.
The bill would authorize the Assistant Secretary No provision.
to designate an officer or employee who shall
be responsible for the administration of mental
health services authorized under the act.
The Assistant Secretary, acting through the
officer or employee, would be required to
develop objectives, priorities, and a long-term
plan for supporting state and local efforts
involving education, prevention, and detection,
and treatment of mental disorders, including
age-related dementia, depression, and
Alzheimer’s disease and related neurological
disorders. (p. 12)
Assistive technology
Section 202(a)(5) requires the AoA to
The bill would add assistive technologies to the
No provision.
develop plans, conduct and arrange for
list of programs. (p. 12)
research in the field of aging, and assist in
the establishment and implementation of
programs designed to meet the needs of
older individuals for supportive services

CRS-18
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

(including nutrition), hospitalization,
education and training services (including
preretirement training, and continuing
education); low-cost transportation and
housing; and health (including mental
health) services.
Coordination with Centers
No provision.
The bill would require the Assistant Secretary
Same as H.R. 5293, but does not include
for Medicare and Medicaid
to consult and coordinate activities with the
requirement to coordinate with other federal
Services (CMS) regarding
CMS and other federal entities to implement
entities. (p. 10)
new benefits
and build awareness of programs providing
benefits affecting older individuals. (p. 12)
Technical assistance
Section 202(a)(20) requires the AoA to
The bill would add reference to service
No provision.
regarding benefits outreach
encourage and provide technical assistance
providers to carry out outreach activities. It
and establishment of a
to states and area agencies on aging, to
would require outreach regarding any other
National Center on Senior
carry out outreach to inform older
applicable federal programs, or any other
Benefits
individuals with greatest economic need
service (including technology and internet-
who may be eligible to receive, but are not
based decision support tools) to assist
receiving, benefits under the Supplemental
consumers to learn about, to receive benefits
Security Income (SSI), Medicaid, and food
under, and to participate in programs for which
stamps programs.
they may be eligible. (p. 13)
The bill would require AoA to provide
Similar to H.R. 5293, with different wording.
technical assistance and support for benefits
Also refers to greatest economic need. (p. 11)
enrollment assistance and outreach to support
efforts to inform and enroll low-income older
individuals who may be eligible to participate,
but who are not participating, in federal and
state programs for which they are eligible, and
may in cooperation with federal partners, make
grants or contracts to establish a National
Center on Senior Benefits Outreach and
Enrollment, which is required to —
• maintain and update web-based decision
Similar to H.R. 5293, with slightly different
supports and enrollment tools and integrated,
wording. Also refers to benefits under
person-centered systems designed to inform
federal and state programs. (p. 11)
older individuals about the full range of

CRS-19
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

benefits for which they may be eligible;
(p. 14)
• utilize cost-effective strategies to find and
Same as H.R. 5293, with slightly different
enroll those with greatest economic need;
wording. (p. 11)
(p. 14)
• create and support efforts for ADRCs, and
Same as H.R. 5293, with slightly different
other public and private state and community-
wording. (p. 11)
based organizations and coalitions, including
faith-based organizations, to serve as
enrollment benefit centers; (p. 14)
• develop and maintain an information
Similar to H.R. 5293, with slightly different
clearinghouse on best practices and cost-
wording. Also refers to individual with
effective methods for identifying and
greatest economic need, instead of limited
enrolling limited income older Americans in
income (in the act greatest economic need
benefits for which they are eligible; and
refers to income below the federal poverty
(p. 14)
level). (p. 12)
• provide, in collaboration with federal partners
Same as H.R. 5293, slightly different
administering programs, training and
wording. Also refers to follow-up strategies
technical assistance on effective outreach
for federal and state programs. (p. 12)
screening, enrollment and follow-up
strategies. (p. 14)
Data collection on home and
Section 202(a)(26)(D) requires AoA to
The bill would eliminate reference to gaps in
Similar to H.R. 5293. (p. 12)
community-based care
design and implement data collection
services needed, and change reference to
procedures, including procedures for
services needed by older individuals (including
collecting information on gaps in services
services that would permit such individuals to
needed by older individuals.
receive long-term care in home and
community-based settings)
. (p. 15)
Evidence-based disease
No provision.
The bill would add a new provision requiring
Same as H.R. 5293, but would make
prevention and health
AoA to make available to states, area agencies,
information available to states only. (p. 13)
promotion
and service providers, information and
technical assistance to support the provision of
evidence-based disease prevention and health
promotion services. (p. 15)

CRS-20
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

AoA role in long-term care
Section 202(b) requires AoA to strengthen
The bill would rewrite requirements for AoA’s
Same as H.R. 5293. (p. 13)
its involvement in the development of
role in long-term care. It would require the
policy alternatives in long-term care and to
Assistant Secretary to promote the development
give the development of community
and implementation of comprehensive,
alternatives priority attention. In doing so,
coordinated systems at federal, state, and local
the Assistant Secretary is required to —
levels for providing long-term care in home and
• develop planning linkages with
community-based settings, in a manner
utilization and quality control peer
responsive to the needs and preferences of
review organizations under Title XI of
older individuals and their family caregivers. In
the Social Security Act, the Substance
doing so, the Assistant Secretary would be
Abuse and Mental Health Services
required to —
Administration (SAMHSA), and the
• collaborate, coordinate, and consult with
Administration on Developmental
other federal agencies and departments
Disabilities (ADD);
responsible for formulating and implementing
• participate in all departmental and
programs, benefits, and services related to
interdepartmental activities related to
providing long-term care, and authorize the
institutional and noninstitutional long-
Assistant Secretary to make grants, contracts,
term health care services development;
and cooperative agreements with funds
• review and comment on all departmental
received from other federal entities;
regulations and policies on community
• conduct research and demonstration projects
health and social service development for
to identify innovative, cost-effective
older individuals; and
strategies for modifying state systems of
• participate in all departmental and
long-term care to respond to the needs and
interdepartmental activities to provide a
preferences of older individuals and family
leadership role for AoA, and for state
caregivers; and target services to individuals
and area agencies on aging in the
at risk for institutional placement, to permit
development and implementation of
them to remain in home and community-
national community-based long-term
based care settings; and
care programs for older individuals.
• establish criteria and promote the
implementation (through area agencies on
aging, service providers, and such other
entities as the Assistant Secretary determines
to be appropriate) of 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. (p. 16)

CRS-21
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Home and community-based
No provision.
Facilitate, in coordination with CMS, the Cash
Similar to H.R. 5293; excludes reference to
long-term care, and models for
and Counseling National Program office, and
the Cash and Counseling National Program
care
other federal entities as appropriate, the
office and other federal entities as
provision of long-term care in home and
appropriate, but would facilitate with CMS.
community-based settings, including self-care
(p. 14)
models that —
Assessment of needs
• provide for the assessment of the needs and
Same as H.R. 5293, except refers to
preferences of an individual at risk for
institutional placement (rather than nursing
institutional placement to help them avoid
home placement), and has slightly different
unnecessary nursing home placement and
wording. (p. 14)
depletion of income and assets to qualify for
Medicaid eligibility; (p. 17)
Option of individual to direct
• respond to the needs and preferences of the
Similar to H.R. 5293 with different wording.
and control supportive
individual and provide him/her (or
Includes a definition of representative. (p.
services
representative, as appropriate) the option to
15)
direct and control the receipt of support
services provided; and (p. 17)
Individual plan for long-term
• assist an older individual (or a representative,
Same H.R. 5293, slightly different wording.
care
as appropriate) develop a plan for long-term
(p. 15)
support, including the selecting, budgeting,
and purchasing of home and community-
based long-term care and supportive services;
(For purposes of this paragraph, the term
‘representative’ means a person appointed by
the eligible individual, or legally acting on the
individual’s behalf to represent or advise the
individual in financial or service coordination
matters). (p. 17)
AoA to play lead role in long-
No provision.
Require the AoA to play a lead role with
Same as H.R. 5293. (p. 15)
term care
respect to issues concerning home and
community-based long-term care, including —
• directing (as the Secretary or the President
determines to be appropriate) or otherwise
participating in departmental and
interdepartmental activities concerning long-

CRS-22
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

term care;
• reviewing and commenting on departmental
rules, regulations, and policies related to
providing long-term care; and
• making recommendations to the Secretary
with respect to home and community-based
long-term care, including recommendations
based on findings made through research and
demonstration projects to modify state long-
term care systems. (p.18)
Advance planning for long-
No provision.
Promote, in coordination with other appropriate
Same as H.R. 5293. (p. 16)
term care
federal agencies, enhanced public awareness
for the importance of planning in advance for
long-term care and the availability of
information and resources to assist in such
planning. (p. 19)
Aging and Disability
No provision.
Implement in all states ADRCs —
No provision. (See section on ADRCs in
Resource Centers (ADRCs)
• to serve as visible and trusted sources of
Title III under State plans.)
information on the full range of long-term
care options that are available in the
community, including both institutional and
home and community-based care;
• to provide personalized and consumer
friendly assistance to empower people to
make informed decisions about their care
options;
• to provide coordinated and streamlined access
to all publicly supported long-term care
options so that consumers can obtain the care
they need through a single intake, assessment
and eligibility determination process;
• to help people to plan ahead for their future
long-term care needs; and
• to assist, in coordination with the state Health
Insurance Assistance Program, Medicare
beneficiaries in understanding and accessing
the Prescription Drug Coverage and

CRS-23
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

preventative health benefits available under
the Medicare Modernization Act. (p. 19)
National technical assistance
No provision.
The bill would establish, either directly or
Similar to H.R. 5293, refers to a national
programs for home and
through grants or contracts, national technical
technical assistance program (rather than
community-based services
assistance programs to assist state agencies,
programs) and the term evidence-based does
area agencies on aging, and community-based
not include health promotion and disease
service providers funded under this act in
prevention programs. (p. 16)
implementing home and community-based
long-term care systems, including evidence-
based health promotion and disease prevention
programs. (p. 20)
Performance standards for
No
provision.
D e v e l o p , i n c o l l a b o r a t i o n
wi t h
t h e
Same as H.R. 5293. (p. 17)
long-term care
Administrator of CMS, performance standards
and measures for use by states to determine the
extent to which their systems of long-term care
fulfill the objectives described in this
subsection. (p. 20)
Other long-term care
No provision.
Conduct such other activities as the Assistant
Same as H.R. 5293. (p. 17)
activities
Secretary determines to be appropriate. (p. 21)
Involvement of older
No provision.
The bill would require the Assistant Secretary,
Similar to H.R. 5293 with slightly different
individuals in voluntary
in consultation with the Corporation for
wording. (p. 17)
community activities
National and Community Service to —
• encourage and permit voluntary groups active
Similar to H.R. 5293, but references national
in supportive services and civic engagement,
service programs. (p. 17)
including youth organizations active at the
secondary or postsecondary levels, to
participate and be involved individually or
through representative groups, in such
programs or activities to the maximum extent
feasible; (p. 21)
• develop a comprehensive strategy for
Similar to H.R. 5293, but does not reference
utilizing older individuals to address critical
engagement of older individuals in the
local needs of national concern, including the
activities of public and nonprofit
engagement of older individuals in the
organizations, such as community-based and

CRS-24
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

activities of public and nonprofit
faith-based organizations. (p. 17)
organizations such as community-based and
faith-based organizations; and (p. 21)
• encourage other community capacity building
Similar to H.R. 5293, but does not reference
initiatives involving older individuals, with
with particular attention to initiatives that
particular attention to initiatives that
demonstrate the effectiveness and cost
demonstrate the effectiveness and cost
savings in meeting critical needs. (p. 18)
savings in meeting critical needs. (p. 21)
AoA collaboration with other
Section 203(a) requires the heads of
The bill would add reference to older
Same as H.R. 5293. (p.18)
federal agencies: reference to
federal departments, agencies, or
individuals with limited English proficiency. (p.
impact on persons with
instrumentalities administering programs
22)
limited English proficiency
and services related to the Older
Americans Act to develop a written
analysis of their impact on older
individuals (with particular attention to
low-income minority older individuals and
older individuals residing in rural areas)
and Title V eligible individuals.
Assistive Technology Act
Section 203(a) requires the
AoA
to
The bill would add reference to sections 4 and
Same as H.R. 5293. (p. 18)
coordinate, advise and consult with heads
5 of the Assistive Technology Act of 1998 (29
of numerous federal agencies and
U.S.C. 3003-3004). (p. 22)
programs.
Coordinating committee on
No provision.
No provision.
The bill would require the Secretary of HHS
aging
to establish an interagency coordinating
committee (Committee) focusing on the
coordination of agencies with respect to
aging issues, particularly related to
demographic changes and housing needs
among older individuals. This would be
established in collaboration with the
Secretary of Labor, the Secretary of Housing
and Urban Development (HUD), the
Attorney General, the Secretary of

CRS-25
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Transportation, the Secretary of the Treasury,
the Secretary of Agriculture, the
Commissioner of Social Security, the
Surgeon General, the Administrator of CMS,
the Director of the Centers for Disease
Control and Prevention, the Director of the
National Institutes of Health, the Assistant
Secretary for Children and Families, the
Administrator of the National Highway
Traffic Safety Administration, and such other
federal officials as the Secretary of HHS
determines to be appropriate. (p. 18)
The bill would require the Secretary of HHS
to serve as the first chairperson of the
Committee, for an initial period of two years.
After the initial period, the bill would require
the Secretary of HUD and the Secretary of
HHS to alternate as chairpersons, each
serving as chairperson for a period of two
years. (p. 19)
The Committee is required to:
1) review all federal programs and services
that assist older individuals in finding and
affording housing, health care, and other
services, including those federal programs
and services that assist older individuals in
accessing health care, transportation,
supportive services, and assistance with daily
activities, at the place or close to the place
where the older individuals live;
2) monitor, evaluate, and recommend
improvements in programs and services
administered, funded, or financed by federal,
state, and local activities to assist older

CRS-26
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

individuals in meeting their housing, health
care, and other service needs and make any
recommendations about how the agencies can
better carry out and provide the programs and
services to house and serve older individuals;
recommend ways to —
• facilitate aging in place, by identifying and
making available the programs and services
necessary to enable older individuals to
remain in their homes as they age;
• reduce duplication by federal agencies of
programs and services to assist in meeting
older individuals’ housing, health care, and
other service needs;
• ensure collaboration among and within
agencies in providing and making available
programs and services so that older
individuals are able to easily access needed
programs and services;
• work with states to better provide housing,
health care, and other services to older
individuals by holding individual meetings
with state representatives, providing
ongoing technical assistance to states about
better meeting the needs of older
individuals; and working with states to
designate state liaisons for the Committee;
• identify model programs and services to
assist older individuals in meeting their
housing, health care, and other service
needs, including programs linking housing,
health care, and other services, financing
products offered by government, quasi-
government, and private sector entities, and
innovations in technology applications that
give older individuals access to information

CRS-27
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

on available services or that help in
providing services to older individuals;
• collect and disseminate information about
older individuals and the programs and
services available to them to ensure that
they can access comp rehensive
information; and
• work with the Federal Interagency Forum
on Age-Related Statistics, the Bureau of the
Census, and member agencies to collect
and maintain data relating to the housing,
health care, and other service needs of older
individuals so that all such data can be
accessed in one place on a designated
website; and to identify and address unmet
data needs. (p. 20)
3) Make recommendations to guide policy
and program development across federal
agencies with respect to demographic
changes among older individuals; and (p. 22)
4) Actively seek input from and consult with
all appropriate and interested parties,
including public health interest and research
groups and foundations about these activities.
(p. 23)
Each year, the Committee is required to
prepare and submit to the President, the
Committee on Financial Services of the
House of Representatives, the Committee on
Education and the Workforce of the House of
Representatives, the Committee on Banking,
Housing and Urban Affairs of the Senate, the
Committee on Health, Education, Labor, and
Pensions of the Senate, and the Special

CRS-28
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Committee on Aging of the Senate, a report
that —
• d e s c r i b e s t h e a c t i v i t i e s a n d
accomplishments of the Committee in
working with federal, state, and local
governments, and private organizations, in
coordinating programs and services to meet
the requirements of the Committee; (p. 23)
• assesses the level of federal assistance
required to meet the needs described for the
Committee; (p. 23)
• incorporates an analysis from the head of
each agency that is a member of the
Committee that describes the barriers and
impediments, including barriers and
impediments in statutory and regulatory
law, to the access and use by older
individuals of programs and services
administered by such agency; and (p. 23)
• makes recommendations for appropriate
legislative and administrative actions to
meet the needs described for the Committee
and/or coordinating programs and services
designed to meet those needs. (p. 24)
The Secretary of HHS is required to appoint
an executive director of the Committee, after
consultation with the Secretary of HUD. On
the request of the Committee, any federal
government employee may be detailed to the
Committee without reimbursement, and such
detail shall be without interruption or loss of
civil service status or privilege. (p. 24)

CRS-29
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Functions of nutrition
Section 205 requires the AoA nutrition
The bill would change the reference to
Same as H.R. 5293. (p. 25)
program officer
project officer to carry out a number of
designing, implementing, and evaluating
functions. These include:
evidence-based programs to support improved
• designing, implementing, and evaluating
nutrition and regular physical activity for older
nutrition programs;
individuals. (p. 23)
• disseminating information to nutrition
The bill would require the officer to conduct
Same as H.R. 5293. (p. 25)
service providers about nutrition
outreach and disseminate evidence-based
advancements.
information to nutrition service providers about
the benefits of healthful diets and regular
physical activity, including information about
the most current Dietary Guidelines for
Americans published under section 301 of the
National Nutrition Monitoring and Related
Research Act of 1990 (7 U.S.C. 5341), the
Food Guide Pyramid published jointly by the
Secretary of HHS and the Secretary of
Agriculture, and advances in nutrition science.
(p. 23)
No provision.
The bill would require the officer to:
Same as H.R. 5293, but does not include
• disseminate guidance that describes strategies
reference to strategies for increasing the
for improving the nutritional quality of meals
consumption of whole grains, low-fat dairy
provided under Title III, particularly
products, fruits, and vegetables. (p. 26)
strategies for increasing the consumption of
whole grains, low-fat dairy products, fruits
and vegetables; (p. 24)
No
provision.
• develop and disseminate guidelines
for
No provision.
conducting nutrient analyses of meals,
including guidelines for averaging key
nutrients over an appropriate period of time;
and (p. 24)
No provision.
• provide technical assistance to the AoA
Same as H.R. 5293. (p. 26)
regional offices. (p. 24)

