Older Americans Act Amendments of 1987

(Conference report filed in House, H. Rept. 100-427)

Older Americans Act Amendments of 1987 - Title I: Amendments to the Older Americans Act of 1965 - Part A: Objectives and Administration - Amends the Older Americans Act of 1965 (the Act) to include within the Act's declaration of objectives the protection of the elderly from abuse, neglect, and exploitation. Establishes a direct reporting relationship between the Commissioner on Aging and the Secretary of Health and Human Services (Secretary). Requires the Administration on Aging to annually collect, and include in its annual report to the Congress and the President, data on: (1) expenditures for and utilization of services funded by this Act; (2) the number of senior centers supported by this Act; and (3) the extent to which area agencies on aging comply with certain requirements regarding the delivery of services. Directs the Commissioner to report to the Congress and specified public agencies and private organizations by January 15 of each year on State long-term care ombudsman programs and the quality of care provided to residents of long-term care facilities. Adds the Veterans Administration and the Alcohol, Drug Abuse, and Mental Health Administration to the list of Federal agencies with which the Commissioner may consult in carrying out the Act's programs. Includes, where appropriate, a representative of veterans' health care on the advisory councils which serve area agencies on aging.

Revises the provision which includes mental health services within the compass of activities to receive funding under the Act.

Adds: (1) the Alcohol, Drug Abuse, and Mental Health Administration and the Administration on Developmental Disabilities to the list of agencies with which the Commission must develop planning linkages for the long-term care of the disabled elderly; and (2) disability programs created by specified Acts to the list of programs related to the Act's purposes.

Establishes an Office for American Indian, Alaskan Native, and Native Hawaiian Programs within the Administration on Aging to be headed by an Associate Commissioner on American Indian, Alaskan Native, and Native Hawiaiian Aging. Sets forth the duties of such position which include evaluating the adequacy of, and recommending improvements in, the delivery of old age services to Native Americans.

Requires that the majority of the members of the Federal Council on Aging be older Americans. Authorizes appropriations for the Council for FY 1988 through 1991.

Directs the Secretary to issue proposed regulations for the administration of the Act by February 8, 1988 and final regulations by May 9, 1988. Requires the Commissioner to issue a statement by September of each year of the proposed specific goals to be achieved by implementing the Act.

Directs the Commissioner to report to the Congress by September 30, 1989, regarding the unmet need for supportive and nutrition services and multipurpose senior centers.

Part B: Grants for Suppportive Services, Nutrition, and Other Activities - Includes Indian tribes, tribal organizations, and Hawaiian Native organizations among the organizations administering the services funded with the Act's grants for State and community programs on aging for FY 1988 through 1991. Authorizes appropriations for State and community programs on aging for FY 1988 through 1991. Increases the percentage of funding for such programs that may be expended by areas agencies on aging for administrative purposes from 8.5 percent to ten percent.

Requires area agencies on aging to: (1) operate as separate organizational units engaged only in the planning and provision of supportive or nutrition services in the service area; (2) hold periodic hearings on activities carried out under area plans; (3) provide opportunities for older individuals to volunteer to assist in the delivery of day care to children and adults, and respite care to families; and (4) coordinate in-home services, services providing access to old age services, and legal assistance provided under the Act with the activities of community-based organizations established for victims of Alzheimer's disease and their families. Directs State agencies on aging to conduct periodic public hearings on activities carried out under State plans.

Directs the Commissioner to report to the Congress and specified public agencies and private organizations by January 15 of each year on problems and issues concerning State long-term care facilities.

Requires the Commissioner to conduct a study and report to the Congress before 1990 on the State long-term care ombudsman programs' impact on problems affecting long-term care facility residents and the effectiveness of recruiting, supervising, and retaining volunteer ombudsmen. Authorizes appropriations for the State long-term care ombudsman programs for FY 1988 through 1991.

