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49-006

109TH CONGRESS

REPORT

HOUSE OF REPRESENTATIVES

2d Session

109-493

--SENIOR INDEPENDENCE ACT OF 2006

JUNE 8, 2006- Committed to the Committee of the Whole House on the State of the Union and ordered to be printed

Mr. MCKEON, from the Committee on Education and the Workforce, submitted the following

R E P O R T

together with

ADDITIONAL VIEWS

[To accompany H.R. 5293]

[Including cost estimate of the Congressional Budget Office]

CONTENTS Page
Purpose 31
Committee Action 31
Summary 34
Committee Statement and Views 40
References 65
Section-by-Section Analysis 66
Explanation of Amendments 70
Rollcall Votes 71
Correspondence 73
Application of Law to the Legislative Branch 74
Statement of Oversight Findings and Recommendations of the Committee 74
Statement of General Performance Goals and Objectives 74
Constitutional Authority Statement 74
Federal Advisory Committee Act 74
Unfunded Mandate Statement 74
Committee Estimate 74
Budget Authority and Congressional Budget Office Cost Estimate 75
Changes in Existing Law Made by the Bill as Reported 77

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
Sec. 3. Establishment of Administration on Aging.
Sec. 4. Functions of the Assistant Secretary.
Sec. 5. Federal agency consultation.
Sec. 6. Administration.
Sec. 7. Evaluation.
Sec. 8. Reports.
Sec. 9. Contractual, commercial and private pay relationships; appropriate use of Act funds.
Sec. 10. Nutrition education.
Sec. 11. Pension counseling and information programs.
Sec. 12. Authorization of appropriations.
Sec. 13. Purpose; administration.
Sec. 14. Authorization of appropriations; uses of funds.
Sec. 15. Organization.
Sec. 16. Area plans.
Sec. 17. State plans.
Sec. 18. Payments.
Sec. 19. Nutrition services incentive program.
Sec. 20. Consumer contributions.
Sec. 21. Supportive services and senior centers program.
Sec. 22. Nutrition service.
Sec. 23. Congregate nutrition program.
Sec. 24. Home delivered nutrition services.
Sec. 25. Criteria.
Sec. 26. Nutrition.
Sec. 27. Evaluation of nutrition projects.
Sec. 28. Improving indoor air quality to buildings where seniors congregate.
Sec. 29. Caregiver support program definitions.
Sec. 30. Caregiver support program.
Sec. 31. Activities of national significance.
Sec. 32. Title IV grant programs.
Sec. 33. Career preparation for the field of aging.
Sec. 34. Health care service demonstration projects in rural areas.
Sec. 35. Demonstration projects for multigenerational activities.
Sec. 36. Native American programs.
Sec. 37.Responsibilities of Assistant Secretary.
Sec. 38. Community service employment-based training for older Americans.
Sec. 39. Native Americans caregiver support program.
Sec. 40. Vulnerable elder rights protection activities.
Sec. 41. Native American organization provisions.
Sec. 42. Elder abuse, neglect, and exploitation prevention.
Sec. 43. Technical amendments.

SEC. 2. DEFINITIONS.

SEC. 3. ESTABLISHMENT OF ADMINISTRATION ON AGING.

SEC. 4. FUNCTIONS OF THE ASSISTANT SECRETARY.

SEC. 5. FEDERAL AGENCY CONSULTATION.

SEC. 6. ADMINISTRATION.

SEC. 7. EVALUATION.

SEC. 8. REPORTS.

SEC. 9. CONTRACTUAL, COMMERCIAL AND PRIVATE PAY RELATIONSHIPS; APPROPRIATE USE OF ACT FUNDS.

`SEC. 212. CONTRACTING AND GRANT AUTHORITY; PRIVATE PAY RELATIONSHIPS; APPROPRIATE USE OF FUNDS.

SEC. 10. NUTRITION EDUCATION.

`SEC. 214. NUTRITION EDUCATION.

SEC. 11. PENSION COUNSELING AND INFORMATION PROGRAMS.

SEC. 12. AUTHORIZATION OF APPROPRIATIONS.

SEC. 13. PURPOSE; ADMINISTRATION.

SEC. 14. AUTHORIZATION OF APPROPRIATIONS; USES OF FUNDS.

SEC. 15. ORGANIZATION.

SEC. 16. AREA PLANS.

(aa) in subclause (V) by striking `and' at the end; and

(bb) by adding at the end the following:

SEC. 17. STATE PLANS.

SEC. 18. PAYMENTS.

SEC. 19. NUTRITION SERVICES INCENTIVE PROGRAM.

SEC. 20. CONSUMER CONTRIBUTIONS.

SEC. 21. SUPPORTIVE SERVICES AND SENIOR CENTERS PROGRAM.

SEC. 22. NUTRITION SERVICE.

`SEC. 330. PURPOSE.

SEC. 23. CONGREGATE NUTRITION PROGRAM.

SEC. 24. HOME DELIVERED NUTRITION SERVICES.

`SEC. 336. PROGRAM AUTHORIZED.

SEC. 25. CRITERIA.

`SEC. 337. CRITERIA.

SEC. 26. NUTRITION.

SEC. 27. EVALUATION OF NUTRITION PROJECTS.

SEC. 28. IMPROVING INDOOR AIR QUALITY IN BUILDINGS WHERE SENIORS CONGREGATE.

SEC. 29. CAREGIVER SUPPORT PROGRAM DEFINITIONS.

SEC. 30. CAREGIVER SUPPORT PROGRAM.

SEC. 31. ACTIVITIES OF NATIONAL SIGNIFICANCE.

SEC. 32. TITLE IV GRANT PROGRAMS.

SEC. 33. CAREER PREPARATION FOR THE FIELD OF AGING.

SEC. 34. HEALTH CARE SERVICE DEMONSTRATION PROJECTS IN RURAL AREAS.

SEC. 35. DEMONSTRATION PROJECTS FOR MULTIGENERATIONAL ACTIVITIES.

SEC. 36. NATIVE AMERICAN PROGRAMS.

SEC. 37. RESPONSIBILITIES OF ASSISTANT SECRETARY.

SEC. 38. COMMUNITY SERVICE EMPLOYMENT-BASED TRAINING FOR OLDER AMERICANS.

`TITLE V--COMMUNITY SERVICE EMPLOYMENT-BASED TRAINING FOR OLDER AMERICANS

`SEC. 501. SHORT TITLE.

`SEC. 502. OLDER AMERICAN COMMUNITY SERVICE EMPLOYMENT-BASED TRAINING PROGRAM.

`SEC. 503. ADMINISTRATION.

`SEC. 504. PARTICIPANTS NOT FEDERAL EMPLOYEES.

`SEC. 505. INTERAGENCY COOPERATION.

`SEC. 506. DISTRIBUTION OF ASSISTANCE.

`SEC. 507. EQUITABLE DISTRIBUTION.

`SEC. 508. REPORT.

`SEC. 509. EMPLOYMENT ASSISTANCE AND FEDERAL HOUSING AND FOOD STAMP PROGRAMS.

`SEC. 510. ELIGIBILITY FOR WORKFORCE INVESTMENT ACTIVITIES.

`SEC. 511. TREATMENT OF ASSISTANCE.

`SEC. 512. COORDINATION WITH THE WORKFORCE INVESTMENT ACT OF 1998.

`SEC. 513. PERFORMANCE.

`SEC. 514. COMPETITIVE REQUIREMENTS RELATING TO GRANT AWARDS.

`SEC. 515. AUTHORIZATION OF APPROPRIATIONS.

`SEC. 516. DEFINITIONS.

131`low income' means income received during the 12-month period (or, at the option of the grantee involved, the 6-month period that is not multiplied) ending on the date an eligible individual submits an application to participate in the project carried out under this title by such grantee.

SEC. 39. NATIVE AMERICANS CAREGIVER SUPPORT PROGRAM.

SEC. 40. VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES.

SEC. 41. NATIVE AMERICAN ORGANIZATION PROVISIONS.

SEC. 42. ELDER ABUSE, NEGLECT, AND EXPLOITATION PREVENTION.

SEC. 43. TECHNICAL AMENDMENTS.

`TITLE IV--ACTIVITIES FOR HEALTH, INDEPENDENCE AND LONGEVITY'.

PURPOSE

H.R. 5293, the Senior Independence Act of 2006, amends the Older Americans Act to authorize appropriations for fiscal years 2007 through 2011; and for other purposes.

COMMITTEE ACTION

COMMITTEE HEARINGS

On May 25, 2005, the Subcommittee on Select Education held a hearing entitled An Examination of the Older Americans Act. The hearing was the first in a series of hearings to review the implementation of the amendments to the law enacted in 2000, explore issues facing today's seniors, and to begin debating the appropriate federal response to these circumstances. The witnesses who testified before the Subcommittee included: Joan Lawrence, Director of the Ohio Department of Aging, Columbus, OH; Michael O'Donnell, Executive Director of the East Central Illinois Area Agency on Aging (AAA), Bloomington, IL; Jane Metzger, President Elect of the Meals on Wheels Association of America, Topeka, KS; and Jesse Leos, National Director of the Senior Community Service Employment Program (SCSEP) Program of SER-Jobs for Progress, Inc., Irving, TX.

On April 3, 2006 the Subcommittee on Education Reform held a field hearing entitled The Older Americans Act: Strengthening Communities to Support the Next Generation of Older Americans at the University of Texas Pan-American in Edinburg, TX. The hearing allowed Members to gain a local perspective on issues involved in the Older Americans Act. The witnesses included: Karl Urban, Manager of Policy Analysis and Support at the Texas Department of Aging and Disability, Austin, TX; Armondo Dominguez, Assistant Director of the Center on Aging and Health at the University of Texas-Pan American, Edinburg, TX; Marlon Sullivan, Senior Director of Staffing of The Home Depot, Atlanta, GA; Jose Perez, Executive Director of the Senior Community Outreach Services, Inc., Donna, TX; and Rosa Anzaldua, program participant at Amigos del Valle, Mission, TX.

On April 28, 2006, the Subcommittee on Select Education held a second field hearing, entitled The Older Americans Act: Improving Quality of Life for Aging Americans, at the Westerville Senior Center in Westerville, OH. The field hearing allowed Members to gain more information and recommendations for reauthorization at the local level. The Witnesses included: Elise Geig, Legislative Liaison at the Ohio Department of Aging, Columbus, OH; David Bibler, Executive Director of the Licking County Aging Program, Newark, OH; Charles Gehring, President and CEO of Lifecare Alliance, Columbus, OH; Bob Horrocks, Executive Director of the Council for Older Adults of Delaware County, Columbus, OH; and Virginia Ragan, community representative for Westerville, OH.

On May 2, 2006, the Subcommittee on Select Education held a hearing entitled The Senior Independence Act of 2006. The hearing was held to hear comments and recommendations on a discussion draft of the bill. The Witnesses included: Josefina Carbonell, Assistant Secretary for Aging at the Department of Health and Human Services, Washington, DC; Mason Bishop, Deputy Assistant Secretary for the Employment Training Administration at the Department of Labor, Washington, DC; Andre Bauer, Lieutenant Governor, SC; Vinsen Faris, Executive Director of Meals on Wheels of Johnson and Ellis Counties, Cleburne, TX; Ling Cheung, President of the Chinese American Senior Service Association, Montgomery County, MD; and Richard Browdie, President and CEO of the Benjamin Rose Institute, Cleveland, OH.

LEGISLATIVE ACTION

On Thursday, May 4, 2006, Mr. Patrick J. Tiberi, along with Mr. Ruben Hinojosa, introduced H.R. 5293, the Senior Independence Act of 2006, a bill to reauthorize the Older Americans Act through 2011.

On Wednesday, May 10, 2006, the Subcommittee on Education Reform considered H.R. 5293 in a legislative session and reported it favorably, as amended, to the Committee on Education and the Workforce by voice vote. The Subcommittee adopted the following amendments:

An amendment in the nature of a substitute offered by Mr. Patrick J. Tiberi, adopted by voice vote. The substitute amendment contained changes to H.R. 5293 to:

An amendment offered by Mr. Luis G. Fortun.AE6o, adopted by voice vote. Mr. FortunAE6o's amendment adds `or who is an individual with a disability' to the definition of a child under the Caregiver Support Program.

On May 17, 2006 the Committee on Education and the Workforce considered H.R. 5293 in legislative session, and reported the bill favorably, as amended, to the House of Representatives by voice vote. The Committee adopted the following amendments:

An amendment in the nature of a substitute offered by Mr. Howard P. `Buck' McKeon, adopted by voice vote. The substitute amendment contained the following technical and clarifying changes to H.R. 5293 to:

An Amendment offered by Mr. Mark E. Souder, adopted by voice vote. This amendment authorizes the Assistant Secretary to conduct an evidence-based evaluation of the nutrition programs included in the Act.

An Amendment offered by Mr. John R. `Randy' Kuhl, adopted by voice vote. Mr. Kuhl's amendment authorizes federal entities to implement and build awareness of programs providing benefits to older Americans.

An Amendment offered by Mr. Jon C. Porter and Mr. Danny K. Davis, adopted by voice vote. This Amendment strengthens efforts to prevent elder abuse and neglect and improves coordination of elder justice activities at the Federal, State, and local levels.

An Amendment offered by Mr. Rush D. Holt, adopted by voice vote. This Amendment excludes certain sources of income for the purpose of determining eligibility for Title V. The amendment excludes SSDI, 25 percent of Social Security, veterans' payments, and unemployment compensation--all of which were previously not counted as income.

An Amendment offered by Mr. Danny K. Davis and Mr. Jon C. Porter, adopted by voice vote. This Amendment supports consumer-driven models of home and community-based care and helps prevent high-risk individuals from spending down their savings to receive Medicaid.

An Amendment offered by Mr. Raul M. Grijalva, adopted by voice vote. This Amendment changes the look-back period for determining an individual's income for purposes of SCSEP eligibility to allow grantees to either annualize six months of income or the individual's previous 12 months of income.

An Amendment offered by Mr. Robert E. Andrews, adopted by voice vote. This Amendment encourages professionals who provide nutrition services under the Act to also provide information about the availability of flu shots.

An Amendment offered by Mr. Robert E. Andrews, adopted by voice vote. This Amendment authorizes the Assistant Secretary to work in consultation with qualified experts to provide information on methods of improving indoor air quality to buildings where seniors congregate.

SUMMARY

H.R. 5293, the Senior Independence Act of 2006, reauthorizes all titles of the Older Americans Act through 2011 and authorizes such sums as may be necessary to carry out programs and services under the Act.

Title II of the Act stipulates functions of the Assistant Secretary in administering the Older Americans Act. The legislation strengthens the roles and responsibilities of the Secretary on Aging to assist states, area agencies on aging, and service providers to better serve older Americans.

