Dementia Friend Information Session

Modernization of the Older Americans Act Amendments

Modernization of the Older Americans Act Amendments





Reauthorizes Older Americans Act of 1965 Title II programs.


Sec.102.Aging and Disability Resource Centers.

Encourages Aging and Disability Resource Centers to collaborate with Centers for Independent

Living and other aging or disability entities.


Sec.103.Assistive technology.

Modernizes the Older Americans Act to ensure programs consider and coordinate with State

assistive technology programs authorized by the Assistive Technology Act of 1998.


Sec.104.National Resource Center for Women and Retirement.

Codifies the National Resource Center for Women and Retirement. The Center provides basic

financial management, retirement planning and other educational tools that promote financial literacy and help identify and prevent fraud and elder exploitation for women.


Sec.105.Evidence-based program adaptation.

Requires the Assistant Secretary for Aging to provide technical assistance on how to deliver

evidence-based disease prevention and health promotion programs for different populations in a variety of different settings, such as in local communities and rural areas.


Sec.106.Coordination with Assistant Secretary for Mental Health and Substance Use and Director of the Centers for Disease Control and Prevention.

Requires the Assistant Secretary for Aging to coordinate with the Assistant Secretary for Mental

Health and Substance Use and the Director of the Centers for Disease Control and Prevention in implementing suicide prevention activities for older individuals.


Sec.107.Modernizing the Interagency Coordinating Committee on Healthy Aging and Age- Friendly Communities.

Modernizes the existing Interagency Coordinating Committee on healthy aging and includes

supporting age-friendly communities as part of the activities and recommendations of the Committee.


Sec.108.Report on social isolation.

Requires the Assistant Secretary for Aging to review existing programs under the Older

Americans Act to determine if and how such programs are adequately addressing greatest social need and make recommendations on ways to improve how programs address negative impacts associated with social isolation for older individuals.


Sec.109.Business partnerships.

Clarifies grantees ability to engage in business partnerships with private entities, and, at the


request of grantees, directs the Assistant Secretary for Aging to provide technical assistance for developing and establishing business partnerships.


Sec.110.Notification of availability of or updates to policies, practices, and procedures through a uniform e-format.

Requires the Assistant Secretary for Aging to regularly update State agencies, area agencies on

aging, and service providers on the availability of, or updates to, policies, practices and procedures through electronic format.


Sec.111.Family caregivers.

Extends the authorization for the RAISE Family Caregivers Act from 3 years to 8 years.


Sec.112.Innovation, demonstration, and evaluation within aging programs.

Modernizes the evaluation of the Older Americans Act programs. Ensures the Secretary reviews,

coordinates, and streamlines the evaluation of existing Older Americans Act programs to assess the impact of the existing programs on older individuals’ or caregivers’ health and on health care spending. Ensures the Secretary will also measure future demonstration projects’ impact on reducing health care spending and their ability to maintain or improve quality of care. Requires the Secretary to prepare and submit to Congress a 5 year evaluation plan of all the Older Americans Act programs by December 1, 2020 and every fifth year thereafter. This section also renames Title IV of the Older Americans Act to Innovation, Demonstration, and Evaluation Within Aging Programs.





Reauthorizes Older Americans Act of 1965 Title III programs.


[Sec.202.Hold harmless.]


Sec.203.Maintenance of effort for State Long-Term Care Ombudsman program. Updates the maintenance of effort funding provisions for State Long-Term Care Ombudsman program.


Sec.204.Senior legal hotlines.

Recognizes the practice of statewide senior legal hotlines for purposes of supporting and

providing legal assistance for older individuals and requires the Assistant Secretary for Aging to submit a report with information on existing statewide senior legal hotlines and recommendations to Congress three years after enactment.


Sec.205.Increase in limit on use of allotted funds for State administrative costs.

Updates the cap for state administrative costs from the 1992 level of $500,000 to $750,000.


Sec.206.Improvements to nutrition programs.

Makes improvements to nutrition programs. Encourages states to work with area agencies on


aging to reduce the administrative burden for transferring funds between nutrition programs for congregate and home-delivered meals. Defines ‘nutrition service provider’ and makes conforming edits.