CRS-30
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Expertise of the nutrition
Section 205(a)(2)(C) requires that the
The bill would require the officer to have
Similar to H.R. 5293, but does not include
officer
nutrition officer have expertise in nutrition
expertise in nutrition, energy balance, and meal
expertise in energy balance. (p. 26)
and dietary services and planning.
planning. (p. 24)
Set aside of funds for
Section 206 authorizes the Secretary to use
The bill would authorize the Secretary to use up
Same as H.R. 5293. (p. 26)
evaluation projects
such funds as may be necessary, but not to
to ½ of 1 percent of Title III funds for
exceed $3 million (of which $1.5 million
evaluation. (For FY2006, for example, this
shall be available from Title III funds
would amount to $6 million rather than $3
appropriated and $1.5 million shall be
million in current law). (p. 25)
available from Title IV funds), to conduct
evaluations under this section.
Reports on the activities
Section 207(b)(2) requires the Assistant
The bill would change the provision to require
Same as H.R. 5293. (p. 27)
under the act
Secretary to submit a report on activities
the report be submitted to —
under the act to —
• the Special Committee on Aging of the
• the Special Committee on Aging of the
Senate;
Senate;
• the Committee on Education and the
• the Committee on Education and Labor
Workforce of the House of Representatives;
of the House of Representatives; and
and
• the Committee on Labor and Human
• the Committee on Health, Education, Labor,
Resources of the Senate.
and Pensions of the Senate. (p. 25)
Contracting and grant
Section 212 requires that none of the
The bill would amend the provision to read as
Similar to H.R. 5293, but specifies that
authority; commercial and
provisions are to be construed to prevent a
follows: Section 212. Contracting and Grant
individuals who seek services may
private pay relationships;
recipient of a grant or a contract from
Authority; Private Pay Relationships;
voluntarily pay at their own private expense.
appropriate use of act funds
entering into an agreement, subject to the
Appropriate Use of Funds.
(p. 28)
approval of the state agency (or in the case
(a) In General. — Subject to subsection (b), this
of a grantee under Title VI, subject to the
act shall not be construed to prevent a recipient
recommendation of the Director of the
of a grant or a contract from entering into an
Office for American Indian, Alaskan
agreement —
Native, and Native Hawaiian Aging, and
• with a profitmaking organization;
the approval of the Assistant Secretary),
• under which funds provided under such grant
with a profitmaking organization to carry
or contract are used to pay part or all of a cost
out the provisions of this act and of the
(including an administrative cost) incurred by
appropriate state plan.
such recipient to carry out a contract or
commercial relationship for the benefit of
older individuals or their family caregivers,

CRS-31
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

whether such relationship is carried out to
implement a provision of this act or to
conduct activities inherently associated with
implementing such provision; or
• under which any individual, regardless of age
or income (including the family caregiver of
such individual), who seeks to receive one or
more services pays, at their own private
expense, to receive such services based on the
fair market value of such services. (p. 26)
(b) Ensuring Appropriate Use of Funds. — An
agreement described under subsection (a) may
not —
• be made without the prior approval of the
state agency (or, in the case of a grantee
under Title VI, without the prior
recommendation of the Director of the Office
for American Indian, Alaska Native, and
Native Hawaiian Aging and the prior
approval of the Assistant Secretary);
• directly or indirectly provide for, or have the
effect of, paying, reimbursing, or otherwise
compensating an entity under such agreement
in an amount that exceeds the fair market
value of the goods or services furnished by
such entity under such agreement;
• result in the displacement of services
otherwise available to an older individual
with the greatest social need, an older
individual with greatest economic need, or an
older individual who is at risk for institutional
placement; or
• in any other way compromise, undermine, or
be inconsistent with the objective of serving
the needs of older individuals, as determined
by the Assistant Secretary. (p. 27)

CRS-32
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Nutrition education
Section 214 authorizes the
Assistant
The bill would authorize the Assistant
Same as H.R. 5293, but adds reference to
Secretary and the Secretary of Agriculture
Secretary, in consultation with the Secretary of
providing information on optimal nutrition
to provide technical assistance and
Agriculture, to conduct outreach and provide
intake. (p. 29)
appropriate material to agencies carrying
technical assistance to agencies and
out nutrition education programs in
organizations that serve older individuals to
accordance with section 339(2)(J).
assist them in carrying out integrated health
promotion and disease prevention programs
that are designed for older individuals and that
include nutrition education, physical activity,
and other activities to modify behavior and to
improve health literacy (including information
on optimal nutrition intake) through education
and counseling in accordance with section
339(2)(J). (p. 27)
Pension counseling and
Section 215 authorizes the Assistant
The bill would add reference to older
Same as H.R. 5293. (p. 30)
information programs
Secretary to include, as part of the
individuals with limited English proficiency. (p.
application, a plan to provide information,
28)
counseling, referral and assistance
regarding pension and other retirement
benefits, with particular emphasis on
outreach to women, minorities, older
individuals residing in rural areas and low-
income retirees.
Section 215 requires the Assistant
The bill would add reference to populations
Same as H.R. 5293. (p. 30)
Secretary to consider, among the criteria in
with limited English proficiency. (p. 28)
awarding pension counseling programs
grants, the applicant’s ability to perform
effective outreach to affected populations,
particularly populations that are identified
in need of special outreach.
No provision.
No provision.
The bill would add reference to individuals
with limited English proficiency
to the
content of the pension assistance national
telephone hotline. (p. 30)

CRS-33
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Authorization of
Section 216 authorizes the appropriation of
The bill would authorize such sums as may be
Same as H.R. 5293. (p. 30)
appropriations for Title II
such sums as may be necessary for AoA
necessary for FY2006-FY2011. (p. 29)
activities
administration, salaries and expenses, the
National Elder Locator Service, and
Pension Counseling and Information
Programs for FY2001-FY2005.
TITLE III, GRANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING
Purpose of Title III:
Section 301 of the act states that the
The bill would add to the entities, organizations
Same as H.R. 5293. (p. 31)
coordination with volunteer
purpose of Title III is to encourage and
with experience in providing senior volunteer
services
assist state and area agencies on aging to
services, such as federal volunteer programs
develop greater capacity and foster the
administered by the Corporation for National
development and implementation of
and Community Services designed to provide
comprehensive and coordinated systems to
training, placement and stipends for volunteers
serve older individuals by entering into
in community service settings. (p. 29)
cooperative arrangements with a number
of entities, including other state agencies,
Indian tribes, tribal organizations, and
providers, among others.
Authorization of
The law authorizes such sums as may be
The bill would authorize such sums as may be
Same as H.R. 5293. (p. 32)
appropriations: supportive,
necessary for each of FY2001-FY2005.
necessary for each of FY2007-FY2011. (p. 30)
nutrition, and disease
prevention and health
promotion services

Authorization of
The law authorizes $125 million for
The bill would authorize such sums as may be
The bill would authorize $170 million in
appropriations: National
FY2001, if the aggregate amount
necessary for each of FY2007-FY2011.
FY2008; $180 million in FY2009; $190
Family Caregiver Support
appropriated for supportive services,
(p. 30)
million in FY2010; and $200 million in
Program
congregate nutrition services, home-
FY2011. (p. 32)
delivered nutrition services, and disease
prevention and health promotion exceeds
the FY2000 amount. It also authorizes
such sums as may be necessary for
FY2002-FY2005.

CRS-34
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

The law requires that of funds authorized
No provision.
No provision.
for the national caregiver program, 4% be
reserved for national innovative
approaches to caregiving, and 1% be
reserved for activities of national
significance to promote quality and
improvement in caregiver support.
Area agency administrative
No provision.
No provision.
The bill would allow an additional 1% of the
funds to be use for needs
state’s allotment to be used for area plan
assessment of growing elder
administration to carry out activities related
population
to assessment of the needs of the growing
elderly population (added by the bill). This
could occur only when appropriations for
Title III supportive, nutrition, and disease
prevention and health promotion services
exceed 110% of the FY2006 appropriations
level. (p. 33)
State plans on aging: focus on
Section 305(a) of the law requires state
The bill would add reference to older
Same as H.R. 5293. (p. 33-34)
older individuals with limited
agencies to divide the state into planning
individuals with limited English proficiency.
English proficiency
and service areas that consider among
(p. 31)
other things, the distribution of older
people, with particular attention to low
income minority individuals and older
individuals residing in rural areas and that
preference in providing services will be
given to these groups.
State long-term care systems
No provision.
The bill would require that the state agency on
Similar to H.R. 5293, but with slightly
aging promote the development and
different wording in some places. (p. 34)
implementation of a comprehensive,
coordinated system in the state for providing
long-term care in home and community-based
settings, in a manner that is responsive to the
needs and preferences of older individuals and
their families by:

CRS-35
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

• collaborating, coordinating, and consulting
with other agencies responsible for
formulating, implementing, and administering
programs, benefits, and services regarding
long-term care;
• participating in state government activities
regarding long-term care;
• conducting analysis and making
recommendations with respect to strategies
for modifying the state’s long-term care
system in order to respond to the needs and
preferences of individuals and family
caregivers; facilitate provision of home and
community-based care; target services to
Refers to targeting services to older
those at risk of institutional placement; and
individuals at risk of institutional placement.
implement evidence-based programs to assist
older individuals and their family caregivers
No reference to evidence-based programs.
in learning about and making behavioral
changes to reduce the risk of injury, disease,
and disability; and
• providing for distribution of information on
the need to plan in advance for long-term care
and on the range of available public and
private long-term care programs, options, and
resources. (pp. 31-33)
Puerto Rico, single planning
No provision.
No provision.
The bill would allow the Commonwealth of
and service area
Puerto Rico to designate a single planning
and service area, with the approval of the
Assistant Secretary. (p. 36)
AREA PLANS ON AGING
Area plans on aging: focus on
Section 306(a)(1) requires area plans on
The bill would add reference to older
Same as H.R. 5293. (p. 37)
older individuals with limited
aging to develop a comprehensive and
individuals with limited English proficiency.
English proficiency
coordinated system for supportive,
(p. 33)
nutrition, and multi-purpose senior centers

CRS-36
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

taking into consideration the number of
older individuals with low income, the
number of older individuals with greatest
economic need, and the number with
greatest social need (with particular
attention to low-income minority people
and older individuals residing in rural
areas).
Area plans on aging: focus on
Section 306(a)(1) requires area plans on
The bill would add reference to the number of
Same as H.R. 5293. (p. 37)
persons at risk of institutional
aging to develop a comprehensive and
older individuals at risk for institutional
placement
coordinated system for supportive,
placement residing in the area. (p. 34)
nutrition, and multi-purpose senior centers
taking into consideration the number of
older individuals with low-income, the
number of older individuals with greatest
economic need, and the number with
greatest social need (with particular
attention to low income minority people
and older individuals residing in rural
areas).
Area plans on aging: mental
No provision.
No provision.
The bill would require area agencies to
health services
provide assurances that an adequate
proportion of Title III funds be spent on
services associated with access services,
including health services (including mental
health). (p. 37)
Area plans on aging:
No provision.
No provision.
The bill would include as information and
information and assistance
assistance, services on the availability of
supportive services under part B of the act,
and how to receive benefits under and
participate in publicly supported programs
for which the consumer may be eligible.
(p. 38)

CRS-37
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Area plans on aging: specific
Section 306(a)(4) requires area plans on
The bill would require area plans to set
Similar to H.R. 5293, but wording is
objectives for serving older
aging to assure that they will set specific
objectives, consistent with state policy, for
different. (p. 38)
individuals
objectives for providing services to older
providing services to not only those with the
individuals with greatest economic and
greatest economic and social need, but also to
social need, and include specific objectives
individuals at risk of institutional placement,
for providing services to low-income
and include objectives and proposed methods to
minority individuals and older individuals
serve these individuals. (p. 34)
residing in rural areas.
Area plans on aging:
Section 306(a)(4)(A)(ii) requires area
The bill would add reference to older
Similar to H.R. 5293. (p. 38)
provider agreement
agencies on aging to include in provider
individuals with limited English proficiency.
regarding serving older
agreements they make with service
(p. 35)
individuals
providers, a requirement that providers
specify how they intend to serve the needs
of low-income minority individuals
(among other groups).
Area plans on aging:
Section 306(a)(4)(B) requires that the area
The bill would also require outreach to older
Similar to H.R. 5293, but also changes
outreach efforts
agency on aging will use outreach efforts
individuals at risk for institutional placement.
reference to individuals with limited English
that will identify eligible individuals for
(p. 35)
proficiency, instead of limited English-
assistance, with special emphasis on those
speaking ability. (p. 39)
residing in rural areas, those with greatest
economic and social need, those with
severe disabilities, those with limited
English-speaking ability, and those with
Alzheimer’s disease or related neurological
and organic brain dysfunction.
Section 306(a)(5) requires area agencies to
The bill would require area agencies to give
Similar to H.R. 5293. (p. 39)
assure that they will coordinate planning,
particular attention to individuals at risk for
identification, need assessment, and
institutional placement. (p. 36)
service provision with particular attention
to individuals with severe disability, and
with agencies that develop or provide
services to individuals with disabilities.

CRS-38
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Area plans on aging: use of
No provision.
The bill would require area agencies to make
Similar to H.R. 5293. (p. 40)
trained volunteers
use of trained volunteers in providing direct
services to elderly and disabled individuals
needing care, and, if possible, work in
coordination with volunteer programs
(including programs administered by the
Corporation for National Service) designed to
povide training, placement and stipends for
volunteers in community service settings.
(p. 36)
Area plans on aging:
Section 306(a)(6) requires area agencies on
The bill would add to the membership, family
Similar to H.R. 5293. (p. 40)
advisory council membership
aging to establish an advisory council and
caregivers of older individuals, service
specified council membership.
providers, and the business community. (p. 36)
Area plans on aging:
Section 306(a) requires area agencies to
The bill would require area agencies on aging,
The bill would add reference to mental health
increasing public awareness
coordinate mental health services
in coordination with the state agency on aging
screening. It does not include the provision
of mental health
provided with funds expended by area
and the state agency responsible for mental
regarding public awareness of mental health
agencies with mental health services
health services, to increase public awareness of
disorders or removing barriers to diagnosis
provided by community health centers and
mental health disorders, to remove barriers to
and treatment. (p. 41)
by other public agencies and nonprofit
diagnosis and treatment, and to coordinate
private organizations.
mental health services (including mental health
screenings) with funds expended by the area
agency with mental health services provided by
community health centers and other agencies.
(p. 37)
Area plans on aging:
Section 306(a)(7) requires that area
The bill would rewrite the section as follows.
Similar to H.R. 5293, but with slightly
comprehensive coordinated
agencies on aging facilitate the
The bill would require that area agencies
different wording in some places. (pp. 41-43)
system for home and
coordination of community-based long-
facilitate the areawide development and
community-based long-term
term care services to enable older
implementation of a comprehensive,
care
individuals to remain in their own homes.
coordinated system for providing long-term
Area agencies are to accomplish this by:
care in home and community-based settings, in
• developing case management services as
a manner that is responsive to the needs and
a component of long-term care;
preferences of older individuals and their
• involving long-term care providers in the
families by:
coordination of these services; and
• collaborating, coordinating, and consulting

CRS-39
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

• increasing community awareness of and
with other local public and private agencies
involvement in addressing the needs of
responsible for formulating, implementing
residents of long-term care facilities.
and administering programs, benefits, and
services regarding long-term care;
• conducting analysis and making
recommendations and implementing
programs related to strategies for modifying
the state’s long-term care system in order to
respond to the needs and preferences of older
individuals and family caregivers; facilitate
provision of home and community-based
care; target services to older individuals at
risk of institutional placement;
• implementing evidence-based programs to
assist older individuals and their family
caregivers in learning about and making
behavioral changes to reduce the risk of
injury, disease, and disability; and
• providing for distribution of information on
the need to plan in advance for long-term care
and on the range of available public and
private long-term care programs, options, and
resources. (pp. 37-39)
Area plans on aging: area
Section 306(a)(14) and (15)(second
Deletes these provisions (duplication in current
Retains paragraph (14), but eliminates second
agency costs to carry out
paragraph (15)) prohibits area agencies
law.) (p. 39) For related content, see the
paragraph (15). (p. 43) For related content,
commercial relationships
from paying any costs incurred as a result
provisions that immediately follow (in the next
see the provisions that immediately follow
of a contract or commercial relationship
row) relating to maintaining public purpose
(in the next row) relating to maintaining
unrelated to the act. (These paragraphs are
mission of Title III.
public purpose mission of Title III.
duplicative.)
Section 306(a)(15) (first paragraph (15))
Deletes first paragraph (15) but retains
Same as H.R. 5293. (p. 43)
and (16) also prohibits area agencies from
paragraph (16), essentially retaining current
giving preference to particular individuals
law. (p. 39)
as a result of a contract or commercial
relationship unrelated to the act. (These
paragraphs are duplicative.)