Requires that State long-term care ombudsman programs be carried out through an Office of the State Long-Term Care Ombudsman, with local ombudsman entities being designated as subdivisions of such Office. Directs States to: (1) identify and remedy conflicts of interest which arise in the appointment of ombudsman personnel or in the pursuit of ombudsman duties; (2) provide the Office with adequate legal counsel; (3) ensure that the Office has the ability to pursue remedies on behalf of residents of long-term care facilities; (4) ensure that Office personnel will not be liable under State law for the good faith performance of official duties; (5) prohibit willful interference with Office personnel in the performance of their official duties, or retaliation by a long-term care facility or other entity against residents or employees who file a complaint with, or provide information to, the Office; (6) provide Office personnel with access to long-term care facilities, their residents, and, with the resident's approval, a resident's records; and (7) expend at least as much as the Ombudsman program as was expended in FY 1987 if the State allotment for such program and for supportive services under the Act is at least as much as it was in FY 1987. Requires the Office to: (1) report annually regarding problems experienced and complaints received by or on behalf of individuals residing in long-term care facilities; (2) analyze and monitor the development and implementation of Federal, State, and local laws, regulations, and policies with respect to such facilities; (3) provide information to public agencies, legislators, and others regarding the problems and concerns of older individuals residing in long-term care facilities; (4) train Office staff; and (5) coordinate ombudsman services with the protection and advocacy systems for developmentally disabled and mentally ill individuals established under specified Federal laws.

Gives individuals and service providers the right to a hearing at the State level if they are from an area subject to a proposed waiver of the requirement that an adequate portion of an allotment for supportive services be expended on access, in home, and legal services for older individuals. Sets forth special reporting requirements when such a waiver is in effect. Requires States to specify a minimum percentage of funds received by each area agency for supportive services that will be expended, in the absence of a waiver, to provide access, in-home, and legal services for the elderly.

Requires that area and State plans identify the number of low-income minority older individuals within service areas and describe how their service needs have been met. Requires that nutrition and supportive services provided under the Act be targeted to older individuals with the greatest economic or social needs, with particular attention to low income minorities.

Directs area agencies on aging to coordinate mental health services funded from allotments for supportive services with mental health services provided in the community.

Requires that the number of older Indians residing in an area be taken into account in determining the extent of an area's need for services funded under the Act, including the need for informing Indians in such area of the availability of such services.

Requires that grants and contracts for training, research, and discretionary projects and programs under the Act be equitably awarded to organizations representing minorities. Directs the Commissioner to provide: (1) in-service training opportunities and instruction on aging to Indian tribes through nonprofit Indian aging organizations; and (2) special training programs and technical assistance designed to improve services to minorities.

Directs the Commissioner on Aging to: (1) establish a permanent interagency task force that is representative of Federal departments and agencies having an interest in older Indians and submit recommendations for coordinating and improving services to older Indians to the Commissioner at six-month intervals; and (2) arrange a study into the availability and quality of the Act's services for older Indians and report to the Congress regarding such study by December 31, 1988.

Directs area agencies on aging to compile information on institutions of higher education in their area and to make a survey of such information available to the elderly.

Defines a disability as a mental or physical impairment that results in substantial functional limitations in one or more specified major life activities. Defines a "severe disability" as one that is likely to continue indefinitely and results in substantial functional limitation in three or more of the major life activities. Requires that nutrition and supportive services under the Act be targeted to older individuals suffering severe disabilities. Allows nutrition project administrators to offer a meal to disabled individuals who reside with and accompany eligible older individuals. Requires a State to coordinate services for the disabled elderly, especially the severely disabled, with State agencies having primary responsibility for such individuals and develop callaborative programs, where appropriate, to meet the needs of such individuals.

Preserves the confidentiality of information related to legal assistance provided to individuals under the Act.

Requires areas agencies on aging to facilitate the coordination of community-based services for those at risk of institutionalization or its unnecessary continuance.

Modifies the method of reducing a State's allotment of grants for State and community programs on aging under the Act when funding from State sources is less than in previous fiscal years.

Directs the Commissioner to implement a program making grants to States for the provision of in-home services to frail older individuals (including individuals with Alzheimer's disease or similar disorders). Requires that such services be coordinated with similar services provided by State and local agencies and private nonprofit organizations. Authorizes appropriations for such program for FY 1988 through 1991.

Directs the Commissioner to implement a program making grants to States for the provision of services designed to satisfy the special needs of older individuals.

Requires State plans for State and community programs on aging to describe the methods used during the preceding fiscal year to satisfy the service needs of elderly rural residents.

Directs the Commissioner to implement a program making grants to States for specified periodic preventive health services provided at senior centers or appropriate alternative sites. Prohibits the use of such grants on services covered under the Medicare program (title XVIII of the Social Security Act). Requires that States give priority in the provision of such services to areas which are medically underserved and where a large number of those with the greatest economic need for such services reside. Authorizes appropriations for such program for FY 1988 through 1991.

Requires the Commissioner to provide grants to States for the establishment and administration of elder abuse prevention and protection programs which: (1) provide public education and outreach activities regarding such abuse; (2) receive reports on abuse, neglect, and exploitation of the elderly; and (3) refer reports of abuse to appropriate abuse prevention organizations. Authorizes appropriations for such programs for FY 1988 through 1991.