The Senior Independence Act seeks to improve coordination and cooperation among multiple federal agencies involved in programs and services for older Americans. The legislation requires the Assistant Secretary to coordinate federal elder justice activities, including elder abuse prevention, detection, intervention, and response; to consult and coordinate with the Centers for Medicare & Medicaid to assist in benefit enrollment and outreach; and to strengthen coordination at the federal, state, and local levels for long-term care provided in home and community-based settings.

H.R. 5293 encourages the Assistant Secretary to provide outreach and technical assistance to promote evidence-based health promotion and prevent disease prevention initiatives. Additionally, it requires the Assistant Secretary to provide information on methods to improve indoor air quality in buildings where seniors congregate.

Title III of the Act authorizes grants and stipulates state requirements and conditions for receiving grants to operate state units on aging and fund local area agencies on aging within a state.

Under the legislation, states and area agencies on aging are required to develop and implement a comprehensive, coordinated system for providing long-term care in home- and community-based settings. Additionally, it requires states to provide assurances to the Assistant Secretary that area agencies on aging will advance state efforts to furnish long-term care services in a manner consistent with consumer focused self-directed care models.

H.R. 5293 encourages both states and area agencies on aging to plan for demographic shifts that are expected to increase the population of older Americans. The legislation encourages states and area agencies on aging to conduct an assessment of anticipated change in the number of older individuals within the state or planning and service area, and to work in cooperation with public agencies and other state and community partners to prepare for an increased number of older Americans.

H.R. 5293 also clarifies that service providers may enter into contractual, commercial, or private pay relationships provided that such provider operate in a manner consistent with the public purpose mission and targeting provision under the Act.

The Senior Independence Act encourages efforts by states, area agencies on aging, and local providers to improve access to supportive services that help foster independence and maintain a good quality of life. The legislation encourages the creation of opportunities for civic engagement and seeks to enhance the coordination of senior volunteer programs. H.R. 5293 requires public outreach to facilitate program access for eligible individuals with limited English proficiency, and promotes financial literacy and pension counseling for older Americans who may need assistance in planning for future financial needs, including budgeting for long-term care expenses. States and local providers also are encouraged to promote evidence-based preventive care, including screenings for nutritional deficiencies or impaired mental health, and access to assistive technology devices for older adults with disabilities.

Title III of the Act authorizes the provision of home delivered and congregate meals to older individuals. H.R. 5293 updates nutrition program requirements consistent with current science and the most recent Dietary Guidelines for Americans. To support this effort, the bill requires the Assistant Secretary to consult with experts in the field of nutrition science, dietetics, meal planning, food service, and aging, and to establish guidelines for the efficiency and quality of home delivered meals. The legislation simplifies nutrition requirements by allowing providers to average key nutrients over time.

H.R. 5293 maintains the dual purpose of OAA nutrition programs to ensure the effective delivery of nutritious meals to older adults, and to provide opportunities for socialization and assistance in accessing other health and social services provided in and outside the aging network. The bill encourages local meal providers to provide information to homebound seniors on how to obtain an influenza vaccine in their area, and allows but does not require congregate meal providers to offer a single multivitamin-mineral supplement to seniors who also receive a meal. Older individuals participating in meal programs under the Act also are eligible to receive nutrition screening, nutrition education or counseling as needed to support the health of participants.

The Senior Independence Act strengthens a current law provision allowing service providers to solicit voluntary contributions from eligible individuals who receive services. H.R. 5293 clarifies that service providers, including nutrition service providers may encourage voluntary contributions from clients. Providers are required to encourage such contributions for services provided to individuals with self-declared incomes at or above 125 percent of poverty.

H.R. 5293 also reauthorizes the Nutrition Services Incentive Program, which provides commodity support to states and tribal organization operating senior nutrition programs. The legislation streamlines access to commodity foods by providing cash to purchase commodities through school food authorities.

To ensure that nutrition services are effectively supporting the nutritional needs of program participants, H.R. 5293 authorizes a study by the Institute of Medicine to evaluate the effectiveness of program, including the value of the investment in nutrition services funded under the Act.

Title III of the Act also authorizes the National Family Caregiver Support Act. Under current law, this program provides caregiver support to relative caregivers of individuals age 60 and over, and to grandparents who are the primary caregiver of grandchildren up to age 18. H.R. 5293 modifies eligibility for caregiver support by decreasing from 60 to 55 the age of eligibility for grandparent participation. The legislation also provides support to grandparents who care for an adult child with a disability. H.R. 5293 also authorizes caregiver support for relatives responsible for the care of an individual of any age who is diagnosed with Alzheimer's disease or a related neurological disorder.

H.R. 5293 continues ongoing research and demonstration grants awarded competitively by the Assistant Secretary to support intergenerational programs, families who have a child with a disability, programs unique to rural areas, Alzheimer's programs, and family caregiver support programs.

Under current law, the Assistant Secretary may use a limited amount of funds to conduct evaluations of programs and services funded by the Act. H.R. 5293 limits the total amount of funding that may be used for evaluation to an amount that does not exceed 1/2 of 1 percent of title III appropriations.

Title IV of the Act provides technical assistance and supports a range of ongoing research and demonstration activities designed to spur innovation and identify best practices in the field of aging. These activities as authorized under current law include career preparation in the field of aging, protection from violence projects, and grants to improve the delivery of health care services to older individuals residing in rural areas. H.R. 5293 authorizes the Secretary to use these funds, in part, to develop and assess technology-based service models and best practices. The bill revises eligibility criteria for Career Preparation in the Field of Aging grants to include Hispanic serving organizations among the entities eligible to receive a grant.

Title V of the Act authorizes community service employment and training for older Americans. H.R. 5293 revises the name of title V of the Act to the Older American Community Service Employment-Based Training Act. In addition, the bill revises the purposes of the program commonly called the Senior Community Service Employment Program (SCSEP). The bill authorizes the Secretary of Labor to establish an older American community service employment-based training program to foster and promote useful part-time public and private-sector employment-based training opportunities for unemployed low-income eligible individuals who have poor employment prospects and to provide vital social and human services to communities by providing work experience to eligible individuals in public agencies, community-based and faith-based organizations.

The bill requires that not less than 50 percent of hours are worked in authorized activities to be in community-service employment-based training provided by a grantee in a program year.

Current law does not limit the duration of participation in SCSEP. The bill requires grantees to have an average period per capita that does not exceed 24 months (whether or not consecutive) during each program year in which the grantee has participated in the program.

Current law permits work placements in publicly owned and operated facilities or in nonprofit organizations. In addition to these placements, H.R. 5293 also allows placements in for-profit organizations.

The bill allows grantees to provide payment for necessary supportive services costs to allow participants to participate in the program. The bill defines supportive services as services such as transportation, child care, dependent care, housing, and needs-related payments, which are necessary to enable an individual to participate in authorized activities under the program.

Under current law, the administrative costs are costs both personnel and non-personnel and both direct and indirect associated with the following: (1) the costs of performing overall general administrative functions such as accounting, budgeting, financial, and cash management functions; procurement and purchasing functions; property management functions; personnel management functions; payroll functions; coordinating the resolution of findings arising from audits, reviews, investigations, and incident reports; audit functions; general legal services functions; and developing systems and procedures; (2) the costs of performing oversight and monitoring responsibilities related to administrative functions; (3) the costs of goods and services required for administrative functions; (4) travel costs incurred for official business in carrying out administrative activities or overall management; and (5) the costs of information systems related to administrative functions. Under the bill, the following additional items are classified as administrative costs: quality assurance; preparing program plans; administrative salaries; preparing reports; all travel costs other than travel costs related to the provision of services; and the costs of technical assistance, professional organization membership dues, removal of architectural barriers and operating and maintaining assistive technology, public information, and evaluating program results.

Under current law grants may be used to pay for enrollee wages and fringe benefits. H.R. 5293 clarifies what benefits may be included, which are those required by law (such as workers compensation or unemployment compensation), the costs of physical examinations, compensation for scheduled work hours during which an employer is closed for a federal holiday, and necessary sick leave that is not part of an accumulated sick leave program. No amounts provided under the program may be used to pay the cost of pension benefits, annual leave, accumulated sick leave or bonuses.

Currently, not less than 75 percent of the funds made available under a grant to operate a SCSEP program shall be used to pay wages and benefits for eligible individuals who are employed to carry out projects. The bill requires grantees to spend not less than 65 percent of their funds on wages and benefits to allow additional flexibility and resources for classroom or on-the-job training opportunities.

Under current law, the Secretary may use monies reserved under section 506(a)(1) to fund special projects designed to assure second career training and the placement of eligible individuals in employment opportunities with private business concerns. H.R. 5293 replaces this authority with new authority for the Secretary to conduct pilot, demonstration, and evaluation projects. Projects may include activities linking businesses and eligible individuals; demonstration projects and pilot projects designed to attract more eligible individuals into the labor force, improve the provision of services to eligible individuals under the One-Stop delivery system established under the Workforce Investment Act (WIA), enhance the technological skills of eligible individuals, and provide incentives to grantees for exemplary performance; demonstration and pilot projects for older workers if the projects are designed to assist in developing and implementing techniques and approaches in addressing the employment and training needs of eligible individuals; training and technical assistance to support the projects; dissemination of best practices; and evaluation of activities authorized.

Currently funds under the program are distributed to states and national organizations according to a set of requirements that include a fiscal year 2000 hold harmless amount so that funds are distributed to state agencies and national organizations at their fiscal year 2000 level of activities. Additional funds are distributed based on relative state population 55 years of age or older and the relative state per capital income. The bill updates the hold harmless provision so that the distribution of funds between states and national organizations will be based on fiscal year 2006 distribution.

Currently, states and national grantees are measured on the following performance indicators: (1) the number of participants served, with particular consideration given to individuals with greatest economic need, greatest social need, or poor employment history or prospects, and individuals who are over the age of 60; (2) community services provided; (3) placement into and retention in unsubsidized public or private employment; (4) satisfaction of the enrollees, employers, and their host agencies with their experiences and the services provided; and (5) additional indicators that the Secretary determines to be appropriate. H.R. 5293 establishes four core performance measures: entry into unsubsidized employment; retention in unsubsidized employment for six months; earnings; and hours (in the aggregate) of community services employment based training pursuant to subparagraphs (A) and (B)(i) or section 502(b)(1) (which requires at least 50 percent of placement in community service positions). States and national grantees also will report on retention in unsubsidized employment for one year; the number of eligible individuals served, including the number of participating individuals age 65 and older or who have barriers to employment; and any other indicators of performance that the Secretary determines to be appropriate.

Under current law states and national grantees negotiate expected levels of performance. H.R. 5293 continues this practice and requires adjustment for significant numbers or proportions of participants with barriers to employment.

Current law requires the minimum percentage for the entry into unsubsidized employment to be 20 percent. The bill incrementally increases this requirement by two percentage points each year so that the required placement rate is 22 percent in fiscal year 2007, 24 percent in fiscal year 2008, 26 percent in fiscal year 2009, 28 percent in fiscal year 2010, and 30 percent in fiscal year 2011.

States and national grantees both now face sanctions for failure to meet expected levels of performance. H.R. 5293 maintains this structure for states. However, national grantees that fail to attain expected levels of performance now only will receive technical assistance. Each such grantee also will submit a corrective action plan not later than 160 days after the end of the program year. The plan shall detail the steps the grantee will take to meet the national performances measures in the next program year.

Under current law, the Secretary shall award grants to national organizations for a period not to exceed three years. In addition, the Secretary shall hold a competition for program funds when a state or national grantee fails to meet its performance measures for at least two consecutive years. The bill maintains this structure for states. The bill replaces current requirements to compete the funds of national grantees that fail to meet performance with a requirement that all grants be competed every three years. The bill maintains current law's criteria for selection of grantees and has added as an additional criterion review of the applicant's prior performance, if any, in meeting performance measures under this program and under other federal or state programs.

The bill changes the term `community service' to `community service employment-based training' and defines the term as work experience that is related to providing social, health, welfare, and educational services (including literacy tutoring), legal and 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; antipollution and environmental quality efforts; weatherization activities; economic development; and such other services essential and necessary to the community as the Secretary determines by rule.

Current law allows services to be provided to individuals 55 years of age or older who have a low income (including those with incomes not more than 125 percent of the federal poverty guidelines). In addition, current law includes a priority for those individuals over 60 years of age. H.R. 5293 continues to allow low-income individuals 55 years of age or older to be eligible for SCSEP, but the bill creates a new priority of service for older individuals or those with barriers to employment. Under the bill, an individual who is 65 years of age or older, has a disability, has limited English proficiency, resides in a rural area, is a veteran, has low employment prospects, or has failed to find employment after utilizing services provided under title I of WIA shall have priority for the work opportunities provided under the program.

States and grantees shall exclude any income that is unemployment compensation, Supplemental Security Income (SSI) benefits received under Title XVI of the Social Security Act, or veterans' payments and 25 percent of benefits received under title II of the Social Security Act (Old-Age, Survivors and Disability Insurance [OASDI] payments). In addition, H.R. 5293 provides state and national grantees operating SCSEP the flexibility to use either the income for the 12 months preceding an individual's application or an individual's income for the six months preceding one's application when determining eligibility.

The bill excludes an individual who has participated in the program for a period of 48 months in the aggregate (whether or not consecutive) from participation in the program. However, to create a transition period for those already participating in the program, the bill allows individuals who have already participated in the program for at least 24 months to have an additional 24 months of eligibility. Anyone who has been participating in the program for 24 months or less at the time of enactment will have a four year time limit, inclusive of time already spent in the program.

H.R. 5293 makes no additional substantive amendments to titles VI and VII of the Older Americans Act.

COMMITTEE STATEMENT AND VIEWS

OVERVIEW

The Older Americans Act of 1965 (OAA) is the major federal statute governing the delivery of social services for elderly Americans and their family caregivers. The Act provides a wide range of supports such as information and personal assistance, transportation, nutritional services, personal care, chore services, and adult day care. Nutrition services include the `Meals on Wheels' home delivery meal program and congregate meal programs. The OAA also funds research, demonstration projects, and elder rights protection activities.

The OAA, first enacted in the 89th Congress, created a series of federal programs specifically designed to meet the service needs of older persons. Although older persons may receive services under other federal programs, this Act is the major vehicle for the organization and delivery of services to senior citizens. It authorizes a wide array of programs through a network of 56 state agencies on aging, 655 area agencies on aging, 238 tribal organizations, 29,000 local service organizations, and a cadre of 500,000 volunteers.

The Administration on Aging (AoA) within the Department of Health and Human Services is the primary federal entity charged with serving the needs of older Americans and coordinating the development of a comprehensive, nationwide system of services that will enable older adults to remain in their own homes and communities as long as possible. OAA programs administered by the AoA received $1.366 billion for fiscal year 2006.