CRS-40
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Area plans on aging: priority
No provision.
The bill would require that area agencies assure
Similar to H.R. 5293, but adds reference to
for use of funds for specified
that Title III funds will be used in a manner that
older individuals with limited English
older individuals;
gives priority in furnishing benefits and
proficiency and those living in rural areas. (p.
maintaining public purpose
services to older individuals with greatest
43)
mission and disclosure of
economic need, older individuals with great
information on contractual
social need and older individuals at risk for
relationships
institutional placement. (p. 39)
The area agency would also be required to
Same as H.R. 5293.
assure that funds will be used in a manner that
is consistent with Section 306(a)(13) (regarding
.
maintaining the integrity and public purpose of
services provided and service providers, in all
contractual and commercial relationships,
among other things) and Section 212(b) of the
act (as amended by the bill). (p. 40 )
Area plans on aging: self-
No provision.
The bill would require that area plans on aging
Similar to H.R. 5293 (does not include to the
directed care
provide for, to the maximum extent feasible,
maximum extent feasible). (p. 43)
furnishing of services under the act consistent
with self-directed care. (p. 40)
Area plans on aging:
No provision.
No provision.
The bill would require area plans to include
emergency preparedness
information detailing how the area agency
will coordinate activities and develop long-
range emergency plans with local and state
emergency response agencies, relief
organizations, local and state governments,
and any other institutions that have
responsibility for disaster relief service
delivery. (p. 43)
Area plans on aging: area
No provision.
The bill would authorize area agencies on aging
Same as H.R. 5293, with slightly different
agency planning for
to include in their area plans, an assessment of
wording in some places. (p. 44)
demographic changes in the
how prepared the planning and service area is
older population in planning
for any anticipated change in the number of
and service areas
older individuals during the 10-year period

CRS-41
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

following the fiscal year for which the plan is
submitted.
The assessment may include:
• the projected change in the number of older
individuals in the planning and service area;
• an analysis of how this change may affect
older individuals, including those with low
income, greatest economic need, minority
older individuals, those residing in rural
areas, and those with limited English
proficiency;
• an analysis of how the programs, policies,
and services provided in the planning and
service area can be improved, and how
resource levels can be adjusted to meet the
needs of the changing population of older
individuals in the areas, and an analysis of
how the change in the number of persons age
85 and older is expected to affect the need for
supportive services. (p. 40)
The bill would authorize area agencies on
The bill would also add reference to
aging, in cooperation with governmental
emergency preparedness. (p. 45)
officials, state agencies, tribal organizations, or
local entities, to make recommendations to
government officials in the planning and
service area and the state, on actions to build
the capacity to meet the needs of older
individuals for:
• health and human services;
• land use;
• housing;
• transportation;
• public safety;
• workforce and economic development;

CRS-42
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

• recreation;
• education;
• civic engagement; and
• any other services determined by the area
agency. (p. 41)
STATE PLANS ON AGING
State plans on aging: focus on
Section 307(a) requires the state plan to
The bill would add reference to older
Same as H.R. 5293. (p. 46)
older individuals with limited
conduct periodic evaluations on state
individuals with limited English proficiency.
English proficiency
activities and projects, including
(p. 42)
evaluations of the effectiveness of services
provided to individuals with greatest
economic or social need, or disabilities
with particular attention to low-income
minority individuals and older individuals
residing in rural areas.
State plans on aging:
Section 307(a)(15) requires the state plan
The bill would add reference to the number of
Similar to H.R. 5293. (p. 47)
identifying service needs of
to identify the number of low-income
low-income older individuals with limited
low-income minority older
minority older individuals in the state and
English proficiency. (p. 42)
individuals with limited
describe the methods used to satisfy their
English proficiency
service needs.
State plans on aging:
Section 307(a)(16) requires the state
The bill would add reference to low-income
Same as H.R. 5293. (p. 46)
outreach to individuals with
agency to conduct outreach to older
older individuals with limited English
limited English proficiency
individuals with greatest economic or
proficiency. (p. 43)
social need (with particular attention to
low-income minority individuals and older
individuals residing in rural areas).
State plans on aging: self-
No provision.
The bill would require that state plans on aging
Same as H.R. 5293. (p. 47)
directed care
provide assurances that area agencies will, to
the maximum extent feasible, furnish services
under the act consistent with self-directed care.
(p. 43)

CRS-43
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

State plans on aging:
No provision.
The bill requires state agencies on aging, at the
Same as H.R. 5293. (p. 47)
planning for demographic
election of the state, to include an assessment of
changes in the older
how prepared the state is, under its statewide
population in the state
service delivery model, for a change in the
number of older individuals during the 10-year
period following the fiscal year for which the
plan is submitted. The assessment may include:
• the projected change in the number of older
individuals in the state;
• an analysis of how this change may affect
older individuals, including those with low-
income, greatest economic need, minority
older individuals, those residing in rural
areas, and those with limited English
proficiency;
• an analysis of how the programs, policies,
and services provided by the state can be
improved, including coordinating with area
agencies on aging, and how resource levels
can be adjusted to meet the needs of the
changing population of older individuals in
the state; and
• an analysis of how the change in the number
of persons age 85 years and older is expected
to affect the need for supportive services.
(p. 43)
State plans on aging:
No provision.
No provision.
The bill requires state plans to include
emergency preparedness
information detailing how the state will
coordinate activities, and develop long-range
emergency preparedness plans, with area
agencies on aging, local emergency response
agencies, relief organizations, local
governments, and any other institutions that
have responsibility for disaster relief service
delivery. The plan is to include information
describing the involvement of the head of the

CRS-44
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

state agency in the development, revision,
and implementation of emergency
preparedness plans, including the State
Public Health Emergency Preparedness and
Response Plan. (p. 48)
State plans on aging: Aging
No provision.
No provision in Title III (see ADRCs in title II
The bill requires the state to implement an
and Disability Resource
above.)
ADRC which is to:
Centers (ADRCs)
• serve as a visible and trusted source of
information on the full range of options for
long-term care, including institutional and
home and community-based care, that are
available in the state;
• provide personalized and consumer-
friendly assistance to empower individuals
to make informed decisions about their
long-term care options;
• provide coordinated and streamlined access
to all publicly funded long-term care
options so that consumers can obtain the
care they need through a single intake,
assessment and eligibility determination
process;
• help individuals plan ahead for their long-
term care needs; and
• assist Medicare beneficiaries and
prospective beneficiaries in understanding
and accessing prescription drug and
preventive health benefits under provisions
of, and amendments made by, the Medicare
Prescription Drug, Improvement, and
Modernization Act of 2003, in coordination
with the entity carrying out the health
insurance information, counseling and
assistance program (under Section 4360 of
the Omnibus Reconciliation Act of 1990) in
the state. (pp. 49-50)

CRS-45
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

State plans on aging: non-
Section 309(b)(2) requires that funds
The bill deletes the reference to the non-federal
Same as H.R. 5293. (p. 50)
federal share for Title III
required to meet the non-federal share, in
share prior to 1981. The bill would clarify that
services
amounts that exceed the non-federal share
funds required to meet the non-federal share for
prior to FY1981, are to be from state
Title III funds be from state sources. (p. 44)
sources. (Prior to 1981, the required non-
federal share was 10%; in 1981, the non-
federal share was increased to 15%).
NUTRITION SERVICES INCENTIVE PROGRAM
Disbursement
Section 311 of the act requires the
The bill would clarify that each state agency
Same as H.R. 5293 (p. 51)
Secretary of Agriculture to provide cash or
promptly and equitably disburse amounts
commodities or a combination of cash and
received under Section 311 to recipients of
commodities to state agencies on aging.
grants and contracts. (p. 45)
Bonus of commodities
Section 311 requires
that
agricultural
The bill would also require that additional
Same as H.R. 5293. (p. 51)
commodities available under section 32 of
bonus commodities are to be donated or used
the act of August 24, 1935, section 416 of
by recipients of Title III nutrition funds. (p. 45)
the Agricultural Act of 1949, and under
section 709 of the Food and Agricultural
Act of 1965 are to be donated or used by
recipients of Title III nutrition funds.
High protein foods; terms
No
provision.
The bill would require the Secretary
of
No provision.
and conditions
Agriculture to give special emphasis to high
protein foods. The Secretary of Agriculture, in
consultation with the Assistant Secretary, is
authorized to prescribe the terms and conditions
related to donated commodities. (p. 45)
Cash used to buy
Section 311(d) requires that when a state
The bill would revise the provision to require
No provision.
commodities
elects to receive cash payments under
that Section 311 funds may be used only to
Section 311, the Secretary of Agriculture is
purchase U.S. agricultural commodities and
to make them to the state in an amount
other foods. (p. 45)
equivalent in value to the donated foods
which the state otherwise would have
received in commodities.

CRS-46
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

No provision.
Part or all of Section 311 funds may be used to
No provision.
pay school food authorities to obtain U.S.
commodities for nutrition projects, when state
grantees and contractors, and Title VI grantees,
have an agreement with the school food
authority that the payments:
• cover the cost of the commodities and
• cover related expenses, including the cost of
transporting, distributing, processing, storing,
and handling the commodities. (p. 46)
Authorization of
Section 311(e) authorizes such sums as
The bill would authorize such sums as may be
Same as H.R. 5293. (p. 51)
appropriations for nutrition
may be necessary for FY2001-FY2005.
necessary for FY2007-FY2011. (p. 46)
service incentive program
Distribution of information
Section 312(f) would require that the
The bill would require the Assistant Secretary
No provision.
regarding federal commodity
Secretary of HHS and the Secretary of
on Aging and the Secretary of Agriculture to
processing programs
Agriculture distribute to state and area
distribute information on:
agencies on aging and nutrition service
• school food authorities within geographic
providers information on:
area service by the state agency; and
• any federal commodity processing
• the donated foods available to state and area
program; and
agencies and nutrition service providers.
• procedures to be followed to participate
(p. 46)
in the program.
VOLUNTARY CONTRIBUTIONS FOR TITLE III SERVICES
Solicitation of voluntary
Section 315(b) of the act provides that
The bill would add to current law a provision
The bill would add to current law a provision
contributions
voluntary contributions from older
that voluntary contributions shall be
that voluntary contributions shall be
individuals shall be allowed and may be
encouraged for individuals whose self-declared
encouraged for individuals whose self-
solicited for all Title III services provided
income is at or above 125% of the poverty line,
declared income is at or above 200% of the
that the method of soliciting contributions
and may be requested at contribution levels
poverty line, at contribution levels based on
is noncoercive.
based on the actual cost of services if the
the actual cost of services. (p. 52)
method of solicitation is noncoercive. (p. 47)

CRS-47
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Voluntary contributions are
No provision.
The bill would clarify that funds received
Same as H.R. 5293. (p. 52)
to supplement not supplant
through voluntary contributions are to
Title III funds
supplement, not supplant, funds received under
Title III. (p. 47)
Mandatory cost-sharing:
Section 315(c) requires state and area
The bill would add reference to older
Same as H.R. 5293. (p. 52)
participation of older
agencies to develop plans designed to
individuals with limited English proficiency.
individuals with limited
ensure that cost-sharing procedures will
(p. 48)
English proficiency
not decrease participation in Title III
services by low income older individuals
(with particular attention to low income
minority individuals and older individuals
residing in rural areas).
AoA study of cost-sharing
Section 315(d) requires the Assistant
The bill would add reference to older
Same as H.R. 5293. (p. 52)
Secretary to conduct a study of cost-
individuals with limited English proficiency.
sharing to determine its impact on
(p. 48)
participation rates with particular attention
to low-income and minority older
individuals and older individuals residing
in rural areas.
ALLOWABLE TITLE III
Section 321(a) requires the Assistant
The bill would change the references for the
Similar to H.R. 5293, but does not include
SUPPORTIVE SERVICES
Secretary to carry out a program for
following supportive services under Section
change to the SOS program. (p. 53)
making grants to states under state plans
321(a) to read:
approved under section 307 for supportive
• services designed to provide health screening
services listed in 321(a)(1) through
(including mental health screening);
321(a)(23).
• services (including assistive technology
devices and assistive technology services)
designed to meet the unique needs of older
individuals who are disabled, and older
individuals who provide uncompensated care
to their adult children with disabilities; and
• effective referral to existing health (including
mental health), employment, housing, legal,
consumer, transportation, and other services
(related to Senior Opportunities and Services

CRS-48
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

(SOS)). (p. 48)
The bill would add the following as new
allowable services:
• services designed to support states, area
agencies on aging, 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; and
• activities to promote and disseminate
information about life-long learning programs
It also makes other technical and coordination
changes. (p. 49)
NUTRITION SERVICES
Nutrition services: purpose of
No provision.
The bill would add a new purpose to Title III,
The bill would add a new purpose to Title III,
nutrition services
Nutrition Services, as follows:
Nutrition Services, as follows:

It is the purpose of this part to promote
It is the purpose of this part to promote
socialization and the health and well-being of
socialization and the health and well-being of
older individuals by assisting such individuals
older individuals by assisting such
to gain access to disease prevention and health
individuals to gain access to nutrition
promotion services (including information,
services to delay the onset of adverse health
nutrition services, and programs of physical
conditions. (p. 54)
activity) to delay the onset of health conditions
resulting from poor nutritional health or
sedentary behavior. (p. 50)
Nutrition services: nutrition
Section 331 allows nutrition projects to
The bill would specify that nutrition projects
Same as H.R. 5293. (p. 54)
education
provide nutrition education services and
are to provide nutrition education, nutrition
other appropriate nutrition services.
counseling, and other nutrition services, as
appropriate based on the needs of meal
participants. (p. 51)

CRS-49
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Nutrition services:
No provision.
The bill would allow nutrition projects to
No provision.
multivitamin-mineral
provide a multivitamin-mineral supplement,
supplements
along with a meal, to participants. (p. 51)
Nutrition services: home-
Section 336 requires the Assistant
The bill would add reference to fresh food. It
Same as H.R. 5293. (p. 55)
delivered nutrition services
Secretary to establish the home-delivered
would also delete the reference to (with a
nutrition program which is to provide at
satisfactory storage life). (p. 51)
least one home-delivered hot, cold, frozen,
dried, canned or supplemental foods (with
a satisfactory storage life) meal per day.
Consultation with nutrition
Section 337 requires the Assistant
The bill would eliminate reference to particular
Same as H.R. 5293. (p. 55)
experts
Secretary to consult with representatives
organizations and instead would specify that
from various named organizations to
the Assistant Secretary is to consult with
develop minimum criteria of efficiency
experts in the field of nutrition science,
and quality for home-delivered meals
dietetics, meal planning and food service
services, including the American Dietetic
management, and aging. (p. 52)
Association, among others.
It also requires that the criteria take into
The bill would delete this requirement.
No change in current law.
account the ability of established home
delivered meals programs to continue these
services without major alteration in the
services.
State responsibility to obtain
Section 339 requires a state to solicit the
The bill would require the state to solicit the
Similar to H.R. 5293, but does not refer to
expertise of a dietician
advise of a dietician or an individual with
advise of a dietician or other individual with
equivalent education and training. (p. 56)
comparable expertise in the planning of
equivalent education and training in nutrition
nutritional services.
science, or another individual with comparable
expertise. (p. 52)
Dietary Guidelines for
Section 339 requires that meals comply
The bill would specify that the Guidelines be
Same as H.R. 5293. (p. 53)
Americans
with the Dietary Guidelines for Americans.
the most recent. (p. 53)
It also refers to the daily recommended
The bill would change the reference to dietary
No change in current law.
dietary allowances.
reference intakes. (p. 53)

CRS-50
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Intergenerational meals
Nutrition projects are to
encourage
The bill would clarify that these arrangements
Refers to joint programs but no reference to
arrangements with schools and other
are to be done jointly with schools and other
shared intergenerational programs. (p. 56)
facilities to promote intergenerational
facilities and are to be shared intergenerational
meals programs.
meals programs. (p. 53)
Nutrition screening,
Section 339(2)(J) requires that nutrition
The bill would also require nutrition
Same as H.R. 5293. (p. 57)
education and assessment
projects provide for nutrition screening,
assessment. (p. 54)
and, where appropriate, nutrition education
and counseling.
Influenza and other
No provision.
The bill would encourage professionals who
Similar to H.R. 5293, but would add
vaccinations
distribute home-delivered meals to provide
reference to information about pneumonia
information to homebound seniors on how to
and shingles vaccinations. (p. 57)
get an influenza vaccination in their local areas.
(p. 54)
Evaluation of the Nutrition
No provision.
The bill would require the Assistant Secretary
Similar to H.R. 5293, with some slightly
Program
to use funds set aside for evaluation to conduct
different wording. (p. 57)
an evidence-based evaluation of the nutrition
program. This would be under a contract with
the Food and Nutrition Board of the Institute of
Medicine.
The study would include:
• an evaluation of the effect of nutrition
projects on the health and nutrition status of
participants, prevention of hunger and food
insecurity, and ability of participants to
remain living independently;
• a cost-benefit analysis of nutrition projects,
including their potential to affect costs of
Medicaid; and
• recommendations on how nutrition projects
Does not refer to vitamin-mineral
may be modified to improve outcomes, and
supplementation.
for improving nutritional quality of meals and
other potential strategies to improve the
nutritional status of participants, including

CRS-51
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

vitamin-mineral supplementation.
The Institute of Medicine would be required to
Same as H.R. 5293 (p. 59)
establish a panel of experts within 90 days of
the bill’s enactment. The panel would be
required to submit the report to the Assistant
Secretary within 24 months of enactment. In
addition, the Assistant Secretary would be
required to submit a report on the findings to
the House Committee on Education and the
Workforce of the House and the Senate
Committee on Health, Education, Labor and
Pensions of the Senate. (pp. 54-56)
Improving indoor air quality
No provision.
The bill would require the Assistant Secretary
Same as H.R. 5293. (p. 60)
in building where seniors
to work in consultation with qualified experts to
congregate
provide information on methods of improving
indoor air quality in buildings where seniors
congregate. (p. 56)
CAREGIVER SUPPORT PROGRAM
Definitions
Child
Defines child as an individual who is 18
The bill would define child as an individual
The definition of child would be amended to
years or younger.
who is 18 or younger or an individual with a
include an adult child with mental retardation
disability. (p. 56)
or a related developmental disability. (p. 60)
Family caregiver
Defines family caregiver as an adult family
The bill would add to the definition, caregiver
The bill would add to the definition,
member, or another individual who is an
of an individual with Alzheimer’s disease or a
caregiver of an individual with Alzheimer’s
informal provider of in-home and
related disorder with neurological and organic
disease, or a related disorder with
community care to an older individual.
brain dysfunction. (p. 56)
neurological and organic brain dysfunction,
who is 50 years of age or older. (p. 60)
Grandparent or older
Defines grandparent or older individual
The bill would change the age to 55 years and
Same as H.R. 5293 regarding age of
individual who is a relative
who is a relative caregiver as a
older. (p. 56)
grandparents.
caregiver
grandparent who is 60 and older (among
other things).
It also amends the definition to specify that a

CRS-52
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

child of a grandparent or step-grandparent
caregiver includes an adult child with mental
retardation or a related developmental
disability. It also includes a child who is
adopted. (p. 61)
Developmental disability
No provision.
No provision.
The bill adds a definition of developmental
disability and refers to the definition in
Section 102 of the Developmental
Disabilities Assistance and Bill of Rights Act
of 2000. (p. 61)
Support services for
Section 373 includes as one of the support
The bill would add reference to assisting
Same as H.R. 5293. (p. 61)
caregivers
services for caregivers, individual
caregivers with health, nutrition, and financial
counseling, organization of support
literacy issues. (p. 57)
services groups, and caregiver training to
caregivers to assist them in making
decisions and solving problems relating to
their caregiving roles.
Priority to caregivers
Section 373 stipulates that in providing
No change in current law.
The bill adds a new provision stipulating that
providing care to older
services, priority is to be given to services
in providing services for family caregivers,
individuals
to older individuals with the greatest social
the state is required to give priority for
and economic need and those providing
services to family caregivers who provide
c a r e t o p e r s o n s wi t h m e n t a l
care to older individuals. (p. 62)
retardation/development disabilities.
Coordination with volunteer
Section 373(d) requires area agencies on
The bill would require area agencies to
Same as H.R. 5293. (p. 62)
services
aging to coordinate the caregiver support
encourage the use of trained volunteers to
program with other community agencies
expand available caregiver support services,
and voluntary organizations.
and to coordinate, if possible, with volunteer
programs (including programs administered by
the Corporation for National Service) to
provide training, placement, and stipends for
volunteers in community service settings.
(p. 57)