Prohibits the appropriation of funds for the grant programs providing in-home services to frail older individuals, satisfying the special needs of the elderly, or providing them with preventive health or abuse prevention services until certain other programs under the Act receive at least 105 percent of their previous year appropriation. Includes information relating to assistive technology, addressing the needs of individuals with functional limitations, among the supportive services receiving funding under the Act. Requires multidisciplinary centers of gerontology to provide, if appropriate, information relating to assistive technology.

Part C: Demonstration Grants - Requires that special emphasis be given to the needs of minorities, the poor, the disabled, and frail individuals in the Act's training programs for personnel serving the elderly.

Authorizes the Commissioner to make grants to or enter into contracts with public or private institutions of higher education for the purpose of developing prototype health education and promotion programs for use by State and area agencies in implementing preventive health service programs.

Adds to the list of demonstration projects which the Commission may fund: (1) intergenerational volunteer services by the elderly which address the needs of children; and (2) volunteer service credit projects permitting elderly volunteers to earn credits for services that they provide which may later be redeemed for similar voluntary services.

Requires the Commissioner to make grants to States to support the development of comprehensive, coordinated systems of community long-term care for older individuals.

Directs the Administration on Aging to distribute written information on eligibility requirements for benefits under the Food Stamp Act of 1977 and titles XVI (Supplemental Security Income) and XIX (Medicaid) of the Social Security Act to area agencies on aging. Requires area agencies on aging to: (1) identify older individuals with greatest economic need who may be eligible to receive such benefits; (2) inform older individuals regarding eligibility requirements; and (3) assist them in applying for such benefits. Authorizes appropriations for FY 1989 through 1991 for such outreach activities provided certain other programs under the Act receive at least 105 percent of their previous year appropriation. Sets forth outreach program evaluation and reporting requirements.

Requires the Commissioner to give special consideration to the recruitment and training of individuals preparing to provide services to the disabled elderly in making grants and entering into contracts for education and training projects under the Act. Authorizes the Commissioner to make grants to public or nonprofit private organizations for the establishment or support of gerontology centers having a special emphasis on disabilities. Adds to the list of demonstration projects to be given special consideration projects which identify and provide services to older individuals with severe disabilities. Provides that special projects in comprehensive long-term care may include services to older individuals with severe disabilities who reside in nursing homes.

Authorizes the Commissioner to make grants to from three to ten States for demonstration projects evaluating cooperative projects between the State long-term care ombudsman program and the State protection and advocacy systems for developmental disabilities and mental illness. Requires the Commissioner to report annually to the Congress regarding such projects. Authorizes appropriations for such projects for FY 1989.

Authorizes the Commissioner to make grants to from six to ten States for demonstration projects evaluating the effectiveness of consumer protection projects for in-home services furnished to older individuals with the assistance of public funds. Requires the Commissioner to report annually to the Congress regarding such projects. Authorizes appropriations for such projects for FY 1989 through 1991. Prohibits the appropriation of funds for the Ombudsman and advocacy demonstration projects or the consumer protection projects until certain other programs under the Act receive at least 105 percent of their previous year appropriation.

Authorizes appropriations for training, research, and discretionary project and programs for FY 1988 and 1992.

Part D: Community Service Employment - Freezes the cap on the percentage of Federal funds for community service employment projects for older individuals which may be used for administrative costs at 13.5 percent, but permits the Secretary of Labor to increase such limit to 15 percent given certain circumstances. Requires that such projects take into consideration the rates of poverty and unemployment among minorities, limited English-speaking individuals, and Indians. Requires the Secretary of Labor to reserve funds for grants to, or contracts with, Indian aging organizations which are able to provide employment services to older Indians, and Pacific/Asian organizations under such program but only in fiscal years in which appropriations for the program exceed FY 1987 appropriations.

Directs the Secretary of Labor to distribute to older American community service employment program grantees for distribution to program enrollees, and at no cost to grantees or enrollees, information designed to help enrollees identify age discrimination and understand their rights under the Age Discrimination in Employment Act. Includes literacy tutoring as part of the educational services included in community service employment projects. Authorizes appropriations for the community service employment program for FY 1988 through 1991. Excludes funds received by individuals by reason of their participation in the community service employment program from consideration in determining their eligibility for federally subsidized housing or assistance under the Food Stamp Act of 1977.