The OAA also authorizes the Senior Community Service Employment Program (SCSEP) administered by the Department of Labor (DoL). The principal purpose of SCSEP is to help low-income older workers gain employment skills and job training through temporary subsidized community service activities or unsubsidized employment. SCSEP serves low-income older workers beginning at age 55. Most participants are initially placed in government subsidized, part-time community service activities, with the goal of gaining skills that lead to unsubsidized employment. Subsidized participants are paid no less than the federal or state minimum wage or the local prevailing rate of pay for similar employment, whichever is higher.

Funds are distributed to states and national organizations to operate the program, and since 2002, DoL has distributed funds to national organizations through a competitive grant process. There are currently 13 participating national non-profit organizations. SCSEP received $432.3 million for fiscal year 2006.

Since its enactment in 1965, the Act has been reauthorized 14 times. The 1969 amendments strengthened the community service programs and charged state agencies on aging with statewide responsibilities for planning, coordination, and evaluation of programs for older persons. Major amendments to the Act occurred in the early 1970s, including the enactment of the nutrition component, which evolved from nutrition demonstration projects first funded in 1968.

The 1972 amendments authorized grants to public and nonprofit sponsors for the development of congregate meal services to meet the nutrition and social services needs of older persons. In addition to providing meals, Congress envisioned the program to serve as an important vehicle for fostering social interaction among participants and to facilitate social service delivery. The program's dual purposes of maintaining health through good nutrition and by providing opportunities for social interaction continue today.

The 1973 amendments significantly restructured the Act with the aim of improving the planning and organization of services for older persons at the state and local levels. State agencies were required to divide the state into geographic areas, or planning and service areas, and to establish area agencies on aging at the community level for the purpose of developing area-wide social service delivery systems for older persons. Area agencies were given responsibility for planning and coordinating of programs for older persons within defined planning and service areas designated by the state agencies on aging. In addition, area agencies were responsible for advocating on behalf of older persons.

The 1978 amendments represented a major change in the structure of the program when the separately authorized supportive, nutrition and multipurpose senior center programs were folded into the title III administrative structure. Another major change was the addition of a separate authorization of appropriations for home-delivered nutrition services, which were previously an allowable service under the congregate nutrition program. These amendments also established the state long-term care ombudsman program to investigate and resolve complaints of nursing home and board and care home residents, and a new title VI authorizing grants to Indian tribal organizations for supportive and nutrition services to older Indians. The amendments also incorporated the community service employment program as title V of the Act.

Amendments in 1981 and 1984 gave states greater flexibility in the administration of the nutrition and supportive services programs. The 1987 amendments created new separately authorized service components under the state and area agency on aging program, including in-home services for the frail elderly, and health promotion and disease prevention programs. These amendments also incorporated a grant program for older Native Hawaiians under title VI. The amendments in 1992 again restructured some of the Act's programs by shifting some of the title III service responsibilities to title VII for elder rights protection activities.

The 2000 amendments consolidated several funding authorities and increased state and local flexibility in program administration. The 2000 amendments also established the National Family Caregiver Support Program and required the Secretary of Labor to establish performance measures and award grants competitively for the Senior Community Service Employment Program.

In 2005, authorization for the Act expired. However, OAA programs continue to receive funding through the appropriations process. For fiscal year 2006, $1.78 billion was appropriated for these programs.

Since its creation, the OAA has grown to be one of the most visible service programs for older persons. In fiscal year 2005, the largest component of the Act, the title III nutrition program, provided 250 million meals to about 2.6 million older persons. About 50 percent of the meals were provided in congregate settings, such as senior centers and community centers, and 50 percent were delivered to frail older persons in their homes. The supportive services program provides funds to states for a host of social services and activities. The most frequently used services are transportation, information and referral, senior centers, outreach services, home care, and recreation. In fiscal year 2005, the program funded approximately 6,400 senior centers, 36 million rides, 13 million responses to request for information and assistance, and 20 million home care services. The Senior Community Service Employment Program accounted for about 25 percent of the OAA funds in fiscal year 2006. The program supports about 61,000 employment positions for approximately 91,500 low-income individuals age 55 and older. Funds are provided to State agencies and, through competitive grant awards, to non-profit national organizations. Enrollees work in a variety of community service activities including social services, education, nutrition services, senior centers, home care services, and parks and recreation.

The Senior Independence Act of 2006 is specifically designed to modernize the Older Americans Act in preparation for a growing number of Americans age 60 and older. The U.S. is facing the aging of the largest demographic cohort in its history. In 2006, the first children of the `baby boom' generation will turn age 60, adding to the 49 million Americans who already are age 60 or older, including over 5 million who are older than age 85.

By 2030, 70 million Americans--twice their number in 2000--will be 65 and over and comprise 20 percent of the U.S. population, representing one in every five Americans. With life expectancy also rising, older adults will collectively live longer than their predecessors. With a high percentage of baby boomers expected to live beyond 85, experts predict a 60 percent surge in the population of Americans age 85 and older between 2030 and 2040.

The Senior Independence Act aims to ensure flexibility, streamline services, target resources to individuals with the greatest need, foster consumer choice, improve nutrition services, support family caregivers, and enhance the performance of senior employment programs, so that seniors can live healthier, productive, and longer lives independently in their communities.

Additionally, H.R. 5293 establishes a clear role for the aging network in providing information to assist older Americans make decisions about home and community-based long-term care options, and to gain access to long-term care and other support services when they are needed. The services provided by the OAA are helping older Americans avoid institutional care and have the potential to save billions in federal entitlement spending on Medicare and Medicaid. By the year 2020, CBO projects that total public and private expenditures will reach well over $207 billion.

STATE AND COMMUNITY PLANNING

The first baby boomers have begun turning 60 this year, yet most communities are unprepared to handle the increased demands that this population shift will create. According to Mr. Michael O'Donnell, Executive Director, East Central Illinois Area Agency on Aging, who testified May 24, 2005 before the Select Education Subcommittee:

Over the course of the next three decades, the aging of the baby boomers will have a direct and dramatic impact on the social, physical and fiscal fabric of our nation's cities and counties. The aging of our nation's population will not only impact traditional aging services, it will also affect every aspect of local government programs, policies and services in the areas of health, human services, land use, housing, transportation, public safety, workforce development, economic development, recreation, education/lifelong learning, and volunteerism/civic engagement.

Despite the demographic forecast, few communities have begun to prepare for an aging population . . . AAAs and title VI Native American aging programs are uniquely positioned to serve as a liaison to local agencies to help them prepare to address the challenges and opportunities posed by aging population.

The Committee recognizes that the rise in the number of aging citizens will impact our Nation's cities and counties. H.R. 5293 encourages state and local aging agencies to help communities plan and prepare for the impact of the aging population. The Senior Independence Act authorizes the AoA to support planning activities that include assessment, coordination, and training and technical assistance. The Senior Independence Act also encourages state units on aging and area agencies on aging to incorporate into their state and area plans an assessment of how prepared the state or planning and service area is for the anticipated change in the number of older individuals over the next ten years.

CHOICES FOR INDEPENDENCE

The Committee finds that the United States can best meet the challenges associated with the aging of the baby boom generation by strengthening the Nation's capacity to foster the independence of older people. Consistent with the Choices for Independence plan proposed by President George W. Bush, the Committee is committed to strengthening the Act's role in promoting consumer choice, control, and the independence of older Americans as they age.

Choices for Independence was developed to supplement the President's New Freedom Initiative and the Administration's policy for modernizing Medicare and Medicaid. Choices for Independence integrates best practices to promote consumer choice, access to information, and health promotion. Research shows that by empowering individuals to make informed decisions about their long-term support options; providing more choices for individuals at high-risk of nursing home placement; and enabling older people to make behavioral changes that will reduce their risk of disease, disability, and injury, older individuals can maintain a good quality of life and reduce health care costs.

Assistant Secretary on Aging, Josefina Carbonell, best described the Administration's Choices for Independence plan at the May 2, 2006 hearing of the Subcommittee on Select Education:

Choices embodies three interrelated strategies for advancing systems change at the State and community level and is intended to test the effectiveness of this combined set of strategies. The demonstration builds on the unique assets of the aging network, its core programs and the best practices that have come from AoA's strategic investments since the last reauthorization.

The Committee commends the Administration for its leadership role in advancing long-term care systems change and strongly supports its recent efforts to help move states toward consumer-directed models of care. The Committee recognizes the success of several recent HHS initiatives rooted in the principles of consumer choice, access to information, and preventive health care, such as the Aging and Disability Resource Center Initiative; the Own Your Future Long Term Care Awareness Campaign; the Cash and Counseling Demonstration Program; and the Evidence-Based Disease Prevention for the Elderly Program.

These initiatives, which are part of the larger Choices for Independence plan, build on the mission and success of the OAA and support the Committee's goal of modernizing the Act. The OAA is uniquely positioned to advance these changes; it has a statutory focus on keeping older people independent and living in their own homes and communities for as long as possible, and a successful history of providing low-cost, non-medical supports through federal, state and local partnerships.

The Committee is confident that the core principles of Choices for Independence are elements essential to the strengthening of our Nation's long-term care systems. These principles will make the system more consumer driven and more cost-effective, and should be implemented nationwide. Accordingly, the Committee has embedded the principles of Choices into the core structure of the Act. The Committee also believes Choices for Independence has the potential to generate significant savings to large, taxpayer-funded entitlement programs like Medicare and Medicaid.

Consumer Choice: Research demonstrates that consumer driven, self-directed care models that provide for the assessment of the needs and preferences of an individual at risk for institutional placement can help individuals avoid unnecessary nursing home placement. Furthermore, consumer driven models better respond to individuals' needs and preferences and provide the option for the individual to direct and control the receipt of support services provided.

H.R. 5293 includes an amendment offered by Mr. Danny K. Davis and Mr. Jon C. Porter to support consumer-driven models of home and community-based care and to help prevent high-risk individuals from spending down their savings to receive Medicaid. The provision directs the AoA to develop policy alternatives for long-term care provided in home and community-based settings.

Access to Information: The Senior Independence Act encourages service delivery models that provide consumer-directed and community-based long term care options. For example, H.R. 5293 authorizes the establishment of Aging and Disability Resource Centers (ADRC) in each state and Puerto Rico (AoA currently funds one or more ADRCs in 43 states). ADRCs conduct public outreach and provide individual support through `one stop' centers designed to be `visible and trusted' sources for information on all available support options, including private financing options such as long-term care insurance and home equity instruments. These centers can empower individuals--both those in immediate need and those who have the ability to plan ahead for their long-term care--to make informed decisions about their support options. This will reduce the confusion and frustration consumers and their families often face as they explore long-term care options. It also will improve government efficiency by integrating the multiple eligibility forms and procedures for various public programs that help finance long-term support options.

Health Promotion: The Committee recognizes the importance of evidence-based disease prevention and health promotion initiatives. There is a growing body of scientific evidence on the efficacy of low-cost programs that can empower older individuals, including functionally impaired individuals, to better maintain their health. These programs focus on interventions such as chronic disease self-management, falls prevention, exercise, and nutrition. Activities such as screening for early disease detection and lifestyle changes to increase physical activity, consume healthful foods, stop tobacco use, and avoid risky behaviors can help prevent or delay the onset of chronic disease or functional disabilities.

The Senior Independence Act will strengthen the role of the OAA in translating research into practice by promoting the use of evidence-based health promotion and disease prevention programs at the community-level through local aging services provider organizations such as senior centers, nutrition programs, senior housing projects, and faith-based groups. These programs can improve quality of life, reduce health care costs, and complement the increasing focus on prevention in our health care system.

Overall, H.R. 5293 will, consistent with the Choices for Independence plan, give states and communities greater flexibility under the OAA to help moderate and low-income individuals to remain in their homes and delay their premature entry into nursing homes. Choices will provide flexible funding that will be targeted at individuals, not at service categories as with the current titles under the Act. This will make it easier for states to respond to people's individualized needs and preferences. It also will promote the use of consumer-directed approaches, including `cash and counseling' models that give consumers more control over the care they receive.

TARGETING SERVICES TO INDIVIDUALS WITH THE GREATEST ECONOMIC AND SOCIAL NEED

According to the U.S. Census, 4.4 million people (12.6 percent) of individuals age 65 or older spoke a language other than English at home. Less than half of these individuals (47 percent) spoke English `very well.' The same report states that in 2003, 83 percent of older Americans were white, 8 percent black, 6 percent Hispanic, and 3 percent Asian. By 2030, those percentages are projected to be 72 percent white, 11 percent Hispanic, 10 percent black, and 5 percent Asian.

The Older Americans Act throughout its history has targeted services to those with the greatest economic and social need. The Act directs states and local area agencies on aging to pay particular attention to low-income, minority and rural populations. The Committee recognizes that individuals with limited English proficiency (LEP) may have unique needs, and that language often is a significant barrier to older individuals seeking information or access to services within a community. The Committee included amendments to direct states and local area agencies on aging and service providers to make special efforts in their outreach and services to meet the needs of older individuals who have limited English proficiency.

BENEFITS OUTREACH AND ENROLLMENT

The Committee is aware that older Americans who are eligible for important public benefits are not always receiving them. An estimated 47 percent of the elderly eligible for Supplemental Security Income, 70 percent of seniors eligible for food stamps, 67 percent of people eligible for Qualified Medicare Beneficiary protections, and 87 percent of those eligible for Specified Low-Income Medicare Beneficiary protections are not participating in these programs. While poverty among those age 65 and older has fallen from one-in-three older persons in 1960 to one-in-ten today, an estimated 28 percent of Americans age 65 and older had incomes of less than $10,000 in 2004 (Congressional Research Service, 2006). It is the Committee's view that the aging network should help to ensure that eligible beneficiaries age 65 and older receive support in accessing the full range of public and private services and assistance for which they are eligible.

An amendment offered by Mr. John R. `Randy' Kuhl, Jr. encourages the AoA to support identification and outreach to low-income seniors eligible for public assistance. There are many trusted, non-profit community organizations and many caregivers that can help find and assist low-income seniors, but they need easy-to-use tools to help seniors understand what they are eligible for and to assist them with enrollment. Trusted intermediary organizations also need resources to be able to reach beneficiaries and provide one-on-one counseling and enrollment assistance. While some support is currently being provided in conjunction with outreach for the new Medicare prescription drug benefit and other federal programs such as Food Stamps, there is no focused, coordinated effort to assist low-income seniors in receiving the range of assistance for which they may be eligible.

H.R. 5293 will help improve the health and independence of low-income seniors who are not receiving assistance available to them. The provision has the potential to significantly boost efforts to find and enroll additional low-income seniors in the Medicare prescription drug discount program.