CRS-53
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Reports on caregiver
The state is required to submit reports to
The bill would add a requirement that the
Similar to H.R. 5293, but with slightly
program
the Assistant Secretary, as required by the
reports must describe any mechanism used in
different wording. (p. 62)
Assistant Secretary.
the state to provide family caregivers of an
older individual and relative caregivers of a
child or an adult child with a disability,
information about and access to various
services so that caregivers can better carry out
their care responsibilities. (p. 57)
Limitation on federal and
Section 374(g) stipulates that a state may
The bill would clarify that the limitation applies
No change in current law.
non-federal funds for relative
not use more than 10% of federal and non-
to relative caregivers of children age 18 or
caregiver services
federal funds to support services to
younger. (p. 58)
grandparents and older individuals who are
relative caregivers.
Programs of national
Section 376 requires the Assistant
The bill would repeal this section.
The bill would allow the Assistant Secretary
significance
Secretary to carry out activities of national
to support:
significance to promote quality and
• multigenerational programs, including
continuous improvement in support
supports for grandparents and other older
provided to family and other informal
relatives raising children (such as kinship
caregivers. This provision was sunsetted
navigator programs) and those that sustain
in FY2003.
and replicate innovative multigenerational
family support programs that involve senior
volunteers;
• programs providing support and
information to families who have a child
with a disability or chronic illness and to
other families in need of such family
support programs;
• programs addressing the unique issues
faced by rural caregivers;
• programs focusing on the needs of older
persons with Alzheimer’s disease and
related dementia and their caregivers;
• programs supporting caregivers in the role
they play in health promotion and disease
prevention. (pp. 63-64)

CRS-54
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Allotment of funds to states
Section 373(f) stipulates how funds are to
The bill would update the years to FY2007-
Same as H.R. 5293. (p. 63)
be allotted to states for FY2001-FY2005.
FY2011. (p. 58)
TITLE IV, RESEARCH, TRAINING, AND DEMONSTRATION PROJECTS AND PROGRAMS
Grant programs
Section 411(a) authorizes the Assistant
The bill would add the following grant program
Similar to H.R. 5293, but would change the
Secretary to make grants to and enter into
categories:
reference to:
contracts with states, public agencies,
• planning activities to prepare communities for
• planning activities to prepare communities
private nonprofit agencies, institutions of
the aging of the population, which include
for the aging population, which may
higher education, including tribal
efforts to assess the aging population;
include efforts to assess the aging
organizations, for:
activities to coordinate state and local
population;
• education and training of an adequately
agencies in order to meet the needs of older
• activities to coordinate the activities of state
trained workforce;
individuals;
and local agencies; and
• research and analysis;
• training and technical assistance to support
• training and technical assistance to support
• performance evaluation of programs,
states, area agencies on aging, and tribal
states, area agencies on aging, and tribal
activities, and services;
organizations receiving a grant under Title
organizations receiving grants under Title
• methods and practices to improve quality
VI, engage in community planning activities;
VI, in engaging in community planning
and effectiveness of programs, services,
activities. (p. 64)
and activities;
• demonstration of new approaches to
• development, implementation, and
Same as H.R. 5293. (p. 65)
design, deliver, and coordinate programs
assessment of technology-based service
and services;
models and best practices, to support the use
• technical assistance;
of health monitoring and assessment
• coordination with designated state
technologies, communication devices,
agencies under the Rehabilitation Act to
assistive technologies, and other technologies
provide services to older individuals who
that may remotely connect family and
are blind;
professional caregivers to frail elderly
• training of graduate level professionals
residing in home and community-based
specializing in the mental health needs of
settings or rural areas;
older individuals; and
• conducting activities of national significance
No provision in Title IV. Similar provision in
• any other activities that the Assistant
to promote quality and continuous
Title III under “Programs of national
Secretary of AoA determines will
improvement in the support provided to
significance.”
achieve the objectives of this section.
family and other informal caregivers of older
individuals through activities that include
program evaluation, training, technical
assistance, and research, including
intergenerational programs providing support

CRS-55
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

to grandparents and other older relatives
raising children (such as kinship navigator
programs); and involving senior volunteers
who provide support and information to
families who have a child with a disability or
chronic illness, or other families in need of
such family support; programs addressing
unique issues faced by rural caregivers;
programs focusing on the needs of older
individuals with cognitive impairment such as
Alzheimer’s disease and other dementias, and
their caregivers; programs supporting
caregivers in the role they play in health
promotion and disease prevention; and
• building public awareness of cognitive
No provision.
impairment such as Alzheimer’s disease and
related disorders with neurological and
organic brain dysfunction, depression, and
mental disorders; and developing and
enhancing multidisciplinary systems for the
delivery of mental health screening and
treatment referral services to improve access
to community-based mental health services
for older individuals. (p. 58-59)
Authorization of
Section 411(b) authorizes such sums as
The bill would authorize such sums as may be
No change in current law.
appropriations for grant
may be necessary for FY2001, and such
necessary for FY2006-FY2011. (p. 61)
programs
sums as may be necessary for subsequent
fiscal years.

CRS-56
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Career preparation for the
Section 412 requires the Assistant
The bill would add reference to Hispanic
Similar to H.R. 5293, but keeps reference to
field of aging
Secretary of the AoA to make grants to a
serving institutions, and delete reference to
other educational institutions that serve the
number of entities including institutions of
other educational institutions that serve the
needs of minority students. (p. 66)
higher education, historically Black
needs of minority students. (p. 61)
colleges or universities, Hispanic Centers
of Excellence in Applied Gerontology, and
other educational institutions that serve the
needs of minority students.
Health care service
Section 414(a) requires the Assistant
The bill would add operating model health care
Similar to H.R. 5293. (p. 66)
demonstration projects in
Secretary, after consultation with the state
and mental health services projects. (p. 61)
rural areas
agency of the state involved, to make
grants to eligible organizations to pay part
or all of the cost of developing or
operating model health care service
projects (including those related to home
health care, adult day health care, outreach,
and transportation services).
Graduate programs with
Section 414(b)(1)(B)(i) requires that
The bill would add institutions of higher
Similar to H.R. 5293. (p. 66)
capability in mental health
eligible organizations submit grant
education having graduate programs with
applications containing such information
capability in mental health. (p. 61)
and assurances as the Secretary may
require including, information describing
the nature and extent of the applicant’s
coordination and cooperation with
institutions of higher education that have
graduate programs with capability in
public health, the medical sciences,
psychology, pharmacology, nursing, social
work, health education, nutrition, or
gerontology, for the purposes of designing
and developing such projects.

CRS-57
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Technical assistance and
Section 416 authorizes the Secretary to
No provision.
The bill would rewrite Section 416 to include
innovation to improve
award grants or contracts to nonprofit
authority for the Assistant Secretary to carry
transportation for older
organizations to improve transportation
out demonstration projects on transportation
individuals
services for older individuals.
services, in addition to technical assistance
cited in current law. (p. 66)
A nonprofit organization receiving a grant
or contract is required to use funds
In addition, the organization may use the
received under such grant or contract to
funds to develop and carry out an innovative
provide technical assistance to assist local
transportation demonstration project to create
transit providers, area agencies on aging,
transportation services for older individuals.
senior centers and local senior support
(p. 67)
groups to encourage and facilitate
coordination of federal, state, and local
In carrying out a demonstration project or
transportation services and resources for
providing technical assistance the
older individuals. Such technical
organization may carry out activities that
assistance may include:
include (in addition to other activities as cited
• developing innovative approaches for
in current law) developing innovative
improving access by older individuals to
approaches for improving access by older
supportive services;
individuals to transportation services,
• preparing and disseminating information
including volunteer driver programs,
on transportation options and resources
economically sustainable transportation
for older individuals and organizations
programs, and programs that allow older
serving such individuals through
individuals to transfer their automobiles to a
establishing a toll-free telephone number;
provider of transportation services in
• developing models and best practices for
exchange for the services. (p. 67)
comprehensive integrated transportation
services for older individuals, including
services administered by the Secretary of
Transportation, by providing ongoing
technical assistance to agencies
providing services under Title III and by
assisting in coordination of public and
community transportation services; and
• providing special services to link seniors
to transportation services not provided
under Title III.

CRS-58
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Economically sustainable
No provision.
No provision.
In this section, the term economically
transportation
sustainable transportation means demand
responsive transportation for older
individuals —
• that may be provided through volunteers;
and
• that the provider will provide without
receiving federal or other public financial
assistance, after a period of not more than
five years of providing the services under
this section. (p. 68)
Community planning for the
No provision.
No provision.
The bill would authorize the Secretary to
aging population
establish, either directly or through grants or
contracts, a national technical assistance
program to assist states and area agencies on
aging in planning efforts to prepare
communities for the aging of the population.
(p. 69)
DEMONSTRATION PROJECTS FOR MULTIGENERATIONAL ACTIVITIES
Demonstration projects for
Section 417. Demonstration Projects for
Same as current law, with one change related to
The bill would rewrite Section 417 to include
multigenerational activities:
Multigenerational Activities.
preference in awarding grants (see below).
the following: (p. 69)
grants and contracts
The law authorizes the Assistant Secretary
Section 417. Demonstration, Support, and
to award grants and enter into contracts
Research Projects for Multigenerational
with eligible organizations to establish
Activities and Civic Engagement Activities.
demonstration projects to provide older
individuals with multigenerational
The Assistant Secretary is required to award
activities.
grants and enter into contracts with eligible
organizations to —
• conduct productivity and cost-benefit
research to determine the effectiveness of
engaging older individuals in paid and
unpaid positions with public and nonprofit
organizations;

CRS-59
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

• develop a national agenda and blueprint for
creating paid and unpaid positions for older
individuals with public and nonprofit
organizations to increase the capacity of the
organizations to provide needed services to
communities;
• carry out demonstrations and support
projects to provide older individuals with
multigenerational and civic engagement
activities, designed to meet critical
community needs; and
• carry out demonstration projects to
coordinate multigenerational and civic
engagement activities, and facilitate
development of, and participation in, these
activities. (p. 70)
Demonstration projects for
An eligible organization is required to use
No change in current law.
The bill would require that an eligible
multigenerational activities:
funds made available under a grant
organization use funds made available under
use of funds
awarded, or a contract entered into, to —
a grant awarded, or a contract entered into, to
• carry out a demonstration project that
carry out the activities described above, and
provides multigenerational activities,
to evaluate the activities. (p. 71)
including any professional training
appropriate to such activities for older
individuals; and
• evaluate the project.
Demonstration projects for
In awarding grants and entering into
The bill would add reference to older
The bill would change the reference in
multigenerational activities:
contracts to carry out a demonstration or
individuals with limited English proficiency.
awarding grants and entering into contracts to
preference
support project, the Assistant Secretary is
(p. 61)
carry out a demonstration or support project
to give preference to —
to require the Assistant Secretary to give
• eligible organizations with a
preference to —
demonstrated record of carrying out
• eligible organizations with a demonstrated
multigenerational activities; and
record of carrying out multigenerational or
• eligible organizations proposing projects
civic engagement activities;
that will serve older individuals with
• eligible organizations proposing
greatest economic need (with particular
multigenerational activity service projects;

CRS-60
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

attention to low-income minority
• eligible organizations proposing civic
individuals and older individuals residing
engagement activity service projects that
in rural areas).
will serve communities with the greatest
need; and
• eligible organizations with the capacity to
develop meaningful roles and assignments
that use the time, skills, and experience of
older individuals to serve public and
nonprofit organizations. (p. 72)
It would add reference to older individuals
with limited English proficiency.
(p. 71)
Demonstration projects for
To be eligible to receive a grant or enter
Same as current law.
Same as current law.
multigenerational activities:
into a contract an organization is required
application
to submit an application to the Assistant
Secretary.
Demonstration projects for
Organizations eligible to receive a grant or
Same as current law.
The bill would require that organizations
multigenerational activities:
enter into a contract are organizations that
eligible to receive a grant or enter into a
eligible organizations
employ, or provide opportunities for, older
contract must have the capacity to conduct
individuals in multigenerational activities.
specified activities. (p. 72)
Demonstration projects for
Each organization receiving a grant or a
Same as current law.
The bill would require that each organization
multigenerational activities:
contract to carry out a demonstration is
receiving a grant or a contract evaluate the
local evaluation and report
required to evaluate the multigenerational
multigenerational or civic engagement
activities assisted under the project to
activities assisted under the project to
determine the effectiveness of the
determine the effectiveness of the activities
multigenerational activities, the impact of
involved, the impact of such activities on the
such activities on child care and youth day
community being served and the
care programs, and the impact of activities
organizations providing the activities, and
on older individuals involved in such
the impact of such activities on older
project.
individuals involved. (p. 73)
Demonstration projects for
Not later than six months after the
Same as current law.
Similar to current law, except also requires
multigenerational activities:
Assistant Secretary receives the evaluation
the report to include:
report to Congress
report, the Assistant Secretary is required
• the names or descriptive titles of the

CRS-61
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

to prepare and submit to the Speaker of the
demonstration, support, and research
House of Representatives and the President
projects funded; and
pro tempore of the Senate a report that
in the case of demonstrations and projects
assesses the evaluations and includes, at a
to support older individuals in
minimum —
multigenerational and civic engagement
• the names or descriptive titles of the
activities, a description of the methods and
demonstration projects;
success of the projects in recruiting older
• a description of the nature and operation
individuals as employees and volunteers to
of the projects;
participate in the projects;
• the names and addresses of organizations
• a strategy for disseminating the findings
that conducted the projects;
resulting from the projects to conduct
• a description of the methods and success
productivity and cost-benefit research; and
of the projects in recruiting older
• any policy change recommendations
individuals as employees and volunteers
relating to the projects. (p. 74-75)
to participate in the projects;
• a description of the success of the
projects in retaining older individuals
involved in the projects as employees
and as volunteers; and
• the rate of turnover of older individual
employees and volunteers in the projects.
DEFINITIONS
Civic engagement activity
No provision.
No provision.
The bill would define civic engagement
activity to include an opportunity that uses
the time, skills, and experience of older
individuals, in paid or unpaid positions with
a public or nonprofit organization, to help
address the unmet human, educational, health
care, environmental, and public safety needs
and nurture and sustain active participation in
community affairs. (p. 75)
Multigenerational activity
The law defines multigenerational activity
No provision.
The bill would define multigenerational
to include an opportunity to serve as a
activity to include an opportunity that uses
mentor or advisor in a child care program,
the time, skills, and experience of older

CRS-62
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

a youth day care program, an educational
individuals, in paid or unpaid positions with
assistance program, an at-risk youth
a public or nonprofit organization, to serve
intervention program, a juvenile
as a mentor or adviser in a child care
delinquency treatment program, or a
program, a youth day care program, an
family support program.
educational assistance program, an at-risk
youth intervention program, a juvenile
delinquency treatment program, a before- or
after-school program
, or a family support
program. (p. 76)
Multigenerational
No provision.
No provision.
The bill would define multigenerational
coordinator
coordinator to mean a person who builds the
capacity of public and nonprofit
organizations to develop meaningful roles
and assignments, that use the time, skill, and
experience of older individuals to serve those
organizations; and nurtures productive,
sustainable working relationships between
older individuals and individuals in younger
generations (p. 76)
Native American programs
Section 418(a)(2)(B)(I) requires each
The bill would add reference to mental health
Same as H.R. 5293. (p. 77)
Resource Center that receives funds under
services. (p. 62)
this section to focus on priority areas of
concern, including health problems; long
term care, including home care; elder
abuse; and other problems and issues
regarding older Native Americans.
MULTIDISCIPLINARY CENTERS
Multidisciplinary centers:
Section 419 authorizes the Assistant
The bill would add reference to diverse
The bill adds a new subsection to Section
grant programs
Secretary to make grants to public and
populations of older individuals residing in
419, Multidisciplinary Health Centers in
private nonprofit agencies, organizations,
urban communities. (p. 62)
Communities (see below).
and institutions for the purpose of
e s t a b l i s h i n g o r s u p p o r t i n g
multidisciplinary centers of gerontology,

CRS-63
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

and gerontology centers of special
emphasis (including emphasis on nutrition,
employment, health (including mental
health), disabilities (including severe
disabilities), income maintenance,
counseling services, supportive services,
minority populations, and older individuals
residing in rural areas).
Multidisciplinary centers of gerontology
No change in current law.
are required to conduct research and policy
analysis and function as a technical
resource for the Assistant Secretary,
policymakers, service providers, and
Congress, and to carry out a number of
functions including:
• serving as a repository of information
The bill would require that centers also provide
No change in current law.
and knowledge on aging;
information about best practices in long-term
care service delivery, housing, and
transportation
. (p. 62)
• providing consultation and information
The bill would delete the reference to
No change in current law.
to public and voluntary organizations in
consultation and instead require centers to
planning and developing services
provide technical assistance to public and
provided under other provisions of this
voluntary organizations. (p. 62)
act.
No provision.
The bill would require centers to provide
training and technical assistance to support

No change in current law.
the provision of community-based mental
health services for older individuals.
(p. 62)

CRS-64
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

MULTIDISCIPLINARY HEALTH SERVICES IN COMMUNITIES
Multidisciplinary health
No provision.
No provision.
The bill would add a new provision that
services in communities:
would require the Assistant Secretary to
grant programs
make grants to states, on a competitive basis,
for the development and operation of systems
for the delivery of mental health screening
and treatment services for older individuals
who lack access to such services and
programs to —
• increase public awareness regarding the
benefits of prevention and treatment of
mental disorders in older individuals;
• reduce the stigma associated with mental
disorders in older individuals and other
barriers to the diagnosis and treatment of
the disorders; and
• reduce age-related prejudice and
discrimination regarding mental disorders
in older individuals. (p. 79)
The bill would require that to be eligible to
receive a grant, a state agency shall submit an
application to the Assistant Secretary as
required. (p. 80)
The bill would require that a state agency that
receives funds through a grant, allocate the
funds to area agencies on aging to carry out
multidisciplinary health services in planning
and service areas in the state. In allocating
the funds, the state agency is required to give
priority to planning and service areas in the
state that are medically underserved, and in
which there are a large number of older
individuals. (p. 80)

CRS-65
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

The bill would require that in carrying out
this part, to more efficiently and effectively
deliver services to older individuals, each
area agency on aging shall —
• coordinate mental health and treatment
services with other community agencies,
and with voluntary organizations providing
similar or related services; and
• to the greatest extent practicable, integrate
outreach and educational activities with
existing (as of the date of the integration)
health care and social service providers
serving older individuals in the planning
and service area involved. (p. 80)
The bill would require that funds made
available under this part supplement, and not
supplant, any federal, state, and local funds
expended by a state or unit of general
purpose local government (including an area
agency on aging) to provide multidisciplinary
health services. (p. 81)
The bill would define mental health
screening and treatment services
to mean
patient screening, diagnostic services, care
planning and oversight, therapeutic
interventions, and referrals, that are —
• provided pursuant to evidence-based
intervention and treatment protocols (to the
extent such protocols are available) for
mental disorders prevalent in older
individuals; and
• coordinated and integrated with the
services of social service, mental health,
and health care providers in an area in
order to improve patient outcomes; and

CRS-66
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

ensure, to the maximum extent feasible, the
continuing independence of older
individuals who are residing in the area.
(p. 81)
COMMUNITY INNOVATIONS FOR AGING IN PLACE
Community Innovations for
No provision.
No provision.
The bill would add the following Title IV
Aging in Place: authorization
program: Sec. 422 Community Innovations
for Aging in Place.