Sec.207.Younger onset Alzheimer’s disease.

Recognizes and clarifies existing authority to provide services to those with Alzheimer’s disease

at any age.


Sec.208.Cost sharing and Other Practices.

Requires a GAO study on practices regarding contracting, cost-sharing, waivers, and voluntary

contributions for programs authorized under the Older Americans Act, and the impacts of those practices on older individuals’ access to those programs.


Sec.209.Nutrition services study.

Requires the Assistant Secretary for Aging to review existing policies and practices for

measuring the number of meals provided under the programs and the number of meals in demand, and make recommendations on the most successful ways of capturing this data.


Sec.210.National Family Caregiver Support program.

Makes improvements to the National Family Caregiver Support program. Defines ‘caregiver

assessment,’ and updates the support services to ensure that these services take into consideration information received from such assessments. Removes the ten percent funding cap for older relative caregivers. Requires the Assistant Secretary for Aging to identify best practices for caregiver assessments. Allows the Secretary of Health and Human Services to award funds for activities of national significance that improve support provided to caregivers, including for program evaluation, training, technical assistance, and research. Requires the Assistant Secretary for Aging to provide technical assistance on how to promote and implement caregiver assessments. Requires the Assistant Secretary for Aging to report to Congress on the use of caregiver assessments, how to improve them, and how to further their use.





Reauthorizes Older Americans Act of 1965 Title IV and Title V programs.


Sec.302.Technical assistance and innovation to improve transportation for older individuals.

Modernizes and improves an existing transportation grant program to enhance the aggregation,

availability, and accessibility of information on options for transportation services for older individuals, including through contemporary forms of transportation and technology such as on- demand transportation services.


Sec.303.Grant program for multigenerational collaboration.

Improves an existing grant program for multigenerational collaboration to place an emphasis on

grant funding for the direct services of these projects, including projects that locate programs for


older and younger individuals in the same facility.


Sec.304.Grants for health, independence, and longevity.

Allows grantees to use funds under section 411 for planning the placement of volunteers in

communities to assist family caregivers, older individuals, and individuals with disabilities in maintaining independence by providing non-medical care.





[Committee plans to review Title VI programs and provide language for updating and enhancing these programs.]



Reauthorizes Older Americans Act of 1965 Title VI programs.




Sec.501.Reauthorization; vulnerable elder rights protection activities.

Reauthorizes Older Americans Act of 1965 Title VII programs.


Sec.502.Minimum allotments for ombudsman and elder abuse programs.

Modernizes the minimum funding allotments for the ombudsman and elder abuse programs by

changing years from “2000” to “2019.”


Sec.503.Volunteer State long-term care ombudsman representatives.

Clarifies that volunteer ombudsman representatives can be reimbursed for costs incurred through

their service, such as transportation costs.


Sec.504.Prevention of elder abuse, neglect, and exploitation.

Updates elder justice activities to include community outreach and education as part of the

multidisciplinary efforts. Ensures innovative projects capture programs and materials for developing partnerships in communities.


Sec.505.Best practices for home and community-based ombudsmen.

Updates the best practices for home and community-based ombudsmen.


Sec.506.Senior home modification assistance initiative.

Requires a GAO study on federal programs for home modification assistance for older

individuals and individuals with disabilities.

n4a Responds to Senate Draft OAA Reauthorization Bill

n4a Responds to Senate Draft OAA Reauthorization Bill

June 18, 2019

Earlier this month, the bipartisan working group consisting of members from the Senate Health, Education, Labor and Pensions (HELP) and Aging Committees released a draft bill that would reauthorize the Older Americans Act, Modernization of the Older Americans Act Amendments. As noted in n4a’s June 6 Legislative Update, the working group requested rapid response from advocates to provide feedback and technical assistance on the draft bill. Because the reauthorization process has been moving quickly in the Senate, advocates had an abbreviated timeframe to respond to the bipartisan draft.

n4a was one of many national, state and local stakeholders to submit comments on the draft bill. However, we expect that working group members will thoughtfully consider and incorporate n4a’s member-informed feedback because of the integral role that Area Agencies on Aging and Title VI Native American aging programs serve in deploying OAA services across the country.