FINANCIAL LITERACY

The Committee is aware that vulnerable older Americans are too often victimized by identity theft or other financial exploitation. Family caregivers often must make financial decisions with little or no support or understanding about options and their consequences. Therefore, the Committee included amendments to strengthen financial literacy services in the Act. The first amendment includes financial literacy as one of the family caregiver support activities. The second adds public outreach and education to support financial literacy and prevent identity theft as activities in the prevention of elder abuse.

SENIOR VOLUNTEERS

Adults over 60 represent a source of human capital to meet critical social needs. Tapping this resource through paid and unpaid public service has the potential to expand the economy while providing civic benefit. It is projected that the productivity of seniors could add over $3 trillion to the GNP by 2045.

The Committee recognizes the value and potential return on investment of civic engagement and volunteerism among the Nation's senior population, and encourages the development of new models for civic engagement. Older adults across the country can be strategically mobilized to tutor and mentor children, facilitate access to health services, strengthen communities and families, provide respite to caregivers, and bolster the long-term care system--all civic activities shown also to contribute to their own well-being.

H.R. 5293 includes amendments to promote volunteerism and the coordination of OAA programs with other national volunteer programs such as those authorized through the Corporation for National and Community Service. Volunteers play a critical role in the aging network. Seniors do not just receive services from the Older Americans Act programs; they are primary service providers, contributing countless hours and expertise to improve their communities. The Committee recognizes the tremendous potential in the soon to retire baby-boom generation and encourages the aging network to leverage that resource by expanding opportunities for volunteerism and employment.

NUTRITION

Older Americans Nutrition Programs serve about 250 million congregate and in-home meals to about 2.6 million older adults annually and are intended to reduce nutrition risk among older adults. The goals are to support quality of life, improve functionality, promote independence, and decrease early nursing home admissions and hospitalizations, and reduce health disparities, through better nutrition.

Food is an essential component of quality of life; an unacceptable or unpalatable diet can lead to poor food and fluid intake, resulting in weight loss, under nutrition and a spiral of negative health effects. Normal aging brings about a decrease in both the energy an individual requires and the amount of food consumed.

The Committee is aware that older Americans are often malnourished. Approximately 40 percent of individuals residing in the community age 65 years and older have inadequate nutrient intakes. The malnutrition rate for older Americans is 1 in 4, and 1 in 3 OAA program participants are underweight (Institute of Medicine, 2003). Inadequate nutrient intake is complicated by the fact that as individuals age, the body loses some of its ability to make and absorb nutrients.

The combined effect of poor diet and the inability to make and digest nutrients causes vitamin and mineral deficiencies in many older Americans. According to the Baltimore Longitudinal Study on Aging, a majority of older men and women are deficient in calcium, zinc, iron, magnesium, and vitamin D. Older adults are more susceptible to nutrient deficiencies for a number of reasons, including chronic diseases that impair absorption and utilization of nutrients, oral problems such as gum disease and dysphagia, and loss of appetite due to medications and their side effects. A study conducted by the Institute of Medicine (IOM) found that inadequate nutrient intake affects up to 40 percent of community dwelling older adults, and 87 percent of older Americans suffer from chronic conditions which can be managed in part by appropriate nutrition intervention. Thirty percent of individuals receiving home-delivered meals have three or more activities of daily living (ADL) impairments, comparable to individuals receiving nursing home care.

The Committee finds that stronger and more comprehensive and coordinated nutrition services will improve quality of life, reduce health care costs, and complement efforts focused on prevention. Comprehensive nutrition services, which may include nutrition screening, assessment and counseling, can benefit OAA clients who receive meals, especially those who are homebound. Further, these activities can prevent the devastating and debilitating conditions often seen upon admission to hospitals and nursing homes, such as dehydration, pressure ulcers, unexplained weight loss and uncontrolled diabetes.

Maintaining a healthy body weight is important for older adults, since being overweight or obese is associated with a greater risk of disease and can worsen existing conditions. While research shows that obesity is the most common nutritional disorder in older persons, malnutrition and being underweight also continue to be pervasive problems. One in three older Americans are underweight, and all have a high risk of being deficient in commonly required nutrients (Institute of Medicine, 2000).

Chronic diseases are extremely prevalent in older population and can be prevented, delayed or diminished through diet, exercise, and other positive lifestyle choices. According to the Centers for Disease Control, 85 percent of individuals over the age of 65 have at least one chronic disease. Heart disease and cancer are two chronic diseases that can be prevented or managed by making healthy lifestyle choices, particularly by maintaining a proper diet. According to the American Cancer Society, one third of all cancer deaths are related to unhealthy diet and lifestyle behaviors. Proper nutrition is an important factor in preventing cancer; and studies have shown that greater consumption of fruits and vegetables lowers an individual's risk of developing several cancers including lung, mouth, colon, and stomach (American Cancer Society. Diet, Physical Activity and Cancer . . . What's the Connection? Byers, Tim, MD and Doyle, Colleen, MS, RD. American Cancer Society website: www.cancer.org).

The nutrition services provided under the OAA play a vital role in helping seniors to continue to lead active, independent, healthy lives and avoid unnecessary institutionalization. The OAA nutrition program serves a population that is older, poorer, less healthful, more racially and ethnically diverse, and with more functional impairments than the general US population.

Congregate and home delivered meals provided with OAA funding must deliver 33 1/3 percent of dietary requirements per meal. For the majority of meal program participants, the meal they receive provides over 50 percent of participant's daily dietary intake. Home delivered meals provide about 62 percent of a participant's daily dietary intake. For congregate meal participants, meal participants receive 58 percent of daily dietary intake from the meal provided.

A consistent total diet and eating pattern over a period of time is more important than any single meal to establish a healthy diet in accordance with the most recent dietary guidance. H.R. 5293 simplifies nutrient requirements by authorizing nutrition providers to average key nutrients. There is precedence for averaging nutrient intake in the National School Lunch Program. When local service providers are allowed to average the nutrients their meals provide over time, rather than adhering each meal to the strict 33 1/3 daily value percentages, they can plan meals that better accommodate the preferences of the clients they serve. Furthermore, as the title III language strongly encourages, when registered dietitians and qualified nutrition professionals are closely involved in meal planning, meals can be planned in such a way to be both palatable and appropriate for the client while still meeting their nutritional needs.

Section 23 of the Senior Independence Act allows local meal providers the option of offering a single multivitamin-mineral supplement to a congregate meal participant along with a complete meal. The supplement may not replace all or any part of a meal and is not intended to be factored into the nutrient requirements of such meal. A single, daily multivitamin supplement can help prevent nutrition deficiencies common in many older Americans. A daily multivitamin-mineral supplement is an inexpensive strategy to help insure the nutritional health of older Americans. Multivitamins are broadly available for less than $40 per year per person (7 cents per day at retail price, cheaper if bought in bulk). A 2003 report by the Lewin Group estimated that daily use of a multivitamin by adults over the age of 65 could lead to approximately $1.6 billion in Medicare savings over five years.

ROLE OF NUTRITION PROFESSIONALS

The essential factor in keeping older adults active, healthy and at home is applying the basic nutrition science from the Recommended Dietary Allowances and the Dietary Guidelines for Americans. Nutrition science has become increasingly complex, and the most recent scientific evidence should be put into practice to benefit older adults. Nutrition professionals such as registered dietitians have the necessary education and training to integrate and disseminate scientific information to the providers of nutrition services. Registered dietitians bring specific skills to the design, implementation and evaluation of nutrition programs that are invaluable to service providers. Qualified nutrition professionals also can ensure that the role of nutrition is addressed in the context of long-term care for individuals involved in home- and community-based services. These programs are serving frail older adults who often have more complex nutritional needs than a member of the average population. A registered dietitian or other qualified nutrition professional should, when possible, serve as a resource for training other professionals and as a team member in designing the comprehensive and coordinated services that will meet the unique needs of older adults in each state.

NUTRITION PROGRAM EVALUATION

An amendment offered by Representative Mark E. Souder (R-IN) requires the Administration on Aging to contract with the Food and Nutrition Board at the IOM to conduct an independent study to evaluate the nutrition services provided under the OAA. This study would be the first independent evaluation of the impact the nutrition services provided by the OAA have on older adults' health and quality of life. The advances that have occurred in nutrition knowledge and its application have made the public aware of the importance of food and nutrition for a healthy life, illness or injury risk reduction and disease management and prevention. However, older adults account for a disproportionate share of the escalating costs of Medicaid and Medicare. The purpose of this study is to determine whether the nutrition services are meeting the goal of helping seniors live healthier lives, which in the long term should reduce health care costs. The American Dietetic Association, the National Association of Nutrition Service Providers and the Meals on Wheels Association of America all recognize the importance of this study to ensure that their programs are successful and the public's tax dollars are being spent in the most effective manner.

The Committee also supports the action of the AoA to contract with an outside entity to conduct an administrative review of the title III nutrition program, but notes that the evaluation recently commissioned by AoA serves a different purpose, and therefore is not duplicative of the IOM study authorized by H.R. 5293.

NUTRITION RESOURCE CENTER

The Committee supports the continued funding of a National Center for Nutrition, Physical Activity and Aging. The Administration on Aging has funded such a center through a competitive grant process since 1995. The Center provides senior nutrition service providers and the public vital information to improve food and nutrition services provided to older individuals. The Center encourages risk-based nutrition screening to identify and serve the neediest, provides technical training, disseminates timely information, and conducts policy analysis and outcomes research. The Center's applied, community-based research has fostered vital links among researchers, local nutrition service providers, older adults, and caregivers.

NSIP

Nutrition Services Incentive Program (NSIP) authorized in section 311 of the Older Americans Act provides incentives to States and Tribes for the effective delivery of nutritious meals to older adults. Since 2003, the program is administered by AoA, which provides cash and/or commodities through the United States Department of Agriculture (USDA) to supplement meals provided under the authority of the OAA. State Units on Aging (SUAs) funded through title III of the OAA and Indian Tribal Organizations (ITOs) funded through title VI of the OAA may receive grants of cash from the AoA and/or commodities from the USDA to support OAA nutrition programs. The NSIP cash or cash and commodity allocation to SUAs and ITOs is a proportional share of the annual appropriation based on the number of meals served in the prior year.

Section 19 of the Senior Independence Act converts NSIP into a cash only program. This change in program operation was requested by the Administration on Aging and supported by the Department of Agriculture. The provision is intended to streamline the purchase and delivery of small amounts of commodities by providing cash to states for the purchase of commodities. The provision authorizes but does not mandate that a local nutrition service provider funded under the Older Americans Act make a local agreement with a local school district to better meet unique, local community needs. Local school districts could benefit from discounts provided to larger bulk purchase orders when the needs of the local nutrition service provider and the local school district are combined.

While the proposal would provide cash only to all states, the proposed language does not preclude a state unit on aging from reaching an agreement with another state agency to continue the purchase and distribution of commodities at a state level.

VOLUNTARY CONTRIBUTIONS

The Committee recognizes that seniors have many reasons for needing OAA services, and that those needs are not always economic. The majority of its Members believe that those seniors who can afford to contribute to the cost of their meals and other services should do so. While nutrition programs receive the bulk of the funding under the Older Americans Act, funding is not available to cover all eligible individuals. In many communities there are other programs that provide meals to older individuals. The major source of additional funding for these programs comes from seniors in the form of voluntary contributions. Until the 2000 amendments, the law restricted efforts to solicit voluntary contributions from program participants.

H.R. 5293 retains the long-standing federal policy of prohibiting states from applying cost-sharing to certain services: information and assistance, outreach, benefits counseling, and case management; ombudsman, elder abuse prevention, legal assistance, or other consumer protection services; congregate and home delivered meals; and any services delivered through tribal organizations.

The Committee understands the increasing demand for services and the need to collect additional funding and expand supportive and nutrition services under title III. According to some local providers, confusion remains regarding the extent to which a provider may solicit voluntary contributions. Therefore, the legislation clarifies and strengthens the existing provision relating to the solicitation of voluntary contributions by expressly authorizing service providers to solicit voluntary contributions. Further, service providers are required to encourage such contributions from eligible individuals whose self declared income is at or above 125 percent of the federal poverty line.

Mr. Vinsen Faris, Executive Director, Meals on Wheels of Johnson and Ellis Counties, Texas testified that the need for home-delivered meal services by older individuals is not always economic. As he noted at the Subcommittee on Select Education's May 2, 2006 hearing:

We learned that by giving people an opportunity to do their part, the welfare stigma can be alleviated. We also learned several other important lessons from that experience. We learned that senior meal programs are misunderstood by many in the community and thought to be only for low income people. We learned that voluntary contributions are essential to expanding our program. Our success at encouraging donations from clients has been great. In fact, our client donations have generally accounted for seven to ten percent of our overall revenue. Client contributions have been one of our largest single sources of revenue in our budget each year.

Last time Congress reauthorized the Older Americans Act, you helped us accomplish this by changing the law to allow us to actively solicit contributions. It has made a real difference. I believe the change that you are proposing in your reauthorization bill will have the same effect. It will enable us to be more effective about bringing those seniors who need our services, but also have the ability to pay, into our program. And it will assist our program in encouraging contributions from them.

Determination of the best method of accepting contributions remains a local decision. The law permits providers to send individualized client benefit summaries to program participants in order to increase voluntary contributions. Providers have pointed out that many individuals want to contribute at a level that covers the cost of the meal service if they were provided a statement that summarized the actual cost of their meals. However, H.R. 5293 maintains current law that any contribution is voluntary and all solicitations shall be non-coercive. Written requests should solicit contributions for a fixed period of service (such as a month) only and not reflect any past due balances. Such written requests should state clearly that contributions are voluntary and the statement should not be construed as a bill.

The Committee does not support any method of soliciting voluntary contributions or cost-sharing that would deny meals to eligible individuals due to their inability or refusal to pay. However, the Committee has found that most individuals want to contribute to the cost of their meals or other service and will do so willingly, even if a contribution does not cover the full cost of the meal or service provided.

Further, H.R. 5293 stipulates that monies collected through contributions are supplemental funds for the provision of services from which they are collected and may not be used to supplant other funds provided under the Act. Title III allocations to any service provider should not be reduced based on the amount of voluntary contributions received.

TRANSFER AUTHORITY

Current law allows States to transfer up to 30 percent of Title III-C funding (nutrition services) to Title III-B (supportive services). The allowance of transfers is important because such flexibility of programming and financing in States recognizes the close interrelationship between meals and supportive services that exists in the communities. Flexibility allows States to adapt the use of funding to the needs that arise where they are, and avoid one-size-fits all models of programming. The current flexibility of transfer authority allows State and local entities to accurately identify the units of service being provided under the Act and the unit cost of those services.