Community Innovations for Aging in Place: definitions
Eligible entity
No provision.
No provision.
Defines eligible entity as a nonprofit health or
social service organization, a community-
based nonprofit organization, an area agency
on aging or other local government agency,
a tribal organization, or another entity
determined to be appropriate to carry out a
project under this part; and that demonstrates
a record of, and experience in, providing or
administering group and individual health
and social services for older individuals; and
does not include an entity providing housing
under the congregate housing service
program or the multifamily service
coordinator program. (p. 82)
Naturally Occurring
No provision.
No provision.
Defines naturally occurring retirement
Retirement Community
community as a residential building, a
(NORC)
housing complex, an area (including a rural
area) of single family residences, or a
neighborhood composed of age-integrated
housing where 40% of the heads of
household are older individuals; or a critical
mass of older individuals that exists, based
on local factors which, taken in total, allow
an organization to achieve efficiencies in the

CRS-67
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

provision of health and social services to
older individuals living in the community;
and that is not an institutional care or assisted
living setting. (p. 83)
Community Innovations for
No provision.
No provision.
The bill would require the Assistant Secretary
Aging in Place: grants
to make grants to eligible entities to enable
the entities to pay for developing or carrying
out model aging in place projects. The
projects are required to permit aging in place
for older individuals, including such
individuals who reside in Naturally
Occurring Retirement Communities, which
help to sustain the independence of older
individuals in communities where the
individuals have established personal, family,
and professional supportive networks. The
entities are required to provide
comprehensive and coordinated health and
social services through the projects. (p. 83)
Community Innovations for
No provision.
No provision.
The bill would require the Assistant Secretary
Aging in Place: eligibility and
to make grants for three-year periods. To be
application requirements
eligible to receive a grant for a project, an
entity is required to submit an application to
the Assistant Secretary. (p. 84)
The bill would require that an application
include:
• a description of the entity’s experience in
providing services to older individuals in
age-integrated settings;
• a definition of the contiguous service area
and a description of the project boundaries
in which the older individuals reside or
carry out activities to sustain their well-
being;

CRS-68
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

• a description of how the entity will
cooperate and coordinate planning and
services with agencies and organizations
that provide publicly supported services for
older individuals within the project
boundaries, including the state agency and
area agencies on aging with planning and
service areas within the project boundaries;
• an assurance that the entity will seek to
establish cooperative relationships with
interested local entities, including private
agencies and businesses that provide health
and social services, housing entities,
community development organizations,
philanthropic organizations, foundations,
and other non-federal entities;
• a description of the entity’s protocol for
referral of residents who may require long-
term care services, including coordination
with local information and referral agencies
and ADRCs who serve as single points of
entry to public services;
• a description of how the entity will offer
opportunities for older individuals to be
involved in the governance, oversight, and
operation of the project;
• an assurance that the entity will submit to
the Assistant Secretary such evaluations
and reports as the Assistant Secretary may
require; and
• a plan for long-term sustainability of the
project. (p. 84)
Community Innovations for
No provision.
No provision.
The bill would require an eligible entity that
Aging in Place: use of funds
receives a grant to use funds to provide and
coordinate, through aging in place projects,
services that include a comprehensive and

CRS-69
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

coordinated array of community-based health
and social services, which may include
mental health services, for eligible older
individuals. (p. 86)
Community Innovations for
No provision.
No provision.
The bill would require the following services
Aging in Place: required
to be provided:
services
• case management, case assistance, and
social work services;
• health care management and health care
assistance, including disease prevention and
health promotion services;
• education, socialization, and recreational
activities;
• volunteer opportunities for project
participants; and
• coordinating the services provided under
Title III for eligible older individuals
served by the project. (p. 87)
Community Innovations for
No provision.
No provision.
In carrying out an aging in place project, the
Aging in Place: service areas
bill would require an eligible entity, to the
extent practicable, to serve communities of
low-income individuals and operate or locate
projects and services, in or in close proximity
to, locations where large concentrations of
older individuals have aged in place and
resided, such as Naturally Occurring
Retirement Communities. (p. 87)
Community Innovations for
No provision.
No provision.
The bill would require that funds made
Aging in Place: supplement
available to an eligible entity under this
and not supplant federal,
section be used to supplement, not supplant,
state, or other funds
any federal, state, or other funds otherwise
available to the entity to provide health and
social services to eligible older individuals.
(p. 88)

CRS-70
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Community Innovations for
No provision.
No provision.
The bill would require the Assistant Secretary
Aging in Place: technical
(or require the Assistant Secretary to make a
assistance
grant on a competitive basis to an eligible
nonprofit organization) to provide technical
assistance to recipients of grants and to carry
out other duties. (p. 88)
Community Innovations for
No provision.
No provision.
To be eligible to receive a grant to provide
Aging in Place: eligibility
technical assistance, an organization is
requirements for grants to
required to be a nonprofit organization
provide technical assistance
(including a partnership of nonprofit
organizations), that has:
• experience and expertise in providing
technical assistance to entities serving older
individuals;
• experience evaluating and reporting on
programs; and
• knowledge and expertise in community-
based health and social services. (p. 89)
To be eligible to receive a grant to provide
technical assistance, the bill would require an
organization (including a partnership of
nonprofit organizations) to submit an
application to the Assistant Secretary,
including an assurance that the organization
will submit an evaluation as required. (p. 89)
Community Innovations for
No provision.
No provision.
The bill would require the Assistant Secretary
Aging in Place: report to
to annually prepare and submit a report to
Congress
Congress that includes:
• the findings resulting from the evaluations
of the model projects conducted under this
section;
• a description of recommended best
practices regarding carrying out health and
social service projects for older individuals

CRS-71
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

aging in place; and
• recommendations for legislative or
administrative actions, as the Assistant
Secretary determines appropriate. (p. 89)
CHOICES FOR INDEPENDENCE DEMONSTRATION PROJECTS
Choices for Independence:
No provision.
No provision.
The bill would add a new Title IV program:
authorization
Sec. 423 Choices for Independence
Demonstration Projects.
(p. 90)
Choices for Independence: definitions
Consumer
No provision.
No provision.
Defines consumer as an older individual, a
family member of such individual, and any
other person seeking information or
assistance with respect to long-term care.
(p. 90)
High-risk individual
No provision.
No provision.
Defines high-risk individual as an older
individual who has a functional impairment
affecting the individual’s activities of daily
living; is ineligible for the Medicaid
program; and meets such income and
functional status criteria as are determined to
be appropriate by the state involved and
approved by the Assistant Secretary. (p. 90)
Qualified expenditures
No provision.
No provision.
Defines qualified expenditures as reported
expenditures of a state under this section that
have been reviewed and approved by the
Assistant Secretary. (p. 90)
Service coordination
No provision.
No provision.
Defines service coordination as a coordinated
approach taken on behalf of high-risk older
individuals to facilitate the development and
implementation of a long-term care plan and
the choice and independence of the

CRS-72
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

individuals in securing long-term care.
(p. 91)
Choices for Independence:
No provision.
No provision.
The bill would require the Assistant Secretary
grants to states
to make grants, on a competitive basis, to
states to enable them to pay for the federal
share of the cost of modifying their systems
of long-term care in order to promote and
facilitate:
• the choice and control of older individuals
and their families in securing long-term
care;
• the coordination and cost-effectiveness of
state systems of long-term care;
• the provision of long-term care in home
and community-based settings; and
• the ability of individuals receiving long-
term care to remain as independent and
self-sufficient as possible. (p. 91)
Choices for Independence:
No provision.
No provision.
For a state to be eligible, the bill would
eligibility
require that the Governor submit an
application to the Assistant Secretary
containing a plan for implementation of the
component strategies and other information
and assurances as the Secretary determines
appropriate. (p. 91)
Choices for Independence:
No provision.
No provision.
The bill would require that a state use funds
use of funds
to carry out a demonstration project under
this section (directly or by contract) by
integrating in the state’s system of long-term
care the following component strategies:
public education, ADRCs, healthy lifestyle
choices, and community living incentives.

CRS-73
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Choices for Independence:
No provision.
No provision.
Public education: The state would be
public education
required to conduct public education
activities that include media campaigns,
targeted mailings, and related activities, to
help ensure that consumers are aware of:
• the need to plan in advance for long term
care;
• available public and private long-term care
options, including private long-term care
insurance; and
• sources of information and resources
related to long-term care, including
ADRCs. (p. 92)
Choices for Independence:
No provision.
No provision.
ADRCs: The state is required to provide for
ADRCs
community-level ADRCs, which are required
to provide —
• comprehensive information on available
public and private long-term care
programs, options, and resources;
• personal counseling and service
coordination to assist consumers in
assessing their existing or anticipated long-
term care needs and circumstances, and
developing and implementing a plan for
long-term care designed to meet their
specific needs and circumstances;
• a convenient point of entry to the range of
publicly-supported long-term care
programs for which an individual may be
eligible, including Medicaid, and to such
other public benefit programs as the state
determines to be appropriate;
• a single process for consumer intake,
assessment, and application for benefits,
including, where appropriate and feasible,
facilitating the determination of an

CRS-74
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

individual’s eligibility under such programs
(including eligibility for Medicaid) by
collaborating with the appropriate
programmatic office; and
• the ability to respond immediately to a
request for assistance from an individual or
an individual’s family member, in the event
of a crisis situation that could result in
placement in an institutional care setting;
and to provide (or coordinate the provision
of), available short-term assistance to
temporarily preclude the need for
institutional placement, until a plan for
home and community-based long-term care
can be developed and implemented. (p. 93)
The bill would require that states ensure
ADRC staff are appropriately trained to
understand the interactions between private
long-term care insurance (especially
insurance through long-term care partnership
policies) and eligibility for benefits under
Medicaid. (p. 95)
Choices for Independence:
No provision.
No provision.
Healthy Lifestyle Choices: The state would
Healthy Lifestyle Choices
be required, in accordance with standards
established by the Assistant Secretary, to
provide for low-cost, community-level,
evidence-based prevention programs and
related tools 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. (p. 95)

CRS-75
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Choices for Independence:
No provision.
No provision.
Community Living Incentives: The state
Community Living Incentives
would be required to provide funding and
(CLI)
assist with the provision of home and
community-based long-term care to
individuals at high risk of placement in
institutional care. The state is required to
ensure that individuals at greatest risk for
becoming eligible for benefits under the
Medicaid program receive priority for the
home and community-based long-term care.
(p. 95)
Needs assessment
No provision.
No provision.
The bill would require the state to provide for
assessments of the needs and preferences of
high-risk individuals with respect to long-
term care, and based on such assessments,
develop with individuals and their family
members, caregivers, or legal representatives,
a plan specifying the types of support,
providers, budget, and if the state elects, cost-
sharing contributions. (p. 96)
Funding for individual
No provision.
No provision.
The bill would require that the state ensure
budgets
that funding will be allocated among, and
disbursed for, the budgets of high-risk
individuals under long-term care plan.
(p. 96)
Option to receive home and
No provision.
No provision.
The bill would require that the state provide
community-based long-term
high-risk individuals with the option to
care
receive home and community-based long-
term care in a manner that permits such
individuals to direct and control, in
conjunction with a service coordinator, the
selection, planning, budgeting, and
purchasing of such care (including the
amount, duration, scope, providers, and

CRS-76
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

location of such care), to the extent
determined appropriate and feasible under
the long-term care plan. The service
coordinator would be required to assist high-
risk individuals in purchasing from a
qualified provider a range of long-term care
services or supplies, not otherwise available
or eligible for payment through an entity
carrying out a federal or state program or a
similar third party, from a qualified provider
that are delivered in home and community-
based settings and in a manner that best
meets individuals’ needs and individuals’
preferences to remain in the least restrictive
setting possible. (p. 97)
Federal share
No provision.
No provision.
The federal share of the cost of modifying
systems of long-term care may not be more
than 75% of costs (calculated on an annual
basis as the state’s qualified expenditures for
such modifications for such year). (p. 97)
Coordination with ADRCs
No provision.
No provision.
The bill would require that a state ensure that
ADRCs:
• fully coordinate their activities with any
health insurance information, counseling,
and assistance (receiving funding under
Omnibus Reconciliation Act of 1990) in
the state;
• be subject to such controls as the Assistant
Secretary determines to be appropriate to
ensure there is no conflict of interest on any
referrals, for information or otherwise,
made by the center for individuals
receiving services through the center; and
• provide no long-term care services or
supplies, with the exception of case

CRS-77
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

management services through area agencies
on aging. (p. 98)
Exclusion of payments as
No provision.
No provision.
The bill would require that payments made
income for determination of
for a high-risk individual not be included in
benefits
the gross income of the high-risk individual
for purposes of the Internal Revenue Code of
1986, or be treated as income, assets, or
benefits, or otherwise be taken into account,
for purposes of determining the individual’s
eligibility for, the amount of benefits under,
or the amount of cost-sharing required of the
individual by any other federal or state
program, other than the CLI program. (p. 98)
Choices for Independence:
No provision.
No provision.
The Assistant Secretary, directly or by grant
technical assistance
or contract, is required to provide for
technical assistance to and oversight of states
carrying out demonstration projects under
this section, for purposes of administration,
quality assurance, and quality improvement.
(p. 99)
Choices for Independence:
No provision.
No provision.
The bill would require that the Assistant
evaluation
Secretary, directly or by grant or contract,
provide for an evaluation of the
demonstration projects carried out under this
section. The Assistant Secretary is required to
submit to the President a report containing
the findings resulting from such evaluation
not later than six months after the termination
of the demonstration projects. (p. 99)

CRS-78
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Choices for Independence:
Section 432(c)(2)(B) requires the Assistant
The bill would also require the Assistant
Same as H.R. 5293. (p. 100)
responsibilities of the
Secretary to use evaluations of Title IV
Secretary to prepare an analysis of such
Assistant Secretary
projects to improve services delivered, or
services, projects, and programs, and how
the operation of projects and programs
evaluations relate to improvements in services,
carried out, under this act.
projects, and programs, and in the AoA’s
strategic plan.
(p. 63)
TITLE V, COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
Title V, Community Service
Title V is entitled “Community Service
The bill would rewrite Title V and change its
No change in current law.
Employment for Older
Employment for Older Americans.”
name to “Older American Community Service
Americans
Employment-Based Training Act.” (p. 64)
Program authorized:
Section 502(a)(1) authorizes the Secretary
The bill would authorize the Secretary to
No change in current law.
purposes
of Labor to establish an older American
establish an older American community service
community service employment program,
employment- based training program. It would
with the following purposes:
change the following purposes:
• to foster and promote useful part-time
• to foster and promote useful part-time public
No change in current law.
opportunities in community service
and private-sector employment-based
activities for unemployed low income
training opportunities for unemployed low-
persons aged 55 or older and who have
income eligible individuals who have poor
poor employment prospects;
employment prospects. (p. 64)
No provision.
• to foster vital social and human services to
No change in current law.
communities by providing work experience to
eligible individuals in public agencies,
c o mmu n i t y-b a s e d a n d fa i t h -b a s e d
organizations. (p. 64)
No
provision.
No
provision.
The bill would add the following: for
p u r p o ses o f t h i s p a r a g r a p h , a n
underemployed person will be considered an
unemployed person. (p. 100)

CRS-79
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Agreements/grants to public
Section 502(b)(1) authorizes the Secretary
The bill would authorize the Secretary to make
No change in current law.
and private non-profit
to enter into agreements with state and
grants to public and private nonprofit agencies
organizations/state
national public and private nonprofit
and organizations, state agencies or tribal
agencies/tribal organizations
agencies and organizations, state agencies
organizations to carry out the program
or a political subdivision of a state, a
requirements below. (p. 64)
combination of political subdivisions, or
tribal organizations to further the purposes
and goals of the program. The Secretary
may not make payments unless the
organization/agency meets the program
requirements described below.
The agreements may include payment of
Similar provision, except the reference is to
costs of projects developed by
grants, not agreements.
organizations and agencies in cooperation
with the Secretary in order to make the
program effective or to supplement the
program.
PROGRAM REQUIREMENTS
Provision of employment for
Section 502(b)(1)(A) requires the program
No provision.
No change in current law.
eligible individuals
to provide employment only for eligible
individuals, except for necessary technical,
administrative, and supervisory personnel.
Personnel shall, to the fullest extent
possible, be recruited from eligible
individuals.
50% of hours worked to be in
No provision.
The bill would require that not less than 50% of
No change in current law.
community service
hours worked in a program year (in the
employment-based training
aggregate) be in community service
employment-based training provided by a
grantee and that the program provide
authorized activities only for eligible
individuals. (p. 65)