While the Senate OAA working group limited the proposals in the draft reauthorization bill to modest changes that could garner bipartisan support, n4a provided comments and technical assistance on nearly all proposals included in the draft with the goal of strengthening the final bill. The Senate has yet to tackle more difficult, and potentially contentious, issues such as specific funding authorization levels and the geographically challenging, population-based federal funding formula for OAA programs (note: n4a does not take positions on funding formula details), so there are still many components of the reauthorization that lawmakers must work through.

n4a’s Response to the Senate’s Draft Bill

n4a supports the working group’s bipartisan, inclusive process and appreciates that left out of the draft were several proposals that we felt strongly would undermine the ability of AAAs and service providers to efficiently and effectively deliver OAA services, including a proposal from the Trump Administration that would eliminate the “right of first refusal” for local governments to serve as AAAs. Simply keeping those harmful proposals out of the bill is a significant advocacy win!

n4a also supports several of the proposals in the working group’s draft as written, including:

  • a simple update to the definition of Aging and Disability Resource Centers;
  • an extension of the authorization for the RAISE Family Caregivers Act, passed in 2018 to develop a national strategy to support family caregivers; and
  • the modernization of technical assistance efforts to improve transportation access for older adults.

While n4a had feedback on many issues outlined in the draft bill, we prioritized our comments to include proposals that were relevant to our OAA reauthorization priorities, as well as those that may have some unintended consequences for the Aging Network. n4a provided feedback on proposals that would:

  • Clarify the ability of AAAs to contract with health care providers and other private payers. n4a is not opposed to the language in the draft, but it does not address the issues that n4a raised in our reauthorization priorities.
  • Mandate that AAAs coordinate with state assistive technology programs, which we believe is beyond the scope of the coordinating and planning roles of AAAs.
  • Add a specific reference in the Act to senior legal hotlines as an authorized component of legal services. n4a is concerned that including this specific reference could be misinterpreted as congressional prioritization of statewide senior legal hotlines.
  • Encourage states to work with AAAs to streamline the transfer process between Title III C home-delivered and congregate nutrition programs. n4a supports the intent of this provision but we believe it isn’t specific enough to be effective.
  • Study and expand the use of caregiver assessments and eliminate the Title III E cap for kinship care. n4a supports the proposal to allow AAAs to use additional III E funding for adults age 55 and older who are raising relative children.
  • Modernize the research, demonstration and evaluation efforts authorized under Title IV of the OAA. We appreciate that the working group prioritized this effort, but are concerned that without additional investments, these activities would be burdensome to AoA.
  • Study both the negative effects of social isolation and the unmet need in Title III C Nutrition Services. n4a supports the intents both studies have, but suggested changes to better reflect the activities of the Aging Network or capture the broader unmet need for all OAA services.

Overall the Senate working group’s draft OAA reauthorization bill requires several studies and reports on various components of service delivery, including the status of caregiver assessment activity, home modification programs for older adults, and cost-sharing activities within the Act.

Next Steps for Aging Advocates

Key staff and Senators will review stakeholder feedback on the draft bill and work with advocates to address issues. Senators will also have to work through potentially controversial issues such as authorization levels and the funding formula over the next few weeks. n4a will update our members as these discussions progress.

On the House side, n4a is having frequent conversations with committee leaders, answering questions and providing initial feedback on preliminary policy ideas, while also educating committee staff on the Act. We expect the House activity to pick up in the next month.

In the meantime, advocates should continue to educate their Members of Congress in both the House and the Senate about the importance of OAA programs and the need to reauthorize. Aging advocates should continue using the advocacy tools and resources available online in n4a’s OAA Reauthorization Toolkit at

This Legislative Update is an n4a membership benefit. For more information about these and other federal aging policy issues, please contact n4a’s policy team: Amy Gotwals ( and Autumn Campbell (, 202.872.0888.