The 2000 amendments liberalized current law restrictions on the transferability of funds from congregate and home-delivered nutrition services allotments. Because the demand for services can change from month to month, states and local providers need the flexibility to fund services when and where they are needed. As such, the Committee supports state flexibility to transfer up to 50 percent of funds between congregate and home-delivered nutrition services. This flexibility allows local providers greater ability to allocate funding based on the types of nutritional services actually needed by older individuals residing in their community.

Most transfers from nutrition to supportive services are from congregate meals funds (which is funded at higher levels than home-delivered meals), and there is justification for such transfers. For many congregate meals programs, there is an almost inseparable relationship between meals and supportive services activities. It is very common, for example, for frail elderly people to be transported between their homes and the congregate meals sites on almost a daily basis, and these transportation services are classified as supportive services.

Transfer authority allows States, where needed, to ensure that they can match the level of financing needed for non-meal costs that are associated with their congregate meals programs. For example, if States were not allowed to use such transfers, the cost of transporting elderly people to congregate meal sites might aversely affect other necessary supportive services for homebound individuals. Similarly, significant other non-meals services, such as exercise services, information, assistance, and counseling, are provided to elderly individuals in congregate meal sites, and so are closely related to the delivery of the meals.

The Committee notes that some nutrition providers are advocating for a prohibition on funds transfers between title III-B, which provides supportive services, and title III-C, which provides nutrition services. In 2005, $708,000 (0.2 percent) was transferred from supportive services to meals, and $36 million (6.4 percent) was transferred from meals to supportive services. Both these amounts are significantly below transfers allowed under the OAA and are slightly less than the percentages transferred in 2003. According to analysis of AoA data, rates of transfer between nutrition and supportive services have remained consistent over time. The Committee finds no indications of widespread interest among the States in increasing levels of transfers.

The Committee cautions States from transferring funds from nutrition services to non-nutrition supportive services unless such transfers support, facilitate, or foster participation in senior nutrition programs. In particular, States with a high prevalence of food insecurity are strongly discouraged from diverting funding provided for food services to non-food expenditures and should do so only as a last resort. Further, the Committee strongly encourages states to use general and administrative dollars provided in the specific line item or category for which the funds were intended. The Committee believes strongly that, while flexibility should be preserved, Title III-C dollars should not be used by states to pay the administrative cost associated with managing Title III-B services.

CONTRACTUAL, COMMERCIAL, AND PRIVATE PAY RELATIONSHIPS

Current law requires area agencies on aging to maintain the integrity and public purpose of services in all partnerships, contractual, and commercial relationships. This provision has been interpreted to prohibit area agencies on aging and other service providers from using any OAA funds, including administrative funds or staff time, to develop contractual or commercial relationships that would result in payment for services to the non-profit agency.

The Committee recognizes that the aging services provider network has knowledge, skills and services that are needed by a growing number of older individuals, adults with disabilities, caregivers and persons planning for longer-term care needs. These skills and services are currently provided by the network while a new industry has developed in the marketplace of unskilled individuals who attempt to sell sometimes inferior information and services to those who can pay. The aging network, if able to implement a system to respond to this market, could provide reliable services--from a known and trusted community resource--to those individuals and businesses accustomed and able to pay for services.

Section 9 of the Senior Independence Act clarifies intent that efforts by the aging services network to be more entrepreneurial, expand services to help support the aging baby boom populations, and allow for private pay opportunities are permissible and encouraged. At the same time, this provision maintains safeguards to ensure that aging network providers operate in a manner consistent with the public purpose mission and targeting provisions of the OAA.

SUPPORTING FAMILY CAREGIVERS

Despite substantial public spending for long-term care (primarily for nursing home care), relatives provide the bulk of long-term care services to family members with physical and cognitive disabilities. Over 7 million caregivers provide informal, or unpaid, care to elderly family members each week. Typically, adult children provide this care to elderly parents. About two-thirds of the functionally impaired elderly rely exclusively on informal assistance. Research has documented the enormous responsibilities that families face in caring for relatives who have significant impairments.

Section 30 of H.R. 5293 reauthorizes the National Family Caregiver Support Act and strengthens assistance available to caregivers. The Family Caregiver program provides grants to States for services such as counseling, training, support groups, respite-care, informational assistance, and supplemental services to family members caring for an aging family member, and for grandparents age 60 or older caring for a grandchild. Funding for the program is distributed on the basis of a State's relative share of individuals age 70 and older in order to target resources to the most frail, however, individuals age 60 and older in need of caregiver services will be eligible to receive the services. Within States, funding is distributed to those seniors who have the greatest social and economic need with particular attention to low-income older individuals.

Since its inception in 2001, the National Family Caregiver Support Program has proven successful in enhancing the quality of life for frail individuals and those who care for them. Today, the program serves over 500,000 caregivers. The Administration on Aging has documented that in 2004, 52 percent of caregivers reported that services provided by the National Family Caregiver Support Program helped them to provide care longer.

Further, the program is saving taxpayer money by preventing or delaying institutionalization of older individuals who, with caregiver supports, are able to live independently. Approximately over 4.5 million persons age 65 and older living in the community need long-term care assistance due to a functional disability. Functional disability is defined as the inability to perform, without assistance, the following activities of daily living (ADLs): dressing, eating, bathing, transferring from a bed to a chair, and toileting; and/or, the inability to perform certain instrumental activities of daily living (IADLs): light housekeeping, meal preparation, shopping, taking medications, and managing money. Caregivers provide an average of 20 hours of unpaid help each week to older individuals with certain functional limitations. Unpaid work, if replaced by paid home care, would cost an estimated $45 billion to $94 billion annually.

According to the 2000 U.S. Census, more than 2.4 million grandparents in the United States have the primary responsibility for raising grandchildren, and 6 million children, or 1 in 12, under the age of 18 live in a home of a grandparent or other relative. Section 29 of the Senior Independence Act expands eligibility for caregiver support to grandparents and other relatives age 55 years of age or older who care for a grandchild or an adult child with a disability. Under current law, a local AAA may reserve up to 10 percent of the programs funds to serve older caregivers age 60 and older. Because a significant number of grandparents raising a grandchild are under age 60, this change increases to nearly half the number of grandparents eligible for caregiver assistance. A May 2006 letter to Congress co-signed by the National Council on Aging, Generations United, Child Welfare League, and Easter Seals stated, `Lowering the age limit to 55 better responds to the demographics of relative caregivers and the unique challenges they face.'

Research suggests that grandparents raising grandchildren have health problems more comparable to individuals of a greater age. A 1999 study reported in the American Journal of Public Health demonstrated that caregiving grandparents had a 50 greater chance of having a functional limitation than non-caregiving grandparents.

The Senior Independence Act allows caregivers who care for individuals of any age with Alzheimer's disease or other dementias or neurological disorders to receive support from the National Family Caregiver Support program. Under current law, caregivers only receive support when they are caring for adults age 60 or over, however, it is estimated that about 300,000 individuals--about six to eight percent of the four million Americans diagnosed with Alzheimer's disease--are cases of early onset (Mayo Clinic, 2005). It is the view of this Committee that in this unfortunate situation, family caregivers should be eligible for services provided under the National Family Caregiver Support Act.

According to the Alzheimer's Association, `increased use of respite care at mild and moderate stages of Alzheimer's have shown to delay nursing home placement significantly, which result in a net savings of as much as $600 to $1,000 per week. Similarly, delaying nursing home admissions for people with Alzheimer's disease by just one month could save at least $1.12 billion a year.'

SUPPORTING OLDER AMERICANS WITH DISABILITIES

Assistive Technology (AT) plays an important role in the lives of millions of Americans with and without disabilities. In no segment of the population, is the impact of AT more significant than with elders who experience a decline in functional skills. AT enables seniors to improve functional abilities and to live independently and safely in the community. Without AT, aging in place would not be possible for many older Americans. Research suggests that keeping people in their communities and avoiding unnecessary institutionalization not only improves quality of life but also reduces the cost of both public and private health care.

Encompassing a range of items, AT can be as complex as a tilt in space wheelchair or an Augmentative Alternative Communication System that gives voice to a person who has lost the ability to speak. AT can also be simple and as commonplace as Velcro or a large handle on a toothbrush that makes it easier to hold. The common denominator is that AT makes it easier to perform activities of daily life. While AT is often used by seniors with disabilities, the Committee notes that other older individuals also may benefit from AT.

PREVENTING ELDER ABUSE AND NEGLECT

While an accurate account of how many seniors experience abuse or neglect in the United States is not known, the best estimates suggest that between one to two million seniors are mistreated (included physical abuse, psychological abuse, and neglect) each year.

According to the National Research Council, the occurrence and severity of elder mistreatment are expected to increase significantly in future decades due in part to the increasing numbers of individuals over 65 (National Research Council, 2003).

The Administration on Aging serves as the primary agency for preventing and addressing elder abuse and neglect. OAA authorizes the National Center on Elder Abuse and a grant program to states to develop and implement programs specifically focused on the prevention and treatment of elder abuse. Several other authorities to address elder care issues are established within HHS and other Federal entities.

The Federal government plays an important role in promoting research, training, public safety, data collection, and the identification, development, and dissemination of promising health care, social, protective services, and law enforcement practices relating to child abuse and neglect, domestic violence, and violence against women. It is the view of the Committee that the federal government, along with its state and local partners, should promote similar efforts and protections relating to elder abuse, neglect, and exploitation.

During Select Education Subcommittee hearings, witnesses testified that a fragmented elder justice system is not serving vulnerable older Americans well, and that information gaps inhibit efforts to protect elders from abuse and neglect.

Mr. David Bibler, Executive Director, Licking County Aging Program in Newark, Ohio testified April 28, 2006, at the Select Education Subcommittee field hearing in Westerville, Ohio about the need to better coordinate elder justice activities:

Abuse, exploitation and neglect are common occurrences for far too many of today's older adults and this problem will only be exacerbated by the rapid growth of the aging population over the next decade. To date there is no federal law that comprehensively addresses elder abuse and neglect, from prevention to intervention through prosecution. Individuals and agencies that are dedicated to protecting older adults against abuse, exploitation and neglect, often do so within a fragmented system and with limited resources. In Licking County we have only one case manager in Adult Protective Services for a senior population of 23,534. This is an injustice to our elderly. Too many seniors are abused and neglected, many by their own family members. This area needs to be addressed.

The Committee supports the utilization of existing federal entities with responsibility for protecting seniors who are at risk or have experienced elder abuse or neglect, and supports a comprehensive infrastructure for elder abuse prevention and treatment. H.R. 5293 seeks to address the apparent need for federal coordination and leadership.

An amendment offered by Mr. Jon C. Porter and Mr. Danny M. Davis authorizes the Assistant Secretary on Aging to develop objectives, priorities, policy, and a long-term plan for carrying out and coordinating federal elder justice activities. Specifically, this amendment provides authority for the Assistant Secretary on Aging to: carry out elder justice programs and activities relating to elder abuse prevention, detection, treatment, intervention, and response (including the training of individuals regarding these matters); collect and disseminate data relating to the abuse, neglect, and exploitation of elders; identify best practices; conduct research; and provide technical assistance to States. The Committee encourages efforts by the AoA to promote collaboration and diminish duplicative efforts in the development and carrying out of elder justice programs at the federal, state, and local levels.

COMMUNITY SERVICES EMPLOYMENT-BASED TRAINING

The Committee views the Senior Community Service Employment Program (SCSEP) as a community-oriented, subsidized employment-based training program for low-income older Americans. It provides work experience and training opportunities to those seniors with the capacity and interest to transition into unsubsidized employment. In addition, the program provides invaluable services to our nation's communities. The Committee is committed to supporting the dual nature of the program and has revised the purposes of the program accordingly.

H.R. 5293 authorizes the Secretary of Labor to establish a program to foster and promote useful part-time public and private sector employment-based training opportunities. In addition, the program is to provide vital social and human services to communities by providing work experience to eligible individuals in public agencies, and community-based and faith-based organizations.

To reinforce this dual goal, the legislation renames `community service' to `community service employment-based training,' which is defined as `work experience that is related to providing social, health, welfare, and educational services (including literacy tutoring), legal and 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; antipollution and environmental quality efforts; weatherization activities; economic development; and such other services essential and necessary to the community as the Secretary determines by rule.' Thus, the bill emphasizes the desire to achieve training but maintains the focus on meeting the needs of communities.

TRANSITION INTO UNSUBSIDIZED EMPLOYMENT

The majority of Committee Members believe that the SCSEP program should be a limited program to assist individuals in transitioning to unsubsidized jobs. Program placements are not intended to be permanent jobs. The work experience received through these positions is intended to allow individuals to gain necessary skills or experience to find work.

Our nation is experiencing significant demographic change as our population ages, which underscores the value of the SCSEP program and its role in assisting individuals as they move into unsubsidized positions. As Mason Bishop, Deputy Assistant Secretary of Labor for Employment and Training at the Department of Labor, testified before the Subcommittee on Select Education on May 2, 2006:

According to the Census Bureau's American Community Survey, 12 percent of the total population in 2004 was aged 65 or over, and this percentage is set to expand rapidly in the coming decades. After the first Baby Boomers turn 65 in 2011, the older population will become twice as large by 2030 as it was in 2000 . . . [Most of the Baby Boomer cohort of older workers] envision a very different retirement than that of their parents--one that includes at least some work, whether for social engagement, intellectual stimulation, or because of financial necessity. However, despite a need for their skills and their desire to remain in or re-enter the workforce, many older Americans find themselves unable to find suitable work.

Through SCSEP, individuals gain new skills and access to employment opportunities, which enables them to find suitable work.

The Committee recognizes that direct skills training, in addition to community-based placements, may help some individuals achieve their employment goals. The current law requirement that no less than 75 percent of a grantee's funds be spent on wages and fringe benefits could limit the kinds of training opportunities available to participants. When coupled with the allowance to use between 13.5 and 15 percent of funds for administrative costs, a grantee currently may use only approximately 10 percent of its funds for classroom training and other supportive services necessary to allow individuals to move into employment. H.R. 5293 changes this requirement to permit grantees to spend no less than 65 percent of their grant funds on wages and benefits. This would allow grantees, if they choose and it is in the best interest of participants, to spend approximately 20 percent of their funds on services such as classroom training or on-the-job training.

A witness at the Subcommittee on Select Education hearing on April 3, 2006 testified regarding the opportunity that on-the-job training presents. Marlon Sullivan, Senior Director of Staffing for the Home Depot, described the benefit of Home Depot's participation in a pilot project conducted under the Secretary's existing discretionary authority and operated by SER--Jobs for Progress, one of the SCSEP national grantees:

As part of SER National's 502(e) On the Job Training program (OJT), 23 participants in each of the 6 markets underwent 2 weeks of pre-employment training. The 80 hours of training included skills such as computer basics, customer service, interview best practices and preparing for the Home Depot application. Having recently completed the training, the 138 total applicants are currently applying on line for Home Depot opportunities, which include but are not limited to Lot Associate, Cashier, Sales Associate and Sales Specialist.