CRS-80
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Employment in communities
Section 502(b)(1)(B)(I) requires the
The bill would require that the program provide
No change in current law.
where eligible individuals
program to provide employment for
authorized activities for eligible individuals in
reside; no less than 50% of
eligible individuals in the community in
the community in which they reside, or in
hours worked to be in
which they reside, or in nearby
nearby communities, in a program year, and
community service
communities.
that no less than 50% of hours worked (in the
employment-based training
aggregate) shall be in community service
employment-based training provided by a
grantee. (p. 65)
Employment for individuals,
Section 502(b)(1)(B)(ii) requires that if a
Similar provision, except refers to authorized
No change in current law.
including Indians residing on
Title V project is carried out by a tribal
activities, including community service
Indian reservations
organization, or a tribal organization
employment-based training. (p. 65).
funded by a state, it will provide
employment for individuals including
Indians who reside on an Indian
reservation as defined in Section 2601(2)
of the Energy Policy Act of 1992.
Prohibition of participation
No provision.
The bill would prohibit participation by eligible
The bill would allow an eligible individual to
by eligible individuals
individuals (in the aggregate) for an average
participate for up to 36 months (whether or
exceeding a specified period
per capita period that exceeds 24 months
not consecutive) in the aggregate. (p. 100)
(whether or not consecutive) during the
program year and the previous program years
A grantee may extend the period of
in which a grantee carried out Title V projects.
participation for not more than 20% of the
(p. 66)
project participants. In selecting participants
for the extended period, the grantee is to give
priority to: participants age 65 and older or
frail older individuals and individuals who
have more than one of the following barriers
to employment:
• a disability;
• limited English proficiency or low literacy
skills;
• rural residence;
• residence in an area of high employment;
• homelessness or a situation that puts the

CRS-81
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

individual at risk for homelessness; and
• failure to find employment after using
services under Title I of Workforce
Investment Act (WIA). (p. 101)
A grantee may petition for a waiver of the
36-month limit if the grantee serves a high
concentration of individuals who are hard-to-
serve because they have more than one
barrier to employment, including a grantee
who operates a project in an area where at
least 60% of the counties are rural counties
(as defined by the Economic Research
Service of the Department of Agriculture).
(p. 101)
Employment in public and
Section 502(b)(1)(C) requires Title V
The bill would require Title V projects to
No change in current law.
private non-profit
projects to employ eligible individuals in
provide employment-based training in publicly
organizations/for-profit
publicly owned and operated facilities or
owned and operated facilities or Section
organizations
private non-profit organizations, other than
501(c)(3) private non-profit organizations and
political parties exempt from taxation
in projects sponsored by profitmaking
under Section 501(c)(3) of the IRS Code.
organizations. It would exclude political
parties exempt from taxation under Section
501(c)(3) of the IRS Code. (p. 66)
Result in unsubsidized
No
provision.
The bill would require that projects
are
No change in current law.
employment
intended to result in unsubsidized employment
after an individual completes Title V
participation. (p. 67)
Contribution to the
Section 502(b)(1)(D) requires that projects
The bill would require that projects contribute
No change in current law.
community
will contribute to the general welfare of the
to the general welfare of the community, which
community.
may include support for children, youth and
families. (p. 67)

CRS-82
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Provision of employment for
Section 502(b)(1)(E) requires projects to
No provision.
No change in current law.
eligible individuals
provide employment for eligible
individuals.
Increase in employment
Section 502(b)(1)(F) requires projects to
Similar provision, but wording is slightly
No change in current law.
opportunities
result in an increase in employment
different: it states that projects will not reduce
opportunities over those otherwise
the number of job opportunities or vacancies
available.
that would otherwise be available to non-
participants. (p. 67)
Prohibition of Title V
Section 502(b)(1)(G) prohibits projects
Same as current law, except refers to an
No change in current law.
enrollees performing work of
from employing individuals to perform
individual in employment-based training.
a person who is on layoff
work that is the same as, or substantially
(p. 67)
the same as, that of an individual who is on
layoff.
Coordination with the
Section 502(b)(1)(H) requires projects to
The bill would require that projects coordinate
No change in current law.
Workforce Investment
use recruitment and selection methods, and
with training and other services under WIA,
system
listing of job vacancies, with the state
including the one-stop delivery system, to
employment agency to assure a maximum
recruit eligible individuals to ensure that the
number of eligible individuals have an
maximum number of eligible individuals have
opportunity to participate.
an opportunity to participate. (p. 67)
Also requires projects to participate in the
one-stop delivery system established under
WIA.
Training and payment of
Section 502(b)(1)(I) requires projects to
Similar provision, except training may include
No change in current law.
trainees’ expenses
provide training, as may be necessary, to
community service employment-based training,
make the most efficient use of the skills
work experience, on-the-job training, and
and talents of participants.
classroom training. (p. 68)
Also requires projects to pay for
Deletes provision for payment of subsistence
reasonable expenses, including a
allowance while in training.
reasonable subsistence allowance, of
people being trained.

CRS-83
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Safe and healthy conditions
Section 502(b)(1)(J) requires projects to
Similar provision, except refers to safe and
No change in current law.
assure safe and healthy conditions of work.
healthy conditions in employment-based
training facilities or other training facilities.
(p. 68)
Wages of enrollees
Section 502(b)(1)(J) requires that enrollees
Similar provision, except that the bill eliminates
No change in current law.
be paid the highest of:
the reference to public occupations in number
1) the federal minimum wage;
3. (p. 68)
2) the state or local minimum wage for the
most nearly comparable covered
employment; or
3) the prevailing rates of pay for persons
employed in similar public occupations by
the same employer.
Projects to be established
Section 502(b)(1)(K) requires the projects
Similar provision, except advice is to be from
No change in current law.
with advice of experienced
be established or administered with the
persons competent in the field of service in
persons
advice of people competent in the field of
which job training is being provided. ( p. 69)
services in which employment is being
provided, and who are knowledgeable
about the needs of older people.
Payment for transportation
Section 502(b)(1)(L) requires projects to
The bill would authorize payment for necessary
No change in current law.
costs/supportive services
authorize payment of necessary
supportive services costs, including
transportation costs of eligible individuals
transportation costs of eligible individuals
incurred in employment.
incurred in training. ( p. 69)
Special needs individuals
Section 502(b)(1)(M) requires projects to
No change in current law.
The bill would change the reference to
serve the needs of minority, limited
eligible individuals with limited English
English-speaking, and Indian eligible
proficiency. (p. 100)
individuals, and those with greatest
economic need, at least in proportion to
their numbers in the state, and to consider
their rates of poverty and unemployment,
to the extent feasible.

CRS-84
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Activities with WIA
Section 502(b)(1)(Q) requires projects to
Refers to content of the cited sections of WIA.
No change in current law.
provide the Secretary the description of
(p. 71)
and information on paragraphs (8) and (14)
of Section 112(b) of WIA.
Sufficient administrative
Section 502(b)(1)(R) requires that entities
Similar provision, except that the Secretary is
No change in current law.
funds for entities
carrying out project activities, including
to determine the amount of the administrative
state agencies, local entities, subgrantees,
cost allocation. ( p. 71)
subcontractors, and affiliates, receive an
amount of the administrative cost
allocation that is sufficient for the
administration of project activities.
Innovative work modes and
Section 502(b)(3) requires the Secretary to
No provision. (See Demonstration projects,
No change in current law.
job opportunities
develop alternatives for innovative work
below.)
modes and provide technical assistance in
creating job opportunities through work
sharing and other experimental methods
with labor organizations, business and
industry and workers and employers.
Reciprocity of assessments of
Section 502(b)(4) stipulates that an
Similar provision. (p. 72)
No change in current law.
individuals under Title V and
assessment and service strategy developed
WIA
for individuals under Title V will be
considered to meet the assessment
requirements for qualification for training
under Title I, Subtitle B of WIA. Also, an
assessment and service strategy under Title
I of WIA will be considered to meet the
Title V requirement for an assessment and
service strategy.
Non-federal share
Section 502(c)(1) authorizes the Secretary
No change in current law (subparagraphs are
No change in current law.
to pay a 90% federal share, except where
added). (p. 72)
projects are located in an emergency or
disaster area or in an economically
depressed area, as determined by the

CRS-85
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Secretary in consultation with the
Secretaries of Commerce and HHS. The
non-federal share may be in cash or in-
kind. In determining the amount of the
non-federal share, the Secretary is
authorized to attribute fair market value to
services and facilities from non-federal
sources.
Definition of administrative
Section 502(c)(4) stipulates that
The bill would add to the definition of
No change in current law.
costs
administrative costs (personnel and non-
administrative costs:
personnel, direct and indirect) are those
• (to accounting) related data processing;
associated with:
• quality assurance;
• accounting, budgeting, financial and cash
• preparing program plans;
management;
• (to personnel management) personnel
• procurement and purchasing;
administration, administration of affirmative
• property management;
action plans, and training and staff
• personnel management;
development;
• payroll;
• administrative salaries, including clerical and
• coordination and resolution of findings
other support staff salaries;
a r i s i ng from audits, revi e ws,
• preparing reports;
investigations and incident reports;
• other activities necessary for the general
• audit;
administration of government funds and
• general legal services;
associated programs; and
• developing systems and procedures
• costs of technical assistance, professional
required for administrative functions;
organization membership dues, removal of
• oversight and monitoring;
architectural barriers, operating and
• goods and services;
maintaining assistive technology, and
• travel for official business; and
evaluating program results against stated
• information systems.
objectives. (p. 74)
It would exclude from travel costs, travel costs
relating to providing services. (p. 76)

CRS-86
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Wages
Section 502(b)(6) stipulates that funds not
Funds not used for administration are to be
No change in current law.
used for administration are to be used for
used for:
programmatic costs including:
• participant wages;
• enrollee wages;
Programmatic costs: fringe
• fringe benefits, including physical
• benefits required by law (such as workers
No change in current law.
benefits
exams;
c o m p e n s a t i o n o r u n e m p l o y m e n t
c o m p e n s a t i o n ) , p h y s i c a l e x a m s ,
compensation for federal holidays if the
employer is closed, necessary sick leave not
part of an accumulated sick leave program;
• excludes costs of pension benefits, annual
leave, accumulated sick leave or bonuses.
(p. 77)
Programmatic costs: training
• enrollee training, provided before or after
Same provision, but wording is slightly
No change in current law.
placement, on the job, in classrooms, or
different. (p. 77)
other arrangements; reasonable costs of
instructors, classroom rental, training
supplies, materials, equipment and
tuition;
Programmatic costs:
• supportive services, including
• Excludes health and medical services. (p. 78)
No change in current law.
supportive services
transportation, health and medical
services, special job-related or personal
counseling, incidentals (work shoes,
badges, uniforms, eyeglasses and tools)
child and adult care, temporary shelter,
and follow-up services.
Limit on fund for wages and
Section 502(b)(6) stipulates that not less
The bill changes the amount for wages and
No change in current law.
benefits of enrollees
than 75% of federal funds be used to pay
benefits to not more than 65% of federal funds
wages and benefits of enrollees.
(excluding funds for pilot and demonstration
and evaluation projects authorized by the bill).
(p. 78)

CRS-87
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Consultation with area
Section 502(d) requires projects to consult
No provision.
No change in current law.
agencies on aging
with the respective area agency on aging,
and to submit to the area agency and the
state agency a description and location of
the project 90 days before undertaking the
project for their review and comment.
Demonstration projects
Section 502(e) requires the Secretary to
The bill would require the Secretary to carry
No change in current law.
conduct projects designed to assure second
out demonstration, pilot and evaluation projects
career training and placement of
to develop and implement techniques and
individuals in private business concerns.
approaches and to demonstrate effectiveness of
The Secretary is required to enter into
specialized methods in addressing the
agreements with states, public agencies,
employment and training needs of eligible
nonprofit private organizations and private
individuals. (p. 78)
business. The Secretary may pay for all of
the costs of these projects and shall, to the
The bill does not specify which entities are to
extent feasible, assure equitable geographic
receive funds, how much the Secretary will
distribution.
pay, or that there will be equitable distribution.
Projects are to:
Projects may include:
• involve different kinds of work modes
• activities linking business and eligible
such as flextime, job sharing, and other
individuals, including assistance to
arrangements relating to reduced
participants transitioning from subsidized
physical exertion;
activities to private sector employment;
• emphasize projects involving second
• demonstration projects to attract more eligible
careers and job placement and give
individuals into the labor force; improve the
consideration to placement in growth
provision of services to eligible individuals
industries in jobs reflecting new
under the one-stop delivery system under
technological skills; and
WIA; enhance technological skills of eligible
• require the coordination of projects with
individuals; and provide incentives to Title V
Title I of WIA.
grantees for exemplary performance, and
incentives to business to promote their
The Secretary is to carry out evaluations of
participation in Title V;
these activities on a regular basis.
• demonstration projects described above only
if they are designed to assist in developing
and implementing techniques to address

CRS-88
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

employment and training needs of eligible
individuals;
• training and technical assistance to support
Title V projects;
• dissemination of best practices; and
• evaluation of Title V activities.
Funds for these projects are to come from
Funds for these projects are to come from
funds reserved under Section 506(a)(1).
reserved funds from Section 506(a)(1). (p. 78)
Evaluation of Title V
Section 502(f) requires the Secretary to
Similar provision above in previous box at end
No change in current law.
activities
carry out evaluations of Title V activities,
but does not specify when evaluations are to
including Section 502(e) demonstration
take place. (p. 80)
projects, on a regular basis.
Sense of the Senate
No provision.
No provision.
The bill would add a provision that it is the
sense of the Senate that:
• the older American community service
employment program was created with the
intent of placing older individuals in
community service positions to provide job
training placements; and
• placing older individuals in community
service positions strengthens the ability of
individuals to become self-sufficient,
provides much-needed volunteer support to
organizations which benefit significantly
from increased civic engagement, and
strengthens the communities that are served
by such organizations. (p. 102)
STATE PLAN
State Plan: submission,
Section 503(a) requires the Governor to
The bill would require that for a state to be
No change in current law.
timing and comments
submit an annual State Senior Employment
eligible to receive an allotment, the chief
Services Coordination Plan to the
executive officer of the state must submit a
Secretary.
single state plan to the Secretary for

CRS-89
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

consideration and approval. (p. 80)
The plan is to outline a three-year strategy for
the statewide provision of training and related
activities. (p. 80)
The plan must contain a description of the
Similar provision regarding the process to
process to ensure participation, and to
ensure participation, but refers to obtaining
include the advice and recommendations
advice and recommendations of unemployed
of individuals representing: state and area
older individuals rather than underserved older
agencies on aging; state and local
individuals. (p. 81)
workforce investment boards; public and
private non-profit organizations providing
employment including Title V projects;
social service organizations; Title III
grantees; affected communities, and
underserved older individuals, among
others.
State plans submitted by the Governor
Refers to chief executive officer.
must include public comments.
The plans must identify and address what
In addition to the cited provisions in current
the relationship of the number of eligible
law, the bill would add new requirements that
individuals in each area is to the total
the plan address the current and projected
number of eligible individuals in the state;
employment opportunities in the state, by
the relative distribution of individuals
occupation, and types of skills of local eligible
residing in urban and rural areas; and the
individuals; the locale and populations most
relative distribution of eligible individuals
needed by Title V projects; and plans for
with greatest economic and social need,
coordination of Title V and WIA activities.
and minority eligible individuals.
(p. 81)
Adds reference to individuals who have limited
English proficiency. (p. 82)

CRS-90
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

State Plan: comments by
The law requires that before a proposal is
Refers to chief executive officer. (p. 83)
No change in current law.
Governor/state chief
submitted to the Secretary, the Governor of
executive officer
the state is to have a reasonable
opportunity to submit recommendations to
the Secretary regarding a number of
factors.
State Plan: avoidance of
The law requires that in developing plans
Eliminates reference to community service
No change in current law.
participant disruption
and considering recommendations,
employment and refers to participants instead of
disruptions of community service
enrollees. (p. 83)
employment opportunities for current
enrollees be avoided to the maximum
extent possible.
State Plan: collaboration by
National grantees (receiving separate
Changes will to may. (p. 84)
No change in current law.
grantees that serve older
grants to serve older Indians from funds
Indians
reserved under Section 506(a)(3) will not
be required to participate in the state
planning process, but will collaborate with
the Secretary to develop a plan for projects
and services for older Indians.
State Plan: distribution of
Section 506 requires the Secretary to
No change in this portion of current law (see
assistance
reserve the following amounts, before
below).
allocating funds to states:
• up to 1.5% of the total appropriation is to
be reserved for Section 502(e)
experimental projects to transition
enrollees into private sector employment;
• 0.75% of the total appropriation is to be
reserved for U.S. territories; and
• “such sums as may be necessary” are to
be reserved for national grants to public
or private organizations serving older
Indians and older Pacific Island and
Asian Americans.

CRS-91
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

After these reservations, the remaining
The bill would change the hold harmless
funds are divided into two amounts, one
amount to the FY2006 level of activities.
for national grant organizations and the
(p. 92)
other for state agency grants, with a
requirement that funds are distributed at
their FY2000 level of activities, that is, the
FY2000 hold harmless amount.
FY2000 level of activities, for national
The bill would delete the reference to Section
grants and for state grants, is defined as
514(e) and (f) amounts. (p. 98)
the FY2000 level of activities after
deduction of funds for failure to meet
performance standards as described in
Section 514(e) and (f).
Level of activities is defined as the number
No change in current law.
of authorized positions multiplied by the
cost per authorized position.
Each allotment is distributed to states
according to a formula that takes into
account a state’s relative population 55 and
older and the relative state per capita
income. Each state is to receive a
minimum amount of funds, defined as one-
half of 1% of the total appropriation for the
respective fiscal year.
If funds for a given year are equal to, or
Refers to FY2006 appropriations and level of
less than, the FY2000 appropriation, states
activities.
are to receive an amount in proportion to
their respective FY2000 level of activities.
If funds are more than the FY2000
appropriation level: (1) the population and
per capita formula factors are applied; and
(2) states are to receive at least 30% of the

CRS-92
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

percentage increase above the FY2000
level.
If funding in any fiscal year is insufficient
Refers to FY2006 level of activities.
to meet FY2000 levels of activity, then
amounts are reduced proportionately. If
funding exceeds the FY2000 level, up to
$35 million of the excess is to be
distributed as follows: 75% of the excess is
to be provided to state agencies, and 25%
of the excess is to be provided to national
organizations. Any funding amount over
$35 million that remains is to be
distributed 50/50 to state agencies and
national organizations, respectively.
COMPETITION FOR AWARD OF GRANTS
Period of grant awards
Section 514(a) requires the Secretary to
The bill would require the Secretary to award
The bill would require the Secretary to award
award grants to eligible applicants for one
grants for three year periods through a
grants to eligible applicants, through a
year. The Secretary is to award grants for
competitive process.
competitive process that emphasizes meeting
a period not to exceed three years, after
performance measures, to carry out projects
establishing regulations and performance
If a grant recipient satisfies the performance
for a four-year period. (p. 105)
measures.
standards established by the bill (in Section
513) during the three-year period for which any
grant is made, the Secretary may award grants
to the recipient to continue the project beyond
the three-year period, but not longer than two
successive one-year periods. (p. 109)
Prohibition on competition
No provision.
No provision.
The Secretary would be prohibited from
until implementation of
carrying out a grant competition until the
indicators, or January 1,
later of (1) the date when the Secretary
2010
implements all required performance
indicators, and (2) January 1, 2010. (p. 105)
Eligibility criteria for awards
The bill would specify that an applicant is
No change in current law.
No change in current law.