World Elder Abuse Awareness Day

June 15th is designated as World Elder Abuse Awareness Day. This is an opportunity for communities all across the world to come together and promote a better understanding of abuse, neglect, and exploitation of older adults. The focus is to raise awareness of the social, cultural, economic and demographic processes affecting elder abuse. According to the National Center on Elder Abuse, more than one million people age 65 or older in America alone have suffered abuse. It is also estimated that for each case of reported elder abuse, neglect, and exploitation, about five more incidents go unreported.

Elder abuse is the willful infliction of physical pain, injury or mental anguish, unreasonable confinement, or the willful deprivation by a caretaker of services necessary to maintain mental and physical health. Elder abuse takes many forms, including:

  • Neglect or isolation
  • Physical abuse
  • Sexual abuse
  • Financial abuse and exploitation
  • Emotional or psychological abuse including verbal abuse and threats

Elders who have been abused have a 300% higher risk of death when compared to those who have not been mistreated. While likely under-reported, estimates of elder financial abuse and fraud costs to older Americans range from $2.9 billion to $36.5 billion annually. Yet, financial exploitation is self-reported at rates higher than emotional, physical, and sexual abuse or neglect. Warning signs of elder abuse include the following:

  • Physical abuse, neglect, or mistreatment: Bruises, pressure marks, broken bones, abrasions, burns
  • Emotional abuse: Unexplained withdrawal from normal activities, a sudden change in alertness, or unusual depression; strained or tense relationships; frequent arguments between the caregiver and older adult
  • Financial abuse: Sudden changes in financial situations
  • Neglect: Bedsores, unattended medical needs, poor hygiene, unusual weight loss
  • Verbal or emotional abuse: Belittling, threats, or other uses of power and control by individuals

If an older adult is in immediate, life-threatening danger, call 911. Anyone who suspects that an older adult is being mistreated should contact a local  Adult Protective Services office within the Department of Social Services, Long-Term Care Ombudsman, or police.

How can elder abuse be prevented?

Educating seniors, professionals, caregivers, and the public on abuse is critical to prevention. If you’re an older adult, you can stay safe by:

  • Taking care of your health.
  • Seeking professional help for drug, alcohol, and depression concerns and urging family members to get help for these problems.
  • Attending support groups for spouses and learning about domestic violence services.
  • Planning for your own future. With a power of attorney or a living will, you can address health care decisions now to avoid confusion and family problems later. Seek independent advice from someone you trust before signing any documents.
  • Staying active in the community and connected with friends and family. This will decrease social isolation, which has been connected to elder abuse.
  • Posting and opening your own mail.
  • Not giving personal information over the phone.
  • Using direct deposit for all checks.
  • Having your own phone.
  • Reviewing your will periodically.
  • Knowing your rights. If you engage the services of a paid or family caregiver, you have the right to voice your preferences and concerns. If you live in a nursing home, call your Long-Term Care Ombudsman. The ombudsman is your advocate and has the power to intervene.

Regional Elder Abuse Awareness Events and Efforts for 2019:

Carteret County: Digital billboard campaign

Craven County: Newspaper media campaign

Duplin County: Elder Abuse Awareness Walk

Greene County: Elder Abuse Awareness Walk

Jones County: Info distribution at Health Fair

Lenoir County: Elder Abuse Awareness Walk

Onslow County: Elder Abuse Awareness Walk

Pamlico County: Digital billboard campaign

Wayne County: Elder Abuse Awareness Symposium



Division of Water Infrastructure Announces Fall 2019 Application Training at 6 Sites Statewide

Division of Water Infrastructure Announces
Fall 2019 Application Training at Six Sites Statewide

(Sylva, Valdese, Kernersville, Winterville, Pembroke, Research Triangle Park)
The Division of Water Infrastructure in the N.C. Department of Environmental Quality announces
training for the Fall
2019 funding round. Funding offered for the State Revolving Fund and Community Development Block
Grant – Infrastructure programs this round will be announced shortly after July 10. Funding for the
State Reserve Program will be announced pending approval of the state budget and funding
availability. All applications must be received by the Division no later than close of business on
Sept. 30, 2019. Application training for the following funding programs will be offered from July
24 to August 9 at the locations indicated in the chart below.