Similar opportunities could be available nationally if grantees have the flexibility to develop such partnerships.

The Committee views the program as a means to an end, and not as permanent employment for participants. To reflect this belief, H.R. 5293 requires national grantees annually to have an average participation by eligible individuals of not more than 24 months in the aggregate. The Committee recognizes that some individuals may be ready to move into unsubsidized employment within months of enrollment, while others may have barriers to employment that make finding a job more challenging. In addition, individuals may live in an area where fewer jobs are available. Requiring average participation of 24 months provides grantees with sufficient flexibility to address the individual needs and circumstances of their participants while reinforcing the temporary nature of the program. According to the Department of Labor, the average time a participant currently remains in the program is 27 months.

To ensure that grantees are assisting participants in moving to employment, the bill creates a four year time-limit (whether or not consecutive) for individual participants. However, to create a transition period for those already participating in the program, the Committee added language allowing individuals who have already participated in the program for at least 24 months to have an additional 24 months eligibility. As a result, someone who already has been enrolled for four years may participate an additional two years if necessary to prepare further for an unsubsidized job. Anyone who has been participating in the program for 24 months or less at the time of enactment will have a four year time limit, inclusive of time already spent in the program.

In addition, a time limit for participants will ensure that the program can serve the greatest number of eligible individuals. In 2000, nine million people were eligible for SCSEP programs. The SCSEP funds support about 61,000 positions, through which about 100,000 participants are served annually. Although State and national grantees are not required to keep or report waiting lists, some do. As of June 30, 2005, there were over 2,100 people on these waiting lists. Clearly demand and unmet need exists.

Under current law, national grantees are expected to move 20 percent of their participants into unsubsidized employment annually. To increase the expectation of job placements, H.R. 5293 incrementally increases this percentage by two percentage points annually so that in 2011 grantees will be expected to place 30 percent of their caseloads in unsubsidized employment. The Committee believes that this phase-in allows grantees sufficient time to adjust their programs, as necessary, to reach higher placement goals.

COMMUNITY SERVICE

The Committee wants to ensure that, while moving individuals toward unsubsidized employment, the program continues to provide the vital services to communities for which it is known. According to the Department of Labor, the program has provided over 45 million hours in community service. Many of the program's participants provide needed services for other older adults. For example, participants work in community senior centers or deliver meals to frail elderly individuals. Others work in health clinics, libraries, or on the campus of Job Corps centers assisting the next generation of workers.

While grantees are free to make placements with either public or private, for profit, or not-for-profit organizations as appropriate for the participant, the Committee recognizes and commends the program for the invaluable contribution participants have made to local communities. Therefore, in addition to maintaining community service as a central purpose of the program, H.R. 5293 requires that not less than 50 percent of hours worked (in the aggregate) by the participants of each grantee shall be in community service employment-based training. This requirement ensures that public agencies and charitable organizations that depend on the assistance of SCSEP participants will continue to receive the support they need.

Further, States and national grantees will be evaluated on the level of community service they provide. H.R. 5293 includes, as a core indicator of performance, hours (in the aggregate) of community service employment-based training pursuant to the requirement that 50 percent of hours worked (in the aggregate) shall be in such positions. By including community service as a core indicator, States may face sanctions for failure to meet expected levels of community service, and national grantees will be evaluated on their level of community service when applying for future grants. The Committee commends the program for successes in community betterment and believes the bill will continue to support these efforts.

IMPORTANCE OF COMPETITION

H.R. 5293 reinforces Congressional intent that full and open competition is the best way to assure the highest quality services to eligible individuals.

Under current law, the Department must hold a competition for SCSEP funds when a State or national grantee fails to meet its performance measures or the responsibility tests established in section 514 of the Act. In addition, the Department may hold a full and open competition before the beginning of a new grant period, or if additional grantees are funded. Current law specifies that the Secretary shall award grants for a period not to exceed three years. The Department first conducted a competition in November 2002 to award national grants starting in program year 2003. The Department's authority to conduct these grant competitions was upheld in U.S. District Court (Experience Works v. Elaine Chao, 2003). Judge Gladys Kessler wrote:

While it is clear that Congress intended to make grantees more accountable for the manner in which they carried out their programs, there is absolutely nothing in the statute which precludes the Secretary from using a national competition to decide under the appropriate criteria set forth in Section 30561, who is the best qualified to receive program year 2003 grants. The use of competitive procedures is a time-honored method for obtaining the most highly qualified awardees of government funds, for allowing new and innovative ideas and organizations to receive those funds, and for assuring public confidence in the integrity of the process to distribute government funds.

The Department published a Solicitation for Grant Application (SGA) on March 2, 2006 for grants beginning in program year 2006.

The Committee supports competition for the selection of national grantees, and the bill eliminates sanctions for national grantees in favor of competition. Current requirements to compete the funds of national grantees that fail to meet performance would be replaced with a requirement that all grants be competed every three years. However, the Committee does not intend to diminish the importance of attaining expected levels of performance, as they are indicators of grantees' ability to assist eligible individuals. Therefore, H.R. 5293 includes the applicant's prior performance, if any, in meeting performance measures under this title and under other Federal or State programs as one of the criterion upon which competitive selection shall be based. Including consideration of past performance should help ensure selection of the highest quality providers.

The Committee also notes that H.R. 5293 maintains authority for the Secretary to provide for the State to conduct a competition to award 25 percent of a State's SCSEP grant after two consecutive years of failure to meet performance measures. In addition, the Secretary shall require a competition to award all of the funds allocated to a State after three years of consecutive failure to meet its expected levels of performance. (The Secretary shall provide technical assistance and require the development of a corrective action plan for the first year States fail to achieve performance measures and for each year a national grantee fails to achieve its performance targets.)

The Committee acknowledges that States face sanctions while national grantees do not. However, States receive funds annually based on formula and are not subject to competition for funds upfront. Therefore, States appropriately should face sanctions and possible requirements to compete funds for failure to perform.

PERFORMANCE INDICATORS

The Committee recognizes that the Department has instituted common outcome measures across employment and training programs. H.R. 5293 holds States and national grantees accountable for these three core measures: (1) entry into unsubsidized employment; (2) retention in unsubsidized employment for six months; and (3) earnings. The Committee believes use of these common measures will allow easier comparisons across employment and training programs for purposes of program evaluation. In addition, using common measures simplifies efforts to coordinate employment and training programs at the State and local level. This may ease coordination with Workforce Investment Act (WIA) services, in particular, to help improve services to older workers.

As previously described, the Committee also has included hours (in the aggregate) of community service employment-based training as a core indicator of performance. The Committee believes that including community service provided as a measure on which possible sanctions and evaluation for purposes of competition will be based appropriately reinforces community service as a purpose of the program.

States and national grantees also report to the Secretary on additional indicators, which include retention in unsubsidized employment for one year, the number of eligible individuals served, and any other indicators the Secretary determines to be appropriate to evaluate the program. Data on the number of individuals served shall include the number of participating individuals with barriers to employment, including those over 65 years of age. Although sanctions are not tied to these indicators, Congress, the Department, and the public will have access to this information to determine whether those most in need are receiving services.

States and national grantees negotiate their expected level of performance with the Department. Expected levels of performance also may be adjusted based on changes in the following factors: high rates of unemployment or of poverty or welfare participation in the areas served by a grantee relative to other areas of the State or nation; significant downturns in the areas served by the grantee or in the national economy; significant number or proportions of participants with one or more barriers to employment served by a grantee relative to grantees serving other areas of the State of Nation; and changes in Federal, State or local minimum wage requirements. For purposes of developing or adjusting levels of performance, barriers to employment include (but are not limited to) having a disability, having limited English proficiency or low literacy skills, residing in a rural area, being a veteran, having low employment prospects, or having failed to find employment after utilizing services provided under title I of the Workforce Investment Act of 1998. The Committee recognizes the unique challenges of placing individuals who reside in remote areas and believes that `low employment prospects' includes geographically isolated areas with the availability of public transportation limited or nonexistent.

Inclusion of adjustment factors allows the expected levels of performance to reflect accurately the population each grantee is to serve, which helps to ensure that the grantee has no disincentive to serve those most in need.

ELIGIBILITY

Current law allows services to be provided to individuals 55 years of age or older who have a low income (including those with incomes not more than 125 percent of the federal poverty guidelines). In addition, current law includes a priority for those individuals over 60 years of age.

The Committee believes that the one-stop delivery system created under the WIA should serve individuals between the ages of 55 and 64, since such individuals have not yet reached the traditional age of retirement. The one-stop delivery system is intended to be a universal system available to all job seekers. The SCSEP program is a mandatory partner in the one-stop delivery system and makes services available through the job centers. However, the Committee recognizes that many older individuals have unique barriers to employment and may need more specialized services than WIA provides.

Therefore, H.R. 5293 continues to allow low-income individuals 55 years of age or older to be eligible for SCSEP, but the bill creates a new priority of service for older individuals or those with barriers to employment. Under the bill, an individual who is 65 years of age or older, has a disability, has limited English proficiency, resides in a rural area, is a veteran, has low employment prospects, or has failed to find employment after utilizing services provided under title I of WIA shall have priority for the work opportunities provided under the program. The Committee aims to ensure that the program serves those most in need of SCSEP's intensive services.

The Committee has clarified that certain sources of unearned income shall not be counted when determining whether an individual meets the low-income threshold of 125 percent of poverty. States and grantees shall exclude any income that is unemployment compensation, Supplemental Security Income (SSI) benefits received under Title XVI of the Social Security Act, or veterans' payments and 25 percent of benefits received under title II of the Social Security Act (Old-Age, Survivors and Disability Insurance [OASDI] payments). This change restores prior operating practice that was in place before 2004 and allows additional low-income seniors to be eligible to participate in the program.

The Committee also aims to ensure that an individual's income is accurately counted. The Department issued guidance in January 2005 that requires grantees to annualize an applicant's income based upon the six months prior to application. Under current practice, annualizing six months of income could distort income for those who only had earnings during that six-month period (such as older individuals who work during the planting and harvesting seasons but are unemployed for the remainder of the year). Basing income determination on individual's six-month income annualized makes many seasonal workers ineligible for SCSEP or can have the unintended consequence of including some individuals who would not otherwise be eligible for the program if a 12-month period was applied.

Allowing grantees the flexibility to use either six months or 12 months of actual income would negate these unintended consequences and promote more accurate eligibility determinations. Therefore, H.R. 5293 provides State and national grantees operating SCSEP the flexibility to use either the income for the 12 months preceding an individual's application or an individual's income for the six months preceding one's application when determining eligibility. Providing grantees with this flexibility when determining income eligibility returns the program to operating practice prior to the January 2005 guidance.

The bill also clarifies who is an unemployed individual for purposes of participating in the program. Under current law, and the bill, the program serves unemployed low-income individuals who have low employment prospects. The Department properly has interpreted this to mean an individual currently must not have any earned income. SCSEP resources are limited, and the Committee is committed to serving those most in need. Therefore, the program is intended for individuals without any employment. WIA services are available through the one-stop delivery system to serve those individuals who have part-time employment and are therefore not eligible for SCSEP.

However, the Committee believes and H.R. 5293 specifies that occasional employment that does not result in a constant source of income should not disqualify an individual from participating in SCSEP if he or she meets other eligibility criteria. As a result, occasional income from sources such as babysitting, mowing lawns for cash, or picking fruits and vegetables at harvest time, does not need to preclude eligibility for SCSEP.

LIMITING FRINGE BENEFITS

H.R. 5293 eliminates fringe benefits for participants. Current law allows grantees to offer annual leave, sick leave, paid holidays, health insurance, social security, physical examinations, and any other fringe benefits approved in the grant agreement. The bill also allows grantees to use funds to pay for benefits required by law, such as workers' compensation accident insurance; the costs of physical examinations; compensation for scheduled work hours during which an employer is closed for a Federal holiday; and necessary sick leave that is not part of an accumulated sick leave program. However, the bill prohibits funds from being used to pay the cost of annual leave, accumulated sick leave, or bonuses. Grantees already have limited these benefits. For example, only four of 13 grantees provide annual leave.

In addition, the bill specifies that no program funds may be used to pay the cost of pension benefits. Some grantees have expressed concerns that pension law allows SCSEP participants to participate in their pension programs.

The Committee believes that providing participants with the benefits now excluded or a pension would serve as a disincentive to obtain unsubsidized employment and is not appropriate for a time-limited assistance program. In addition, the program funds do not provide for payment toward pension programs or other fringe benefits and providing such benefits would reduce the amount of funds available to serve additional participants.

REFERENCES

Institute of Medicine. The Role of Nutrition in Maintaining the Health of the Nation's Elderly. Food and Nutrition Board. National Academies Press, Washington, DC. 2000.

American Cancer Society. Diet, Physical Activity and Cancer . . . What's the Connection? Byers, Tim, MD and Colleen Doyle, MS, RD. www.cancer.org.

Mayo Clinic. Early On-set of Alzheimer's: An interview with a Mayo Clinic specialist. www.mayoclinic.com/health/alzheimers/AZO009. 2005.

National Research Council. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Bonnie, Richard J. and Robert B. Wallace, eds. Committee on National Statistics and Committee on Law and Justice, Division of Behavioral and Social Sciences and Education. National Academies Press, Washington, DC. 2003.

SECTION-BY-SECTION ANALYSIS

Section 1. Short Title; Table of Contents. Cites the short title as the `Senior Independence Act of 2006' and includes the table of contents.

Section 2. Definitions. Amends Section 102 of the Older Americans Act (42 U.S.C. 3002). Modifies and adds to the definitions under this act, including definitions of `assistive device, assistive technology, and assistive technology service', amends paragraph (12)(D) to include evidence-based health promotion programs, including programs related to prevention of chronic disease, `exploitation', `neglect', `Aging and Disability Resource Center', `at risk for institutional placement', `elder justice', `Hispanic serving institution', `long-term care', multivitamin-mineral supplement', `self-directed care', `self-neglect', `State system of long-term care'.

Section 3. Establishment of Administration on Aging. Amends Section 201 of the Older Americans Act (42 U.S.C. 3011). Includes elder abuse prevention and services as a responsibility of the Administration on Aging.

Section 4. Functions of the Assistant Secretary. Amends Section 202 of the Older Americans Act (42 U.S.C. 3012). Modifies and adds to the functions of the Assistant Secretary, including language to provide for the increased use of assistive technology, coordination with the Centers for Medicare & Medicaid and other federal entities to assist in benefit enrollment and outreach, strengthen coordination on the Federal, State, and local levels for providing long-term care in home and community-based settings.

Section 5. Federal Agency Consultation. Amends Section 203(a)(3)(A) of the Older Americans Act (42 U.S.C. 3013(a)(3)(A)). Adds language to support individuals with limited English proficiency.