CRS-93
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

eligible to receive a grant in accordance
with Section 502(b)(1) and Subsections (c)
and (d).
Section 514(c) sets the following that
Generally retains the criteria with these
Generally retains the criteria but would add:
applicants must meet:
changes:
• the applicant’s performance on the required
• administer a program serving the greatest
• Changes age to age 65 and older in first
indicators specified by the bill (in the case
number of eligible individuals, with
criterion listed in current law.
of previous recipients), and the applicant’s
particular consideration to those with the
• Adds applicant’s prior performance, if any, in
ability to meet the required indicators (in
greatest economic need, greatest social
meeting performance measures under Title V
the case of new applicants);
need, poor employment history or
and other federal or state programs. (p. 110)
• the applicant’s ability to administer a
prospects, and over age 60;
program that provides community service;
• administer a program that provides
• the applicant’s ability to minimize
employment for eligible individuals in
disruption in services for participants and
communities in which individuals live, or
employers; and
in nearby communities, that will
• additional criteria specified by the
contribute to the general welfare of the
Secretary. (p. 105)
community;
• administer a program that moves eligible
i n d i v i d u a l s i n t o u n s u b s i d i z e d
employment;
• move individuals with multiple barriers
to employment into unsubsidized
employment; and
• coordinate with other state and local
organizations.
The applicant must include a plan for fiscal
management and meet any other criteria
that the Secretary deems appropriate in
order to minimize disruption for current
enrollees.

CRS-94
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

PERFORMANCE MEASURES
Performance measures:
Section 513(a)(1) requires the Secretary to
No change in current law. (p. 101, lines 17-24)
The bill would require the Secretary to
establishment
establish performance measures, in
establish and implement performance
consultation with grantees, subgrantees,
measures, after consultation with the
host agencies, states, older individuals,
Assistant Secretary for Aging (and others
area agencies and others.
listed in current law). The bill would also
require the Assistant Secretary to provide
recommendations to the Secretary on
establishment and implementation of
performance measures. (p. 103)
Performance measures:
Section 513(a)(3) and (4) requires the
Similar to current law, but shortens the
No change in current law.
annual requirement
Secretary to annually establish national
provisions. (p. 105, lines 5-11)
performance measures for national and
state agency grantees, regardless of
Adds that the measures must include the core
whether the grantee operates the program
indicators and expected level of performance.
directly or through contracts, grants or
(p. 105, lines 12-14)
agreements with other entities.
Grantee performance is to be measured in
No provision.
accordance with requirements of Section
514(e)(f) (requirements on competition,
technical assistance, and corrective action).
Performance measures:
No provision.
The bill would require the Secretary and each
No provision.
agreement on expected levels
grantee to reach agreement on expected levels
of performance for each program year for each
of the core indicators, as specified by the bill.
The agreement must take into account
continuous improvement of performance, and
adjustment factors specified by the bill.
Funds may not be awarded until agreement is
reached. (p. 102, lines 15, p. 103, lines 1-2)

CRS-95
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Performance measures:
Section 513(a)(2) requires that
The bill would establish core indicators and the
No change in current law.
composition
performance measures consist of indicators
expected levels of performance applicable to
of performance and levels of performance
each indicator and additional indicators.
applicable to each indicator.
(p. 102)
Performance measures:
Section 513(b) establishes required
The bill would establish core indicators
No change in current law.
indicators
indicators consisting of:
consisting of:
• placement and retention in unsubsidized
• entry into unsubsidized employment;
public or private employment;
• retention in unsubsidized employment for six
• number of persons served, with
months;
particular consideration to individuals
• earnings; and
with the greatest economic and social
• hours (in the aggregate) of community
need, poor employment history or
service employment-based training pursuant
prospects, and individuals who are age
to 502(b)(1) (that is, in accordance with the
60 and older;
requirement that at least 50% of hours be in
• community services provided; and
community service employment). (p. 106)
• satisfaction of enrollees, employers, and
host agencies with experiences and
services provided.
Performance measures:
Section 513(b)(5) includes additional
The bill would specify the following additional
No change in current law.
additional indicators
indicators as determined appropriate by the
indicators:
Secretary.
• retention in unsubsidized employment for one
year;
• number of eligible individuals served
including the number of participating
individuals in Section 516(2)(A)(ii) (those
having priority for work opportunities); and
• any other indicators determined appropriate
by the Secretary to evaluate services and
performance. (p. 106)

CRS-96
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Performance measures:
Section 513(c) requires the Secretary to
Similar provision (p. 107, lines 4-8)
No change in current law.
issuance of rules on
issue rules on definition of indicators, after
indicators
consultation with national and state
grantees, business and labor, and
providers.
Performance measures:
Section 513(a)(2)(B) requires that the
The bill would specify that the expected levels
The bill would add other adjustments factors:
adjustments
levels of performance (applicable to
of performance be adjusted according to the
• not less than 60% of counties in areas
indicators of performance) are to be
factors in current law, and would add another
served by grantees are rural, as defined by
adjusted only with respect to the following
adjustment factor:
the Economic Research Service of the
factors:
• changes in the federal, state or local minimum
Department of Agriculture;
• high rates of unemployment, poverty, or
wage. (p. 103)
• the areas served by the grantee comprise a
welfare recipiency in areas served by the
difficult to serve territory due to limited
grantee, relative to the state or the nation;
economies of scale. (p. 103)
• significant downturns in areas served by
the grantee or in the national economy;
• significant numbers or proportion of
enrollees with one or more barriers to
employment served by the grantee
relative to other grantees in other areas of
the state or the Nation.
Performance measures:
No provision.
The Secretary would be required annually to
No change in current law.
annual publication of grantee
publish the actual performance of each grantee
performance
with respect to the levels of performance
achieved for each of the core indicators,
compared to expected levels of performance,
including any adjustments; and the levels
achieved for each of the additional indicators of
performance. (p. 105, line 15)
Performance measures:
Section 513(a)(2)(C) requires the Secretary
The bill would change the percentage for
No change in current law.
placement into unsubsidized
to establish a performance measure that
unsubsidized employment as follows: 22% in
employment
places at least 20% of enrollees in
FY2007, 24% in FY2008, 26% in FY2009,
unsubsidized employment (and adjusted
28% in FY2010, and 30% in FY2011. (p. 104)
according to the adjustment factors).

CRS-97
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

No provision.
If a grantee achieved a level of performance
less that these percentages for a preceding FY
before enactment of the bill, the Secretary is
required to provide technical assistance to assist
the grantee to achieve the percentage. (p. 104)
The term placement into public or private
The bill does not include the definition of
unsubsidized employment means full- or
placement.
part-time paid employment in the public or
private sector by an enrollee for 30 days
within a 90-day period without using Title
V, or any other federal or state subsidy
program, or the equivalent of such
employment as measured by enrollee
earnings though the use of wage records.
Performance measures:
The term retention in public or private
No provision.
No change in current law.
retention in employment
unsubsidized employment means full- or
part-time paid employment in the public or
private sector by an enrollee for six months
after the starting day of unsubsidized
employment without the use of Title V
funds or any other federal or state
employment subsidy program.

CRS-98
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Performance measures:
No provision.
No provision.
The bill would prohibit the Secretary from
exemption when a grantee
reducing a score on a performance measure
extends time for participation
of:
• a grantee that receives a waiver to extend
the period of time for enrollee participation
if the grantee serves a high concentration of
hard-to-serve individuals; and
• a grantee that extends the enrollee
participation period of time for more than
20% of participants for priority participants
as specified by the bill. (p. 104)
CORRECTIVE ACTION AND TECHNICAL ASSISTANCE BASED ON PERFORMANCE, AND REQUIREMENTS FOR COMPETITION BASED ON
PERFORMANCE

National organizations:
Section 514(e)(1) and (2) requires the
The bill would require the Secretary to
No change in current law.
technical assistance and
Secretary to determine if a national grantee
determine if a national grantee has met the
corrective action based on
has met the performance measures, within
expected levels of performance, (and
performance
120 days after the end of the program year.
adjustments) for the core indicators established
by the bill, within 120 days after the end of the
program year. (p. 107)
If the Secretary determines that a grantee
No change in current law.
fails to meet the expected levels of
performance, the Secretary is required to
provide technical assistance and require the
grantee to submit a corrective action plan
not later than 160 days after the end of the
program year. The plan must detail the
steps the grantee will take to meet the
national performance measures in the next
program year.

CRS-99
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

National organizations:
Section 514(e)(2)(C) stipulates that if a
Deletes the provision.
Same as H.R. 5293.
second year of failure in
grantee fails to meet the national
meeting performance
performance measures for a second
standards — reduction of
consecutive year, the Secretary is required
25% of funds
to conduct a national competition to award
25% of the funds awarded to the grantee
for the following year (minimizing to the
extent possible, disruptions of services to
enrollees).
National organizations: third
Section 515(e)(2)(D) stipulates that if a
Deletes the provision.
year of failure in meeting
grantee fails to meet the national
Same as H.R. 5293.
performance standards —
performance standards for a third
withdrawal of all funds
consecutive year, the Secretary is required
to conduct a national competition to award
the remainder of funds (after 25%
deduction specified above) for use for the
following year.
The grantee receiving the funds through
the national competition must continue to
serve the geographic areas served by the
former grantee.
National organizations:
In addition to the requirements above,
No provision.
The bill would require the Secretary to
additional competition
Section 514(e)(3) requires the Secretary to
provide technical assistance instead of taking
requirements where national
take corrective action, if the Secretary
corrective action.
organizations have
determines that a project operated by a
performance levels 20% or
national grantee in a state has attained
The bill would eliminate the provisions
more below the national
performance levels 20% or more below the
regarding the first, second and third years of
performance standards
national performance measures, and has
failure. (pp. 106-107)
failed to meet national performance
measures (unless there are adjustment
factors cited above that have to be
considered.)

CRS-100
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

First year of failure: After a project’s first
year of failure, the Secretary must require
a corrective action plan, and may transfer
responsibility of the project to other
grantees, provide technical assistance, and
take other actions.
Second year of failure: After a project’s
second year of failure, the corrective action
plan may include transfer of responsibility
for a portion or all of the project to a state
or public or private organization, or
competition for a portion or all of the
funds to carry out the project among all
eligible entities that meet the responsibility
tests (except for the grantee that is subject
to corrective action).
Third year of failure: After the third
consecutive year of failure, the Secretary is
required to conduct a competition for
funds to carry out the project among all
eligible entities that meet the responsibility
tests (except for the grantee that is subject
to corrective action).
Performance measures:
Section 514(e)(4) requires the Secretary to
No provision.
No change in current law.
request by the Governor
review the performance of a public or
private non-profit agency or organization
within a state, upon request of the
Governor. If performance is not justified,
the Secretary is to take corrective action.
States: technical assistance
Section 514(f) requires the Secretary to
The bill would require the Secretary to
No change in current law.
and corrective action based
determine if a state grantee has met the
determine if a state grantee has met the
on performance
performance measures, within 120 days
expected levels of performance (and

CRS-101
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

after the end of the program year.
adjustments) for the core indicators established
by the bill, within 120 days after the end of the
program year. (p. 108)
If the Secretary determines that a state
No change in current law.
No change in current law.
grantee fails to meet the expected levels of
performance, the Secretary is required to
provide technical assistance and to require
the grantee to submit a corrective action
plan not later than 160 days after the end
of the program year.
The plan must detail the steps the state will
No change in current law.
No change in current law.
take to meet the performance measures.
States: second year of failure
If a state fails to meet the national
Deletes the provision.
Same as H.R. 5293.
— reduction of 25% of funds
performance standards for a second
consecutive year, the Secretary is required
to have the state conduct a competition to
award 25% of the funds awarded to the
state for use during the following year
(minimizing to the extent possible,
disruption of services to enrollees).
States: third year of failure
If a state fails to meet the national
Similar provision. (p. 109)
No provision.
— withdrawal of all funds
performance standards for a third
consecutive year, the Secretary is required
to have the state conduct a competition to
award the funds allocated to the state for
use during the following year.
Grantees serving individuals
No provision.
No provision.
The bill would add a definition of individuals
with barriers to employment
with barriers to employment: minority and
Indian individuals, individuals with limited

CRS-102
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

English proficiency, and individuals with
greatest economic need. (p. 107)
In areas where a substantial population of
individuals with barriers to employment
exist, a grantee that received a national grant
shall give special consideration to selecting
organizations (including former recipients of
national organizations) with demonstrated
expertise in serving individuals with barriers
to employment. (p. 107)
Prohibition on promulgation
No provision.
No provision.
The bill would prohibit the Secretary from
of rules negatively affecting
promulgating rules, affecting grantees in
minority serving grantees
areas where a substantial population of
minority individuals exist, that would
significantly compromise the ability of
grantees to serve their targeted populations.
(p. 108)
Authorization of
Section 515 authorizes $475 million for
The bill would authorize such sums as may be
No change in current law.
Appropriations
FY2001 and such sums as may be
necessary for FY2007-FY2011. (p. 114)
necessary for FY2002-FY2005, plus such
additional funds to provide for 70,000 part-
time employment positions. (defined as at
least 20 hours within a workweek).
Funds are to be used on a July 1-June 30
No change in current law.
basis.
The Secretary is allowed to extend the
No change in current law.
period for use of funds if the Secretary
determines that the extension is necessary
to ensure effective use of funds.

CRS-103
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Unexpended funds
Section 515(c) allows the Secretary to
The bill would eliminate unexpended funds to
No provision.
recapture any unexpended funds for a
be used for incentive grants. (p. 115)
program year and reobligate funds within
the two succeeding programs years to be
used for: (1) incentive grants; (2) technical
assistance, or (3) grants or contracts for
any other program under the Title.
DEFINITIONS
Community
Defines community service as social,
Defines community service employment-based
No change in current law.
service/community service
health, welfare, and educational services
training as work experience that is related to
employment-based training
(including literacy tutoring), legal and
the same elements as in current law. (p. 115)
other counseling services and assistance,
including tax counseling and assistance
and financial counseling, and library,
recreational, and other similar services;
conservation, maintenance, or restoration
of natural resources; community
betterment or beautification; anti-pollution
and environmental quality efforts;
weatherization activities; economic
development, and such other services
essential and necessary to the community
as the Secretary may prescribe by
regulation.
Eligible individuals
Defines eligible individuals as those aged
The bill would exclude as income
The bill would exclude as income items
55 years and older, who have a low
unemployment compensation, Supplemental
excluded by H.R. 5293, as well as payments
income, including those whose income is
Security Income (SSI) benefits, or 25% of
made to or on behalf of veterans or former
not more than 125% of the Office of
benefits received under Title II of the Social
members of the Armed Forces under laws
Management and Budget (OMB) poverty
Security Act. (p. 116)
administered by the Secretary of Veterans
guidelines.
Affairs. (p. 108)
Individuals to have priority
Persons aged 60 and older are to have
The bill would require that any individuals who
No change in current law.
for work opportunities
priority for work opportunities.
meet one or more of the following criteria have
priority for work opportunities —

CRS-104
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

is 65 years of age or older; or has one or more
of the following barriers to employment:
• has a disability;
• has limited English proficiency or low
literacy skills;
• resides in a rural area;
• is a veteran;
• has low employment prospects; or
• has failed to find employment after using
services under Title I of the Workforce
Investment Act of 1998. (p. 116)
Exclusion of individuals who
No provision.
The bill would exclude from Title V projects,
See provision above: “Prohibition of
have participated in Title V
an individual who has participated in Title V
participation by eligible individuals
projects for a specified period
projects for a period of 48 months (whether
exceeding a specified period.”
consecutive or not) after the enactment of the
bill. (p. 117)
It would also exclude an individual who has
participated for a period of 24 months in the
aggregate (whether or not consecutive) after the
date of enactment, if the individual participated
in Title V projects for more than 24 months in
the aggregate (whether or not consecutive) as in
effect before enactment of the bill. (p. 117)
Income
No provision.
Defines income as income received during the
See eligible individuals above.
12-month period (or, at the option of the
grantee, the six-month period that is not
multiplied) ending on the date an eligible
individual submits an application to participate
in the project carried out by a grantee. (p. 118)
Program
Defines program as the older American
Defines program as the older American
No change in current law.
community service employment program
community service employment-based training
under Title V.
program under Title V. (p. 118)

CRS-105
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Supportive services
No provision.
Defines supportive services as transportation,
No change in current law.
child care, dependent care, housing, and needs-
related payments that are necessary to enable an
individual to participate in activities authorized
under Title V. (p. 118) (See also supportive
services under Programmatic costs, above.)