Part E: Native American Programs - Expands the program providing grants to tribal organizations for the delivery of supportive and nutrition services to older Indians so that it includes the provision of grants to public or nonprofit private organizations capable of providing such services to older Hawaiian Natives. Eliminates the prohibition on Indians receiving supportive and nutritional services under such grant program and the program providing grants for State and community programs on aging under the Act. Authorizes appropriations for such programs for FY 1988 through 1991. Prohibits program funding for services for Hawaiian Natives if the amount appropriated for Native American programs does not exceed FY 1987 appropriations. Sets funding limits for the Native Hawaiian program when such appropriations exceed FY 1987 appropriations.

Part F: Miscellaneous and Technical Amendments - Repeals the older Americans personal health education and training program.

Part G: Consumer Price Index for Older Americans - Directs the Secretary of Labor to: (1) develop a consumer price index which reflects expenditures for consumption by the elderly; and (2) submit the index and a report on such index to the Congress within 180 days of this Act's enactment.

Title II: 1991 White House Conference on Aging - Authorizes the President to call a White House Conference on Aging in 1991 the purpose of which shall be to: (1) increase public awareness of the contributions of older individuals to society; (2) identify the problems and examine the well-being of older individuals; (3) develop recommendations for the coordination of Federal policy with State and local needs and for executive and legislative action designed to maintain or improve the well-being of older individuals; and (4) review the status of recommendations adopted at previous White House Conferences on Aging. Includes within such Conference a conference addressing the problems faced by older Indians. Sets forth reporting requirements. Authorizes appropriations for such Conference for FY 1989 through 1991. Establishes an advisory committee to the Conference.

Title III: Alzheimer's Disease Research - Requires the Director of the National Institute on Aging to conduct clinical trials on the use of drugs in the treatment of Alzheimer's disease. Authorizes appropriations for such trials for FY 1988.

Title IV: National School Lunch Act Amendment - Amends the National School Lunch Act to make adult day care centers eligible under the child care food program for reimbursement for meals or supplements served to elderly or chronically impaired disabled persons.

Title V: Native American Programs - Native American Programs Act Amendments of 1987 - Amends the Native American Programs Act of 1974 to require the Secretary of the Treasury to establish a formal panel review process to evaluate applications for financial assistance for specified Native American projects and to determine the relative merits of such projects. Requires the Secretary, when making appointments of members to the review panels, to give preference to American Indians, Hawaiian Natives, and Alaskan Natives. Sets forth the duties of such panels.

Directs the Secretary of the Treasury, upon the request of the chairman of the Senate Select Committee on Indian Affairs and the chairman of the House Committee on Education and Labor regarding the approval of an application for financial assistance, to send written notice to such chairmen containing the list of ranked applications for financial assistance and an explanation as to why such application was approved while higher-ranked applications remain unapproved. Sets forth additional procedural requirements under such Act, including the requirement that general notice of proposed rules (including interpretive rules) and statements of policy be published in the Federal Register and not take effect until 30 days after such publication.

Makes public and nonprofit private agencies serving Native American Pacific Islanders (including American Samoan Natives) eligible to apply for financial assistance for economic and social development projects among such Islanders. Authorizes appropriations for FY 1988 through 1991 for carrying out the Native American Programs Act and providing assistance to Native American Pacific Islanders. Prohibits the provision of such assistance to Native American Pacific Islanders unless appropriations under such Act exceed 105 percent of the preceeding fiscal year appropriation.

Directs the Secretary of the Treasury to establish a five-year revolving loan fund from which economic development loans shall be made to Native Hawaiian organizations and individuals and into which amounts collected from such loans shall be deposited. Prohibits the provision of loans to borrowers who are able to obtain financing from other sources or do not possess a reasonable prospect of repaying such loans. Authorizes appropriations for such fund for FY 1988 through 1990. Sets forth reporting requirements.

Title VI: Health Care Services in the Home - Health Care Services in the Home Act of 1987 - Amends the Public Health Service Act to direct the Secretary to make from three to five three-year grants to States for demonstration projects to: (1) identify low-income, elderly individuals who can avoid institutionalization or prolonged hospitalization if skilled medical or related health services are provided in such individuals' homes; and (2) pay the costs and coordinate the provision of such services. Requires the Secretary to make from three to five three-year grants to States for demonstration projects providing a broad range of services to individuals suffering from Alzheimer's disease or related disorders and to their families and care givers. Prohibits the use of grants under either program in paying for currently financed public or private health services. Sets forth evaluation and reporting requirements.

Title VII: General Provisions - Makes this Act's amendments effective on October 1, 1987, but inapplicable to State and area plans approved prior to enactment.