Section 6. Administration. Amends Section 205 of the Older Americans Act (42 U.S.C. 3016). Adds language to strengthen the design, implementation, and evaluation of evidence-based programs to support improved nutrition and regular physical activity.

Section 7. Evaluation. Amends Section 206(g) of the Older Americans Act (42 U.S.C. 3017(g)). Modifies the total amount appropriated for each fiscal year to carry out title III to use such sums, but not to exceed 1/2 of 1 percent of such amount, for purposes of conducting evaluations under this section, either directly or through grants or contracts.

Section 8. Reports. Amends Section 207(b)(2) of the Older Americans Act (42 U.S.C. 3018(b)(2)) to revise the names of House and Senate Committee of jurisdiction.

Section 9. Contractual, Commercial and Private Pay Relationships; Appropriate Use of Act Funds. Amends Section 212 of the Older Americans Act (42 U.S.C. 3020c) to expand services and allow for private pay opportunities while maintaining safeguards that the aging network providers operate in a manner consistent with the public purpose mission and targeting provision of the Older Americans Act.

Section 10. Nutrition Education. Amends Section 214 of the Older Americans Act (42 U.S.C. 3020e) to require the Assistant Secretary to provide outreach and technical assistance to promote health and prevent disease through improved nutrition.

Section 11. Pension Counseling and Information Programs. Amends Section 215 of the Older Americans Act (42 U.S.C. 3020E-1) to expand outreach and improve program access to individuals with limited English proficiency.

Section 12. Authorization of Appropriations. Amends Section 216 of the Older Americans Act (42 U.S.C. 3020F) by striking `2001, 2002, 2003, 2004, and 2005' and inserting `2007, 2008, 2009, 2010, and 2011'.

Section 13. Purpose; Administration. Amends section 301(a)(2) of the Older Americans Act (42 U.S.C. 3021(a)(2)) to support program access for individuals with limited English proficiency; promote financial literacy; and enhance coordination among senior volunteer programs.

Section 14. Authorization of Appropriations; Uses of Funds. Amends Section 303 of the Older Americans Act (42 U.S.C. 3023) by striking `year 2001' and all that follows through `years' each place it appears, and inserting `years 2007, 2008, 2009, 2010, and 2011'.

Section 15. Organization. Amends Section 305(a) of the Older Americans Act (42 U.S.C. 3025a) to improve program access for individuals with limited English proficiency and requires States to develop and implement a comprehensive, coordinated system for providing long-term care in home- and community-based settings.

Section 16. Area Plans. Amends Section 306 of the Older Americans Act (42 U.S.C. 3026) to improve program access for individuals with limited English proficiency; updates area plan requirements for area agencies on aging to develop and implement a comprehensive coordinated system for providing long-term care in home and community-based settings. Adds mental health services to the list of services that may be accessed. Also authorizes area agencies on aging to conduct an assessment of anticipated change in the number of older individuals and encourages AAA's, in cooperation with public agencies, to support community planning efforts to prepare for an increased number of older Americans.

Section 17. State Plans. Amends Section 307(a) of the Older Americans Act (42 U.S.C. 3027(a)) to improve program access for individuals with limited English proficiency and require States to provide assurances that area agencies on aging will furnish services consistent with self-directed care as well as to prepare for the increased number of older individuals.

Section 18. Payments. Amends Section 309(b)(2) of the Older Americans Act (42 U.S.C. 3029(b)(2)) to update payments to States.

Section 19. Nutrition Services Incentive Program. Amends Section 311 of the Older Americans Act (42 U.S.C. 3030a) to authorize a cash only program to purchase food through school food authorities.

Section 20. Consumer Contributions. Amends Section 315 of the Older Americans Act (42 U.S.C. 3030c-2) to encourage voluntary contributions for individuals with self-declared income at or above 125 percent of poverty and improves program access for individuals with limited English proficiency.

Section 21. Supportive Services and Senior Centers Program. Amends Section 321(a) of the Older Americans Act (42 U.S.C. 3030d(a)) to include mental health screenings in the types of screenings provided to detect or prevent illness. Also includes assistive technology devices and services as types of services to be provided for older adults.

Section 22. Nutrition Service. Amends the heading of part C of title III of the Older Americans Act (42 U.S.C. 3030e-3030g-22) to add a purpose to describe activities under Part C of title III.

Section 23. Congregate Nutrition Program. Amends Section 331 of the Older Americans Act (42 U.S.C. 3030e) to encourage nutrition education and counseling and provides local meal providers the option to provide a single multivitamin-mineral supplement to older individuals as an addition to a meal.

Section 24. Home Delivered Nutrition Services. Amends Section 336 of the Older Americans Act (42 U.S.C. 3030f) to expand the type of meal to be delivered to include fresh and supplemental foods and to encourage nutrition education and counseling.

Section 25. Criteria. Amends Section 337 of the Older Americans Act (42 U.S.C. 3030g) to update the professions of people qualified to consult on the minimum criteria of efficiency and quality for the furnishing of home delivered meal services.

Section 26. Nutrition. Amends Section 339 of the Older Americans Act (42 U.S.C. 3030g-21) to update the nutrition program requirements consistent with current science in addition to encourage professionals who distribute nutrition assistance to provide information to homebound seniors on how to obtain a flu shot in their area.

Section 27. Evaluation of Nutrition Projects. Authorizes a study by the Food and Nutrition Board of the Institute of Medicine to conduct and evidence-based evaluation of the nutrition projects authorized in the Older Americans Act.

Section 28. Improving Indoor Air Quality in Building Where Seniors Congregate. Amends Section 361 of the Older Americans Act (42 U.S.C. 3030m) to work with qualified experts to provide information on methods of improving indoor air quality in buildings where seniors congregate.

Section 29. Caregiver Support Program Definitions. Amends Section 372 of the National Family Support Caregiver Act (42 U.S.C. 3030s) to add an individual with a disability to the definition of child, add individuals with Alzheimer's disease or a related neurological disorder to the type of individuals being cared for by a family caregiver, and by striking `60' and inserting `55' as the qualifying age for a grandparent who is caring for a child.

Section 30. Caregiver Support Program. Amends Section 373 of the National Family Support Caregiver Act (42 U.S.C. 3030s-1) to strengthen assistance available to caregivers and encourage the use of volunteers to care for older individuals. Also, the authorization date is updated through 2011.

Section 31. Activities of National Significance. Amends Section 376(a) of the National Family Support Caregiver Act (42 U.S.C. 3030s-12(a)) to encourage research and demonstrations to support intergenerational programs, families who have a child with a disability, programs unique to rural areas, Alzheimer's programs, and family caregiver support programs.

Section 32. Title IV Grant Programs. Amends Section 411 of the Older Americans Act (42 U.S.C. 3032) to authorize additional uses of funds to support activities to prepare for the aging of the population, and to develop and assess technology-based service models and best practices. Also updates authorization year through 2011.

Section 33. Career Preparation for the Field of Aging. Amends Section 412(a) of the Older Americans Act (42 U.S.C. 3032a(a)) to include grants to Hispanic serving institutions and Hispanic Centers of Excellence in Applied Gerontology to educate and train students for a career in the field of aging.

Section 34. Health Care Service Demonstration Projects in Rural Areas. Amends Section 414 of the Older Americans Act (42 U.S.C. 3032d) to include mental health in the types of service projects that may be funded and the types of graduate programs that are eligible to receive such grant.

Section 35. Demonstration Projects for Multigenerational Activities. Amends Section 417(c)(2) of the Older Americans Act (42 U.S.C. 3032f(c)(2)) to improve program access to individuals with limited English proficiency.

Section 36. Native American Programs. Amends Section 418(a)(2)(B)(i) of the Older Americans Act (42 U.S.C. 3032g(a)(2)(B)(i) to add mental health to the list of areas of concern for the Resource Center on Native American Elders.

Section 37. Responsibilities of Assistant Secretary. Amends Section 432(c)(2)(B) of the Older Americans Act (42 U.S.C. 3033a(c)(2)(B) to authorize the Assistant Secretary to include in its evaluation the effect of such improvements in the yearly report.

Section 38. Community Service Employment-Based Training for Older Americans. Amends title V of the Older Americans Act (42 U.S.C. 3056 et seq.) to reauthorize the community service employment-based training program for older Americans. Requires grantees to serve those with greatest need; clarifies use of SCSEP funds; sets an average time limit for participation; and phases in a requirement to place a greater percentage of exiting participants in unsubsidized employment. Additionally it requires the Department of Labor to exclude certain sources of income for the purpose of determining eligibility for Title V and changes the look-back period for determining an individual's income for purposes of SCSEP eligibility.

Section 39. Native Americans Caregiver Support Program. Amends Section 643 of the Older Americans Act (42 U.S.C. 3057n) by striking `2001' each place it appears and inserting `2007'.

Section 40. Vulnerable Elder Rights Protection Activities. Amends Section 702 of the Older Americans Act (42 U.S.C. 3058a) by striking `2001' each place it appears and inserting `2007'.

Section 41. Native American Organization Provisions. Amends Section 751(d) of the Older Americans Act (42 U.S.C. 3058aa(b)) by striking `2001' and inserting `2007'.

Section 42. Elder Abuse, Neglect, and Exploitation Prevention Amendment. Amends Section 721(b) of the Older Americans Act (42 U.S.C. 3058i(b)) to provide education and outreach to promote financial literacy and prevent identity theft and financial exploitation.

Section 43. Technical Amendments. Amends the Older American Act (42 U.S.C. 2001 et seq.) to include a heading for title IV of the Act.

EXPLANATION OF AMENDMENTS

The provisions of the substitute, as amended, are explained in the descriptive portions of this report.

Insert offset folio 76 here HR493.001

Insert offset folio 77 here HR493.002

Insert offset folio 78 here HR493.003

APPLICATION OF LAW TO THE LEGISLATIVE BRANCH

Section 102(b)(3) of Public Law 104-1 requires a description of the application of this bill to the legislative branch where the bill relates to the terms and conditions of employment or access to public services and accommodations. H.R. 5293 amends the Older Americans Act to authorize appropriations for fiscal years 2007 through 2011.

Legislative branch employees and their families, to the extent that they are otherwise eligible for the benefits provided by this legislation, have equal access to its benefits.

STATEMENT OF OVERSIGHT FINDINGS AND RECOMMENDATIONS OF THE COMMITTEE

In compliance with clause 3(c)(1) of rule XIII and clause 2(b)(1) of rule X of the Rules of the House of Representatives, the Committee's oversight findings and recommendations are reflected in the descriptive portions of this report.

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

In accordance with clause 3(c)(4) of rule XIII of the Rules of the House of Representatives, the Committee's performance goals and objectives are reflected in the descriptive portions of this report.

CONSTITUTIONAL AUTHORITY STATEMENT

Under clause 3(d)(1) of rule XIII of the Rules of the House of Representatives, the Committee must include a statement citing the specific powers granted to Congress to enact the law proposed by H.R. 5293. Article I, Section 8, Clause 18 of the Constitution of the United States grants the Congress the power to enact this law.

FEDERAL ADVISORY COMMITTEE ACT

The Committee finds that the legislation does not establish or authorize the establishment of an advisory committee within the definition of 5 U.S.C. App., Section 5(b).

UNFUNDED MANDATE STATEMENT

Section 423 of the Congressional Budget and Impoundment Control Act (as amended by Section 101(a)(2) of the Unfunded Mandates Reform Act, P.L. 104-4) requires a statement whether the provisions of the reported include unfunded mandates. In compliance with this requirement the Committee has received a letter from the Congressional Budget Office included herein.

COMMITTEE ESTIMATE

Clause 3(d)(2) of rule XIII of the Rules of the House of Representatives requires an estimate and a comparison by the Committee of the costs that would be incurred in carrying out H.R. 5293. However, clause 3(d)(3)(B) of that rule provides that this requirement does not apply when the Committee has included in its report a timely submitted cost estimate of the bill prepared by the Director of the Congressional Budget Office under section 402 of the Congressional Budget Act.

BUDGET AUTHORITY AND CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

With respect to the requirements of clause 3(c)(2) of rule XIII of the Rules of the House of Representatives and section 308(a) of the Congressional Budget Act of 1974 and with respect to requirements of clause (3)(c)(3) of rule XIII of the Rules of the House of Representatives and section 402 of the Congressional Budget Act of 1974, the Committee has received the following cost estimate for H.R. 5293 from the Director of Congressional Budget Office:

U.S. Congress,

Congressional Budget Office,

Washington, DC, June 2, 2006.

Hon. HOWARD P. `BUCK' MCKEON,
Chairman, Committee on Education and the Workforce,
House of Representatives, Washington, DC.

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 5293, the Senior Independence Act of 2006.

If you wish further details on this estimate, we will be pleased to provide them. The CBO staff contact is Christina Hawley Anthony.

Sincerely,

Donald B. Marron,

Acting Director.

Enclosure.

H.R. 5293--Senior Independence Act of 2006

Summary: H.R. 5293 would reauthorize programs under the Older Americans Act of 1965, which provides funding for services such as home and community-based supportive services, congregate and home-delivered meals, family caregiver support, and other services for the elderly. Authorizations for most of those programs expired at the end of fiscal year 2005, although a few of those programs are permanently authorized. Appropriations for the programs covered by this bill totaled $1.8 billion in fiscal year 2006. CBO estimates that H.R. 5293 would increase authorizations by $1.7 billion in 2007 and by $8.8 billion from 2007 to 2011. Appropriation of those amounts would result in $7.3 billion of discretionary spending over the next five years (in addition to amounts spent under current law).

H.R. 5293 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA); any costs to state, local, or tribal governments would be incurred voluntarily.

Estimated cost to the Federal Government: The estimated budgetary impact of H.R. 5293 is shown in the following table. The costs of this legislation fall within budget function 500 (education, training, employment and social services). 



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                                  By fiscal year, in millions of dollars--                               


                                                                      2006  2007  2008  2009  2010  2011 


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SPENDING SUBJECT TO APPROPRIATION                                                                        


Spending Under Current Law:                                                                              


Budget Authority 1                                                   1,795    92    94    95    97    99 


Estimated Outlays                                                    1,810   908   155   101    96    98 


Proposed Changes:                                                                                        


Estimated Authorization Level                                            0 1,688 1,720 1,751 1,783 1,814 


Estimated Outlays                                                        0   877 1,164 1,722 1,760 1,791 


Spending Under H.R. 5293:                                                                                


Estimated Authorization Level 1                                      1,795 1,780 1,813 1,846 1,880 1,913 


Estimated Outlays                                                    1,810 1,784 1,796 1,823 1,856 1,889 


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Basis of estimate: H.R. 5293 would reauthorize programs established under the Older Americans Act of 1965. Through those programs, the Department of Health and Human Services and the Department of Labor provide grants to states and other eligible entities that provide services such as home-delivered meals, subsidized employment and training opportunities, and services to prevent abuse and neglect of older individuals. The authorizations for many of those programs expired at the end of fiscal year 2005. However, those programs received appropriations for fiscal year 2006 totaling $1.8 billion.