Unemployed individual
No provision.
Defines unemployed individual as a person
See purpose statement above. The bill would
without a job and who wants, and is available
consider an underemployed person to be an
for, work, including an individual who may
unemployed person.
have occasional employment that does not
result in a constant source of income. (p. 119)
TITLE VI, GRANTS FOR NATIVE AMERICANS
Distribution of funds among
No provision.
No provision.
Defines covered year as FY2006 or a
tribal organizations
subsequent fiscal year.
The bill would clarify that if a tribal
organization received a grant under this part
for FY1991 as part of a consortium, the
Assistant Secretary would be required to
consider the tribal organization to have
received a grant under this part for FY1991
for purposes of the distribution of funds. The
Assistant Secretary would also be required to
apply the provisions of the subsection to the
tribal organization for each covered year for
which the tribal organization submits an
application for funds, even if the tribal
organization submits a separate application
from the remaining members of the
consortium or an application as one of the
remaining members of the consortium.
(p. 109)

CRS-106
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Native Americans caregiver
Section 643 authorizes the appropriation of
The bill would authorize such sums as may be
This bill would authorize for supportive
support program
such sums as may be necessary for
necessary for supportive services and nutrition
services and nutrition services to Native
supportive services and nutrition services
services to Native Americans and the Native
Americans such sums as may be necessary
to Native Americans for FY2001, and such
American Caregiver Support Program for
for FY2007 and subsequent fiscal years; and
sums as may be necessary for subsequent
FY2007-FY2011. (p. 119)
for the Native American Caregiver Support
fiscal years. For grants to tribal
Program, $6.5 million for FY2007, $7.0
organizations for the Native American
million for FY2008, $7.5 million for
Caregiver Support Program, authorizes
FY2009, $8.0 million for FY2010, and $8.5
$5.0 million for FY2001, and such sums as
million for FY2011. (p. 110)
may be necessary for subsequent fiscal
years.
TITLE VII, ALLOTMENTS FOR VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES
Vulnerable elder rights
Section 702 authorizes the appropriation of
The bill would authorize such sums as may be
Same as H.R. 5293. (p. 111)
protection activities:
such sums as may be necessary for the
necessary for FY2007. (p. 119)
ombudsman program
ombudsman program for FY2001, and
such sums as may be necessary for
subsequent fiscal years.
Native American
Section 751 authorizes the appropriation of
The bill would change the reference to FY2007.
Same as H.R. 5293. (p. 112)
organization provisions
such sums as may be necessary for
and such sums as may be necessary for
assisting entities and providing grants on
subsequent fiscal years. (p. 119)
vulnerable elder rights protection activities
for FY2001, and such sums as may be
necessary for subsequent fiscal years.
Elder abuse, neglect, and
Section 721 authorizes the state agency the
The bill would add the following reference:
Same as H.R. 5293. (p. 111)
exploitation prevention
use of allotments to carry out programs for
providing for public education and outreach to
the prevention of elder abuse, neglect, and
promote financial literacy and prevent identity
exploitatio n (includ ing financial
theft and financial exploitation of older
exploitation), including:
individuals. (p. 120)
• providing for public education and
outreach to identify and prevent elder
abuse, neglect, and exploitation;
• ensuring the coordination of services
provided by area agencies on aging;

CRS-107
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

• promoting the development of
information and data systems;
• conducting analyses of state information
and identifying unmet services,
enforcement, or intervention needs;
• conducting training for individuals in
relevant fields on the identification,
prevention, and treatment of elder abuse,
neglect, and exploitation;
• providing technical assistance to
programs that provide or have the
potential to provide services for victims
and their family members;
• conducting special and on-going training
on the topics of self-determination,
individual rights, state and federal
requirements concerning confidentiality,
and other topics; and
• promoting the development of an elder
abuse, neglect, and exploitation system.
ELDER JUSTICE
No provision.
No provision.
The bill would add a provision for Elder
PROGRAMS: PURPOSES
Justice Programs. The purpose of this
provision would be —
• to assist states and Indian tribes in
developing a comprehensive multi-
disciplinary approach to elder justice;
• to promote research and data collection that
will fill gaps in knowledge about elder
abuse, neglect, and exploitation to support
innovative and effective activities of
service providers and programs that are
designed to address issues relating to elder
abuse, neglect, and exploitation.
• to assist states, Indian tribes, and local
service providers in the development of

CRS-108
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

short- and long-term strategic plans for the
development and coordination of elder
justice research, programs, studies, training,
and other efforts; and
• to promote collaborative efforts and
diminish overlap and gaps in efforts in
developing the important field of elder
justice. (p. 112)
DEFINITIONS
Caregiver
Defines caregiver as an individual who has
the responsibility for the care of an elder,
either voluntarily, by contract, by receipt of
payment for care, or as a result of the
operation of law and means a family member
or other individual who provides (on behalf
of such individual or of a public or private
agency, organization, or institution)
compensated or uncompensated care to an
elder. (p. 113)
Direct care
Defines direct care as care by an employee
or contractor who provides assistance or
long-term care services to a recipient.
(p. 113)
Elder
Defines elder as an individual who is 60
years of age or older. (p. 114)
Elder justice
Defines elder justice as —
• efforts to prevent, detect, treat, intervene in,
and respond to elder abuse, neglect, and
exploitation and to protect elders with
diminished capacity while maximizing their
autonomy; and
• from an individual perspective, the

CRS-109
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

recognition of an elder’s rights, including
the right to be free of abuse, neglect, and
exploitation. (p. 114)
Eligible entity
Defines eligible entity as a state or local
government agency, Indian tribe, or any
other public or private entity, that is engaged
in and has expertise in issues relating to elder
justice. (p.114)
Fiduciary
Defines fiduciary as a person or entity with
the legal responsibility:
• to make decisions on behalf of and for the
benefit of another person;
• to act in good faith and with fairness; and
• includes a trustee, a guardian, a
conservator, an executor, an agency under
financial power of attorney or health care
power of attorney, or a representative
payee. (p. 115)
Grant
Defines grant to include a contract,
cooperative agreement, or other mechanism
for providing financial assistance. (p. 115)
Law enforcement
Defines law enforcement as the full range of
potential responders to elder abuse, neglect,
and exploitation including —
• police, sheriffs, detectives, public safety
officers, and corrections personnel;
• prosecutors;
• medical examiners;
• investigators; and
• coroners. (p. 115)

CRS-110
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Long-term care
Defines long-term care as supportive and
health services specified by the Secretary for
individuals who need assistance because the
individuals have a loss of capacity for self-
care due to illness, disability, or vulnerability.
(p. 115)
Loss of capacity
Defines loss of capacity for self-care as an
inability to engage effectively in activities of
daily living, including eating, dressing,
bathing, and management of one’s financial
affairs. (p.116)
Long-term care facility
Defines long-term care facility as a
residential care provider that arranges for, or
directly provides, long-term care. (p.116)
Nursing facility
Defines nursing facility to have the same
meaning given under such term under section
1919(a) of the Social Security Act (42 U.S.C.
1396r(a)). (p. 116)
State legal assistance
Defines state legal assistance developer as an
developer
individual whose services are provided by the
state to ensure the state has sufficient
leadership in securing and maintaining the
legal rights of older individuals and the
capacity for: coordination; technical
assistance, training and other supportive
functions; promoting fiscal management
services; assisting older individuals in
understanding their rights; and improving the
quality and quantity of legal services
provided to older individuals. (p.116)

CRS-111
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

State long-term care
Defines state long-term care ombudsman as
ombudsman
individual with expertise and experience in
the fields of long-term care and advocacy to
head the Office of the State Long-Term Care
Ombudsman. (p. 116)
STATE AND TRIBAL GRANTS TO STRENGTHEN LONG-TERM CARE AND PROVIDE ASSISTANCE FOR ELDER JUSTICE PROGRAMS
State and tribal grants:
No provision.
No provision.
The bill would authorize the Assistant
authorization
Secretary to award grants to states and Indian
tribes to enable the states and tribes to
strengthen long-term care and provide
assistance for elder justice programs. (p. 117)
State and tribal grants:
The bill would require a state or Indian tribe,
application for eligibility
in order to be eligible to receive a grant, to
submit an application as required. (p. 117)
State and tribal grants: use of
The bill would authorize a state or Indian
funds
tribe receiving a grant (under this subtitle) to
use the funds made available through the
grant to award grants to eligible entities for
the following activities: (p. 117)
Prevention, detection, assessment, and
treatment of, intervention in, investigation of,
and response to elder abuse, neglect, and
exploitation; (p.117)
Examine various types of elder shelters
(referred to as “safe havens”), and test
various safe haven models for establishing
them (at home or elsewhere), that —
• recognize autono my and self-
determination, and fully protect the due
process rights of elders; and
• provide a comprehensive, culturally

CRS-112
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

sensitive, and multidisciplinary team
response to allegations of elder abuse,
neglect, or exploitation; provide a
dedicated, elder-friendly setting; have the
capacity to meet the needs of elders for
care; and provide various services
including nursing and forensic evaluation,
therapeutic intervention, victim support and
advocacy, and case review and assistance to
make the elders safer at home or to find
ap p ro p ria t e p l a c e me n t i n safer
environments, including shelters, and in
some circumstances long-term care
facilities, other residential care facilities,
and hospitals; (p. 117)
Establish or continue volunteer programs that
focus on the issues of elder abuse, neglect,
and exploitation, or to provide related
services; (p. 118)
Support multidisciplinary elder justice
activities, such as —
• supporting and studying team approaches
for bringing a coordinated multidisciplinary
or interdisciplinary response to elder abuse,
neglect, and exploitation, including a
response from individuals in social service,
health care, public safety, and legal
disciplines;
• establishing a state or tribal coordinating
council, which shall identify the individual
state’s or Indian tribe’s needs and provide
the Secretary with information and
recommendations relating to efforts by the
state or Indian tribe to combat elder abuse,

CRS-113
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

neglect, and exploitation;
• providing training, technical assistance, and
other methods of support to groups
carrying out multidisciplinary efforts at the
state or Indian tribe level (referred to in
some states as “State Working Groups”);
• broadening and studying various models
for elder fatality and serious injury review
teams, to make recommendations about
their composition, protocols, functions,
timing, roles, and responsibilities, with a
goal of producing models and information
that will allow for replication based on the
needs of other states, Indian tribes, and
communities; or
• carrying out such other interdisciplinary or
multidisciplinary efforts as the Assistant
Secretary determines to be appropriate;
(p. 119)
Provide training for individuals with respect
to issues of elder abuse, neglect, and
exploitation, consisting of —
• training within a discipline; or
• cross-training activities that permit
individuals in multiple disciplines to train
together, fostering communication,
coordinating efforts, and ensuring
collaboration; (p. 120)
Address underserved populations of elders,
such as —
• elders living in rural locations;
• elders in minority populations; or
• low-income elders; (p. 120)

CRS-114
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Provide incentives for individuals to train for,
seek, and maintain employment providing
direct care in a long-term care facility, such
as —
• to eligible entities to provide incentives to
participants in programs carried out under
part A of Title IV, and section 403(a)(5) of
the Social Security Act (42 U.S.C. 601 et
seq., 603(a)(5)) to train for and seek
employment providing direct care in a
long-term care facility;
• to long-term care facilities to carry out
programs through which the facilities offer
to employees who provide direct care to
residents of a long-term care facility,
continuing training and varying levels of
professional certification, based on
observed clinical care practices and the
among of time the employees spend
providing direct care; and provide, or make
arrangements with employers to provide,
bonuses or other increased compensation or
benefits to employees who achieve
professional certification under such a
program; or
• to long-term care facilities to enable the
facilities to provide training and technical
assistance to eligible employees regarding
management practices using methods that
are demonstrated to promote retention of
employees of the facilities, such as — the
establishment of basic human resource
policies that reward high performance,
including policies that provide improved
wages and benefits on the basis of job
reviews; or the establishment of other

CRS-115
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

programs that promote the provision of
high quality care, such as a continuing
education program that provides additional
hours of training, including on-the-job
training, for employees who are certified
nurse aides; (p. 120)
Encourage the establishment of eligible
partnerships to develop collaborative and
innovative approaches to improve the quality
of, including preventing abuse, neglect, and
exploitation in, long-term care; or (p. 122)
Establish multidisciplinary panels to address
and develop best practices concerning
methods of —
• improving the quality of long-term care;
and
• addressing abuse, including resident-to-
resident abuse, in long-term care. (p. 122)
State and tribal grants:
The bill would require that a state or Indian
administrative expenses
tribe receiving a grant under this section not
use more than 5% of the funds to pay for
administrative expenses. (p. 123)
State and tribal grants:
The bill would require that funds made
supplement not supplant
available be used to supplement and not
supplant other federal, state, and local
(including tribal) funds expended to provide
grant activities. (p. 123)
State and tribal grants:
The bill would require the state or Indian
maintenance of effort
tribe, in using the proceeds of a grant
received under this section, to maintain the
expenditures of the state or tribe grant
activities at a level equal to at least the level

CRS-116
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

of such expenditures maintained by the state
or tribe for the fiscal year preceding the fiscal
year for which the grant is received. (p. 123)
State and tribal grants:
The bill would require the Assistant Secretary
accountability measures
to develop accountability measures to ensure
the effectiveness of the activities conducted
using funds made available under this
section, including accountability measures to
ensure that the grant activities benefit eligible
employees and increase the stability of the
long-term care workforce. (p. 123)
State and tribal grants:
The bill would require the Assistant Secretary
evaluating programs
to evaluate the activities conducted using
funds made available under this section and
use the results of such evaluation to
determine the activities for which funds made
available under this section may be used.
(p. 124)
State and tribal grants:
The bill would require any entity receiving
compliance with applicable
funds to comply with all applicable laws,
laws
regulations, and guidelines. (p. 124)
State and tribal grants:
The bill would define eligible partnerships as
eligible partnerships
a multidisciplinary community partnership
consisting of eligible entities or appropriate
individuals, such as a partnership consisting
of representatives in a community of nursing
facility providers, state legal assistance
developers, advocates for residents of long-
term care facilities, state Long-term Care
Ombudsmen, surveyors, the state agency
with responsibility for adult protective
services, the state agency with responsibility
for licensing long-term care facilities, law

CRS-117
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

enforcement agencies, courts, family
councils, residents, certified nurse aides,
registered nurses, physicians, and other
eligible entities and appropriate individuals.
(p. 124)
State and tribal grants:
The bill would authorize the appropriation of
authorization of
such sums as may be necessary for each of
appropriations
FY2005 to FY2008 to carry out state and
tribal grants to strengthen long-term care and
provide assistance for elder justice programs.
(p. 124)
COLLECTION OF UNIFORM NATIONAL DATA ON ELDER ABUSE, NEGLECT, AND EXPLOITATION
Collection of uniform
No provision.
No provision.
The bill would add a provision for the
national data: authorization
collection of uniform national data on elder
abuse, neglect, and exploitation. (p. 125)
Collection of uniform
The purpose of this provision of the bill
national data: purpose
would be to improve, streamline, and
promote uniform collection, maintenance,
and dissemination of national data relating to
the various types of elder abuse, neglect, and
exploitation. (p. 125)
Collection of uniform
The bill would require, not later than one
national data: phase I —
year after the date of enactment of the Older
development of methods of
Americans Act Amendments, the Assistant
collection and reporting
Secretary, acting through the head of the
Office of Elder Abuse Prevention and
Services, after consultation with the Attorney
General and working with experts in relevant
disciplines from the Bureau of Justice
Statistics of the Office of Justice Programs of
the Department of Justice, to —
• develop a method for collecting national

CRS-118
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

data regarding elder abuse, neglect, and
exploitation; and
• develop uniform national data reporting
forms adapted to each relevant entity or
discipline (such as health, public safety,
social and protective services, and law
enforcement) reflecting the distinct manner
in which each entity or discipline receives
and maintains information; and the
sequence and history of reports to or
involvement of different entities or
disciplines, independently, or the sequence
and history of reports from one entity or
discipline to another over time. (p. 125)
Collection of uniform
The bill would require —
national data: phase I —
• the national data reporting forms to
forms and protection of
incorporate the definitions of Elder Justice
privacy
Programs, for use in determining whether
an event is reportable; and
• the Secretary to ensure the protection of
individual health privacy consistent with
the regulations promulgated under section
264(c) of the Health Insurance Portability
and Accountability Act of 1996, and state
and local privacy regulations (as
applicable). (p. 125)

CRS-119
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Collection of uniform
The bill would require that not later than one
national data: phase II —
year after the date on which the activities
pilot test
described in subsection (b)(1) are completed,
the Secretary (or the Secretary’s designee)
shall ensure that the national data reporting
forms and data collection methods developed
in accordance with such subsection are pilot
tested in six states selected by the Secretary.
(p. 127)
Collection of uniform
The bill would also require the Secretary,
national data: phase II —
after considering the results of the pilot
adjustments to form and
testing and consulting with the Attorney
methods
General and relevant experts, to adjust the
national data reporting forms and data
collection methods as necessary. (p. 127)
Collection of uniform
The bill would require the Secretary, after
national data: phase III —
completion of the adjustment to the national
distribution of national data
data reporting forms under subsection (c)(2),
reporting forms
to submit the national data reporting forms
along with instructions to —
• the heads of the relevant components of
HHS, the Department of Justice, and the
Department of the Treasury, and such other
federal entities as may be appropriate; and
• the Governor’s office of each state for
collection from all relevant state entities of
data, including health care, social services,
and law enforcement data. (p. 127)
Collection of uniform
The bill would authorize the Secretary to
national data: phase III —
award grants to states to improve data
data collection grants,
collection activities relating to elder abuse,
authorization
neglect, and exploitation. (p. 128)

CRS-120
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Collection of uniform
To be eligible to receive a grant, a state
national data: phase III —
would be required to submit an application as
data collection grants,
required to the Secretary. (p. 128)
application
Collection of uniform
For the collection of uniform national data
national data: phase III —
for a fiscal year, each state receiving a grant
data collection grants,
would be required to report data for the
requirements
calendar year that begins during that fiscal
year, using the national data reporting forms.
(p. 128)
Collection of uniform
The bill would require the Secretary to
national data: phase III —
initially distribute 50% of such funds for the
data collection grants,
first fiscal year for which a state receives
funding
grant funds. The Secretary would be required
to distribute the remaining funds at the end of
the calendar year that begins during that
fiscal year, if the Secretary determines that
the state has properly reported data required
under this subsection for the calendar year.
The bill would require the Secretary to
distribute grant funds to a state under this
subsection for a fiscal year if the Secretary
determines that the state properly reported
data required under this subsection for the
calendar year that ends during that fiscal
year. (p. 128)

CRS-121
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

Collection of uniform
The bill would require each report submitted
national data: phase III —
under this subsection to —
required information
• indicate the state and year in which each
event occurred; and
• identify the total number of events that
occurred in each state during the year and
the type of each event. (p. 129)
Collection of uniform
The bill would require the Secretary, not later
national data: report
than one year after the date of enactment of
the Older Americans Act Amendments and
annually thereafter, to prepare and submit to
the appropriate committees of Congress,
including to the Senate Committee on Health,
Education, Labor, and Pensions and the
Senate Special Committee on Aging, a report
regarding activities conducted under this
section. (p. 130)
Collection of uniform
The bill would authorize the appropriation of
national data: authorization
such sums as may be necessary to carry out
of appropriations
the collection of uniform data on elder abuse,
neglect, and exploitation for each of FY2007-
FY2011. (p. 130)
Rule of construction
No provision.
No provision.
The bill would add that nothing in this Title
shall be construed to interfere with or abridge
the right of an older individual to practice the
individual’s religion through reliance on
prayer alone for healing, in a case in which a
decision to so practice the religion —
• is contemporaneously expressed by the
older individual — either orally or in
writing with respect to a specific illness or
injury that the older individual has at the
time of the decision, and when the older

CRS-122
PROVISION
CURRENT LAW
H.R. 5293, the Senior Independence
S. 3570, Older Americans Act
Act of 2006, as passed by the House,
Amendments of 2006, as ordered
June 21, 2006 (RFS)
reported by the Senate HELP Committee,
June 28, 2006 (IS)

individual is competent to make the
decision;
• is set forth prior to the occurrence of the
illness or injury in a living will, health care
proxy, or other advance directive document
that is validly executed and applied under
state law; or
• may be unambiguously deduced from the
older individual’s life history. (p. 130)