• State Reserve Program: This program funds both wastewater and drinking water projects as well as
the Asset Inventory and Assessment Grants and Merger / Regionalization Feasibility Grants. Funding
limits for water and wastewater projects as well as the grant programs are as follows:

     o Project Loans and Grants for Water and Wastewater Infrastructure. Funding is available to all
Local Government Units (LGUs) and non-profit water corporations and has grant limits of $3 million
per applicant per project type (water/sewer) over a period of three consecutive fiscal years. Loans
with a targeted interest rate have a limit of $3 million per applicant per project type over a
period of three consecutive fiscal years. Loans at market interest rate have loan limits up to $3
million per applicant per project type per year. Grant percentages of project costs are based upon
affordability criteria.
o Asset Inventory and Assessment Grants. This program funds both wastewater and drinking water
projects. It is available to LGUs and non-profit water corporations and has a limit of $150,000
per applicant per project type (water/sewer) over three consecutive fiscal years. Funds related to
this grant are available to inventory the existing water and/or sewer system and document the
condition of the inventoried infrastructure.
o Merger / Regionalization Feasibility Grants. This program funds both wastewater and drinking
water projects. It is available to LGUs and non-profit water corporations and has a limit of
$50,000 per applicant per project type over three consecutive fiscal years. Funds related to this
grant are available to determine the feasibility of consolidating the management of multiple
utilities into a single utility operation or to provide regional treatment and the best way of
carrying out the consolidation or regionalization.

• Clean Water State Revolving Fund: This program funds wastewater and green projects. It is
available to all LGUs and non-profit water corporations and offers low-interest loans up to $30
million per applicant.

• Drinking Water State Revolving Fund: This program funds drinking water projects. It is
available to all LGUs, non-profit water corporations, and for-profit water corporations and offers
low-interest loans up to $20 million per applicant.

• Community Development Block Grant- Infrastructure: This program funds wastewater and drinking
water projects. It is available to counties and municipalities and offers grants up to $2 million
per applicant every three years.

If you are considering applying for funding related to any of the available programs listed above,
the Division of Water Infrastructure encourages you to attend a training session. If you cannot
attend training, division staff will be available to meet on an individual basis. Application
training will be held during the weeks of July 22 and August 5. Training begins at 10 a.m. and ends
at 4:00 p.m. Application materials will be available on the division website before training begins
at: Please see the chart below for application
training dates and locations.

Division of Water Infrastructure Application Training Sessions Statewide
for Fall 2019 Funding Round

Space is limited at each location. Please RSVP to Jennifer Haynie at
(919.707.9173) at least a week prior to the training event you plan to attend. Please provide your
name, organization, e-mail, phone number, and the location you plan to attend. All training
sessions will begin at 10 a.m. and end at 4 p.m.
Wednesday, July 24, 2019, Sylva, 10 a.m. – 4 p.m. (20 seats available)
Southwestern Commission 125 Bonnie Lane
Sylva, NC 28779

Thursday, July 25, 2019, Valdese, 10 a.m. – 4 p.m. (50 seats available)
Old Rock School (Waldesian Room) 400 Main Street West
Valdese, NC 28690

Friday, July 25, 2019, Kernersville, 10 a.m. – 4 p.m. (40 seats available)
Piedmont Triad Regional Council of Governments 1398 Carrollton Crossing Drive
Kernersville, NC 27284

Monday, Aug. 5, 2019, Winterville, 10 a.m. – 4 p.m. (50 seats available) Pitt County
Community College (G. Henry Leslie Auditorium, Room #143) 2000 Eddie Smith Street
Winterville, NC 28590

Wednesday, Aug. 7, 2019, Pembroke, 10 a.m. – 4 p.m. (30 seats available)
Lumber River Council of Governments 30 C.J. Walker Road
COMtech Park
Pembroke, NC 28372

Friday, Aug. 9, Research Triangle Park, 10 a.m. – 4 p.m. (30 seats available)
Triangle J Council of Governments 4307 Emperor Boulevard, Suite 110
Durham, NC 27703

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