The bill would reauthorize most of the programs at `such sums as may be necessary' for fiscal years 2007 through 2011. In those instances, CBO estimated the authorization levels by adjusting the 2006 appropriation levels for anticipated inflation. Those programs, along with their fiscal year 2006 appropriation levels, are listed below.



[Dollars in millions]

Program
2006 Appropriation


Home and Community-Based Supportive Services
$351


Congregate Nutrition Services
385


Home-Delivered Nutrition Services
182


Nutrition Services Incentive Program
148


Preventive Health Services
21


Program Administration
18


Community Service Employment
432




Based on the above amounts appropriated for fiscal year 2006 (which total a little more than $1.5 billion), CBO estimates authorization levels for those programs to total about $1.6 billion in fiscal year 2007, and $8.1 billion over the 2007-2011 period.

The bill would authorize the appropriation of $125 million for the National Family Caregiver Support program for fiscal year 2007, and such sums as may be necessary for the following four fiscal years. That program received an appropriation of $156 million for fiscal year 2006; its authorization expired at the end of fiscal year 2005.

The Native American Caregiver Support program--which is permanently authorized under current law--received an appropriation of $6 million for 2006. H.R. 5293 would set the authorization level for that program at $5 million for fiscal year 2007 and such sums as may be necessary in following years.

A handful of other programs are permanently authorized under current law: Native American Nutrition and Supportive Services, the Long-Term Care Ombudsman program, grants to prevent elder abuse and neglect, grants for program innovations, and aging network support activities (including pension counseling and eldercare locator services). Appropriations for those programs totaled $84 million in fiscal year 2006. Three of those (Native American Nutrition and Supportive Services, the Long-Term Care Ombudsman program, and grants to prevent elder abuse and neglect) would retain their permanent authorization under H.R. 5293. The others would be authorized at `such sums as may be necessary' for fiscal years 2007 through 2011. Because those programs are permanently authorized, their reauthorization under H.R. 5293 would not represent an increase in authorization levels for fiscal years 2007 through 2011.

Intergovernmental and private-sector impact: H.R. 5293 contains no intergovernmental or private-sector mandates as defined in UMRA. The bill would authorize funds that would benefit state, local, and tribal governments that provide services authorized in the Older Americans Act. Any costs they might incur to comply with grant requirements would be incurred voluntarily.

Estimate prepared by: Federal Costs: Christina Hawley Anthony. Impact on State, Local, and Tribal Governments: Lisa Ramirez-Branum. Impact on the Private Sector: Jennifer Doleac.

Estimate approved by: Peter H. Fontaine, Deputy Assistant Director for Budget Analysis.

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED




OLDER AMERICANS ACT OF 1965


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TITLE I--DECLARATION OF OBJECTIVES; DEFINITIONS


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DEFINITIONS


SEC. 102. For the purposes of this Act--





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TITLE II--ADMINISTRATION ON AGING


ESTABLISHMENT OF ADMINISTRATION ON AGING


SEC. 201. (a) * * *

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FUNCTIONS OF ASSISTANT SECRETARY


SEC. 202. (a) It shall be the duty and function of the Administration to--



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 [Struck out->][ (b) In order to strengthen the involvement of the Administration in the development of policy alternatives in long-term care and to insure that the development of community alternatives is given priority attention, the Assistant Secretary shall-- ][<-Struck out]









  [Struck out->][ (c) In executing the duties and functions of the Administration under this Act and carrying out the programs and activities provided for by this Act, the Assistant Secretary, in consultation with the Corporation for National and Community Service, shall take all possible steps to encourage and permit voluntary groups active in supportive services, including youth organizations active at the high school or college levels, to participate and be involved individually or through representative groups in such programs or activities to the maximum extent feasible, through the performance of advisory or consultative functions, and in other appropriate ways. ][<-Struck out]



























































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FEDERAL AGENCY CONSULTATION


SEC. 203. (a)(1) * * *

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(b) For the purposes of subsection (a), programs related to the objectives of this Act shall include--



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ADMINISTRATION OF THE ACT


SEC. 205. (a)(1) In carrying out the objectives of this Act, the Assistant Secretary is authorized to--

















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EVALUATION


SEC. 206. (a) * * *

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REPORTS


SEC. 207. (a) * * *

(b)(1) * * *

(2) The Assistant Secretary shall submit the report required by paragraph (1) to--







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 [Struck out->][ CONTRACTING AND GRANT AUTHORITY ][<-Struck out]


 [Struck out->][ SEC. 212. None of the provisions of this Act shall be construed to prevent a recipient of a grant or a contract from entering into an agreement, subject to the approval of the State agency (or in the case of a grantee under title VI, subject to the recommendation of the Director of the Office for American Indian, Alaskan Native, and Native Hawaiian Aging and the approval of the Assistant Secretary), with a profitmaking organization to carry out the provisions of this Act and of the appropriate State plan. ][<-Struck out]

SEC. 212. CONTRACTING AND GRANT AUTHORITY; PRIVATE PAY RELATIONSHIPS; APPROPRIATE USE OF FUNDS.




















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 [Struck out->][ SEC. 214. NUTRITION EDUCATION. ][<-Struck out]




SEC. 214. NUTRITION EDUCATION.




SEC. 215. PENSION COUNSELING AND INFORMATION PROGRAMS.




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SEC. 216. AUTHORIZATION OF APPROPRIATIONS.








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TITLE III--GRANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING


PART A--GENERAL PROVISIONS


PURPOSE; ADMINISTRATION


SEC. 301. (a)(1) * * *





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* * * * * * *

AUTHORIZATION OF APPROPRIATIONS; USES OF FUNDS


SEC. 303. (a)(1) There are authorized to be appropriated to carry out part B (relating to supportive services) such sums as may be necessary for fiscal  [Struck out->][ year 2001, and such sums as may be necessary for each of the 4 succeeding fiscal years ][<-Struck out]  years 2007, 2008, 2009, 2010, and 2011.

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ORGANIZATION


SEC. 305. (a) In order for a State to be eligible to participate in programs of grants to States from allotments under this title--





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AREA PLANS


SEC. 306. (a) Each area agency on aging designated under section 305(a)(2)(A) shall, in order to be approved by the State agency, prepare and develop an area plan for a planning and service area for a two-, three-, or four-year period determined by the State agency, with such annual adjustments as may be necessary. Each such plan shall be based upon a uniform format for area plans within the State prepared in accordance with section 307(a)(1). Each such plan shall--







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 [Struck out->][ (b) ][<-Struck out]  (c) Each State, in approving area agency on aging plans under this section, shall waive the requirement described in paragraph (2) of subsection (a) for any category of services described in such paragraph if the area agency on aging demonstrates to the State agency that services being furnished for such category in the area are sufficient to meet the need for such services in such area and had conducted a timely public hearing upon request.

 [Struck out->][ (c) ][<-Struck out]  (d)(1) * * *

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 [Struck out->][ (d) ][<-Struck out]  (e) An area agency on aging may not require any provider of legal assistance under this title to reveal any information that is protected by the attorney-client privilege.

 [Struck out->][ (e) ][<-Struck out]  (f)(1) * * *

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STATE PLANS


SEC. 307. (a) Except as provided in the succeeding sentence and section 309(a), each State, in order to be eligible for grants from its allotment under this title for any fiscal year, shall submit to the Assistant Secretary a State plan for a two-, three-, or four-year period determined by the State agency, with such annual revisions as are necessary, which meets such criteria as the Assistant Secretary may by regulation prescribe. If the Assistant Secretary determines, in the discretion of the Assistant Secretary, that a State failed in 2 successive years to comply with the requirements under this title, then the State shall submit to the Assistant Secretary a State plan for a 1-year period that meets such criteria, for subsequent years until the Assistant Secretary determines that the State is in compliance with such requirements. Each such plan shall comply with all of the following requirements:



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PAYMENTS


SEC. 309. (a) * * *

(b)(1) * * *

(2) Funds required to meet the non-Federal share required by section 304(d)(1)(D), in amounts exceeding  [Struck out->][ the non-Federal share required prior to fiscal year 1981 ][<-Struck out]  10 percent of the cost of the services specified in such section 304(d)(1)(D), shall be from State sources.

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NUTRITION SERVICES INCENTIVE PROGRAM


SEC. 311. (a) * * *



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(2) The Commodities Credit Corporation shall dispose of food commodities (including bonus commodities) under section 416 of the Agricultural Act of 1949 (7 U.S.C. 1431) by donating them to a recipient of a grant or contract to be used for providing nutrition services in accordance with the provisions of this title.

(3) Dairy products (including bonus commodities) purchased by the Secretary of Agriculture under section 709 of the Food and Agriculture Act of 1965 (7 U.S.C. 1446a-1) shall be used to meet the requirements of programs providing nutrition services in accordance with the provisions of this title.

































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SEC. 315. CONSUMER CONTRIBUTIONS.








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PART B--SUPPORTIVE SERVICES AND SENIOR CENTERS


PROGRAM AUTHORIZED


SEC. 321. (a) The Assistant Secretary shall carry out a program for making grants to States under State plans approved under section 307 for any of the following supportive services:



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PART C--NUTRITION SERVICE


SEC. 330. PURPOSE.




SUBPART 1--CONGREGATE NUTRITION SERVICES


PROGRAM AUTHORIZED


SEC. 331. The Assistant Secretary shall carry out a program for making grants to States under State plans approved under section 307 for the establishment and operation of nutrition projects that--











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SUBPART 2--HOME DELIVERED NUTRITION SERVICES


 [Struck out->][ PROGRAM AUTHORIZED ][<-Struck out]


  [Struck out->][ SEC. 336. The Assistant Secretary shall carry out a program for making grants to States under State plans approved under section 307 for the establishment and operation of nutrition projects for older individuals which, 5 or more days a week (except in a rural area where such frequency is not feasible (as defined by the Assistant Secretary by regulation) and a lesser frequency is approved by the State agency), provide at least one home delivered hot, cold, frozen, dried, canned, or supplemental foods (with a satisfactory storage life) meal per day and any additional meals which the recipient of a grant or contract under this subpart may elect to provide. ][<-Struck out]

 [Struck out->][ CRITERIA ][<-Struck out]


 [Struck out->][ SEC. 337. The Assistant Secretary, in consultation with organizations of and for the aged, blind, and disabled, and with representatives from the American Dietetic Association, the Dietary Managers Association, the National Association of Area Agencies on Aging, the National Association of Nutrition and Aging Services Programs, the National Association of Meals Programs, Incorporated, and any other appropriate group, shall develop minimum criteria of efficiency and quality for the furnishing of home delivered meal services for projects described in section 336. The criteria required by this section shall take into account the ability of established home delivered meals programs to continue such services without major alteration in the furnishing of such services. ][<-Struck out]

SEC. 336. PROGRAM AUTHORIZED.








SEC. 337. CRITERIA.




SUBPART 3--GENERAL PROVISIONS


SEC. 339. NUTRITION.




















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PART D--DISEASE PREVENTION AND HEALTH PROMOTION SERVICES


PROGRAM AUTHORIZED


 SEC. 361. (a) * * *

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PART E--NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM


SEC. 371. SHORT TITLE.




Subpart 1--Caregiver Support Program


SEC. 372. DEFINITIONS.












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SEC. 373. PROGRAM AUTHORIZED.








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Subpart 2--National Innovation Programs


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SEC. 376. ACTIVITIES OF NATIONAL SIGNIFICANCE.
















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TITLE IV--ACTIVITIES FOR HEALTH, INDEPENDENCE AND LONGEVITY


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PART A--GRANT PROGRAMS


SEC. 411. PROGRAM AUTHORIZED.






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SEC. 412. CAREER PREPARATION FOR THE FIELD OF AGING.






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SEC. 414. HEALTH CARE SERVICE DEMONSTRATION PROJECTS IN RURAL AREAS.














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SEC. 417. DEMONSTRATION PROJECTS FOR MULTIGENERATIONAL ACTIVITIES.




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SEC. 418. NATIVE AMERICAN PROGRAMS.














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PART B--GENERAL PROVISIONS


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SEC. 432. RESPONSIBILITIES OF ASSISTANT SECRETARY.




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 [Struck out->][ TITLE V--COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS ][<-Struck out]


 [Struck out->][ SEC. 501. SHORT TITLE. ][<-Struck out]




 [Struck out->][ SEC. 502. OLDER AMERICAN COMMUNITY SERVICE EMPLOYMENT PROGRAM. ][<-Struck out]
























































































































































 [Struck out->][ SEC. 503. ADMINISTRATION. ][<-Struck out]


















































































 [Struck out->][ SEC. 504. PARTICIPANTS NOT FEDERAL EMPLOYEES. ][<-Struck out]






 [Struck out->][ SEC. 505. INTERAGENCY COOPERATION. ][<-Struck out]










 [Struck out->][ SEC. 506. DISTRIBUTION OF ASSISTANCE. ][<-Struck out]


















































































 [Struck out->][ SEC. 507. EQUITABLE DISTRIBUTION. ][<-Struck out]






 [Struck out->][ SEC. 508. REPORT. ][<-Struck out]




 [Struck out->][ SEC. 509. EMPLOYMENT ASSISTANCE AND FEDERAL HOUSING AND FOOD STAMP PROGRAMS. ][<-Struck out]




 [Struck out->][ SEC. 510. ELIGIBILITY FOR WORKFORCE INVESTMENT ACTIVITIES. ][<-Struck out]




 [Struck out->][ SEC. 511. TREATMENT OF ASSISTANCE. ][<-Struck out]




 [Struck out->][ SEC. 512. COORDINATION WITH THE WORKFORCE INVESTMENT ACT OF 1998. ][<-Struck out]






 [Struck out->][ SEC. 513. PERFORMANCE. ][<-Struck out]


















































 [Struck out->][ SEC. 514. COMPETITIVE REQUIREMENTS RELATING TO GRANT AWARDS. ][<-Struck out]








































































































 [Struck out->][ SEC. 515. AUTHORIZATION OF APPROPRIATIONS. ][<-Struck out]




















 [Struck out->][ SEC. 516. DEFINITIONS. ][<-Struck out]












TITLE V--COMMUNITY SERVICE EMPLOYMENT-BASED TRAINING FOR OLDER AMERICANS


SEC. 501. SHORT TITLE.




SEC. 502. OLDER AMERICAN COMMUNITY SERVICE EMPLOYMENT-BASED TRAINING PROGRAM.
















































































































































































SEC. 503. ADMINISTRATION.