II 116TH CONGRESS 1ST SESSION S. 2179 To amend the Older Americans Act of 1965 to provide social service agencies with the resources to provide services to meet the urgent needs of Holocaust survivors to age in place with dignity, comfort, security, and quality of life. IN THE SENATE OF THE UNITED STATES JULY 18, 2019 Mr. CARDIN (for himself, Mr. CRAMER, and Ms. ROSEN) introduced the fol- lowing bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Older Americans Act of 1965 to provide social service agencies with the resources to provide serv- ices to meet the urgent needs of Holocaust survivors to age in place with dignity, comfort, security, and qual- ity of life. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Trauma-Informed Modernization of Eldercare for Holo- 5 caust Survivors Act’’ or the ‘‘TIME for Holocaust Sur- 6 vivors Act’’. 7 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 2 •S 2179 IS (b) TABLE OF CONTENTS.—The table of contents for 1 this Act is as follows: 2 Sec. 1. Short title. Sec. 2. Findings. Sec. 3. Purposes. TITLE I—RESPONDING TO THE NEEDS OF HOLOCAUST SURVIVORS Subtitle A—Definitions, Grants for State and Community Programs, and Other Programs Sec. 101. Definitions. Sec. 102. Organization. Sec. 103. Area plans. Sec. 104. State plans. Sec. 105. Consumer contributions. Sec. 106. National Family Caregiver Support Program authorized. Sec. 107. Prevention of elder abuse, neglect, and exploitation. Subtitle B—Functions Within Administration for Community Living To Assist Holocaust Survivors Sec. 111. Designation of individual within the Administration. Sec. 112. Annual report to Congress. Sec. 113. National Resource Center for Older Individuals Experiencing the Long-Term and Adverse Consequences of Trauma. Sec. 114. Definitions. TITLE II—NUTRITION SERVICES FOR OLDER INDIVIDUALS Sec. 201. Nutrition services. TITLE III—TRANSPORTATION Sec. 301. Transportation services and resources. SEC. 2. FINDINGS. 3 Congress finds the following: 4 (1) During the Holocaust, which took place 5 from 1933 through 1945, an estimated 6,000,000 6 Jews, as well as millions of victims from other tar- 7 geted groups, were murdered by the Nazis and their 8 collaborators. 9 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 3 •S 2179 IS (2) More than 200,000 Jews fleeing from Nazi- 1 occupied territory found refuge in the United States 2 from 1933 through 1945, and approximately 3 137,000 additional Jewish refugees settled in the 4 United States from 1945 through 1952. 5 (3) Hundreds of thousands of additional Jewish 6 refugees continued to immigrate to the United 7 States from Europe and countries of the former So- 8 viet Union during the subsequent decades. 9 (4) The number of Holocaust survivors living in 10 the United States at the end of 2018 was approxi- 11 mately 80,000 individuals, down from an estimated 12 127,000 in 2010. 13 (5) Every Holocaust survivor is now at least 74 14 years old, most are in at least their mid-to-late 15 eighties, and many are in their nineties and beyond. 16 (6) One-third of all Holocaust survivors in the 17 United States live at or below the official poverty 18 threshold (as defined by the Bureau of the Census), 19 including more than half of the Holocaust survivors 20 who emigrated from the countries of the former So- 21 viet Union. 22 (7) Holocaust survivors continue to live with 23 the unique mental and physical scars of the uncon- 24 scionable trauma caused by the Holocaust, and while 25 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 4 •S 2179 IS institutionalized settings are beneficial for some, cer- 1 tain aspects of institutionalization may have particu- 2 larly adverse effects on Holocaust survivors. 3 (8) For many Holocaust survivors, institutional- 4 ized settings produce sights, sounds, smells, emo- 5 tions, and routines that can induce panic, anxiety, 6 and re-traumatization as a result of experiences 7 from the Holocaust. 8 (9) Holocaust survivors are more economically 9 and socially vulnerable, report poorer health and 10 more health problems, and have greater social serv- 11 ice needs, than other older individuals. 12 (10) In comparison to most other older individ- 13 uals, low-income Holocaust survivors are more reli- 14 ant on social service programs that provide services 15 such as personal care, provision of home-delivered 16 and congregate meals, transportation, counseling, 17 and mental health support to promote health and 18 quality of life. 19 (11) Community organizations serving Holo- 20 caust survivors report that approximately one-quar- 21 ter of Holocaust survivors live alone, and living alone 22 is a risk factor for hospitalization and nursing home 23 admission, poverty, falls, depression, poor nutrition, 24 social isolation, and loneliness, which have been as- 25 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 5 •S 2179 IS sociated with poor health outcomes and an increased 1 risk of death. 2 (12) Community organizations serving Holo- 3 caust survivors report that transportation is vital to 4 help Holocaust survivors attend medical appoint- 5 ments, shop and purchase necessary items, visit 6 family and friends, and participate in cultural, rec- 7 reational, or social events, such as congregate meals 8 or religious services. 9 (13) As the general population of older individ- 10 uals increases in the United States and many public 11 or philanthropic resources remain constant, pro- 12 viders serving Holocaust survivors need additional 13 capacity to cover needed services. 14 (14) The Administration for Community Living 15 in the Department of Health and Human Services 16 serves as the Federal agency responsible for increas- 17 ing access to community supports for, focusing at- 18 tention and resources on the unique needs of, older 19 individuals and individuals with disabilities across 20 their lifespans. 21 (15) The mission of the Administration for 22 Community Living is to maximize the independence, 23 well-being, and health of older individuals, individ- 24 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 6 •S 2179 IS uals with disabilities, and their families and care- 1 givers. 2 (16) The Administration for Community Living 3 in 2017 issued guidance entitled ‘‘ACL Guidance for 4 Outreach and Providing Services for Holocaust Sur- 5 vivors’’ in accordance with a requirement of the 6 Older Americans Act Reauthorization Act of 2016 7 which states that the Assistant Secretary for Aging 8 shall ‘‘issue guidance to States, that shall be applica- 9 ble to States, area agencies on aging, and providers 10 of services for older individuals, with respect to serv- 11 ing Holocaust survivors, including guidance on 12 promising practices for conducting outreach to that 13 population.’’. 14 (17) Many social service agencies that receive 15 funding under the Older Americans Act of 1965 for 16 home-delivered or congregate meals serve diverse 17 seniors, including Holocaust survivors, with special- 18 ized dietary needs based on religious, cultural, or 19 ethnic requirements, and the necessary special meals 20 often cost more than other meals. 21 SEC. 3. PURPOSES. 22 The purposes of this Act are— 23 (1) to include ‘‘older individuals who are Holo- 24 caust survivors’’ in the list of groups that receive 25 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 7 •S 2179 IS preference, as specified in section 305(a)(2)(E) of 1 the Older Americans Act of 1965, for services pro- 2 vided under that Act; 3 (2) to require the designation within the Ad- 4 ministration for Community Living of an individual 5 to have responsibility for the provision of services to 6 older individuals who are Holocaust survivors; 7 (3) to promote technical assistance and training 8 for agencies that serve older individuals experiencing 9 the long-term and adverse consequences of trauma; 10 (4) to ensure that the providers of nutrition 11 services through the Older Americans Act of 1965 12 can meet the special health-related or other dietary 13 needs of program participants; and 14 (5) to help meet the urgent transportation 15 needs of Holocaust survivors. 16 TITLE I—RESPONDING TO THE 17 NEEDS OF HOLOCAUST SUR- 18 VIVORS 19 Subtitle A—Definitions, Grants for 20 State and Community Pro- 21 grams, and Other Programs 22 SEC. 101. DEFINITIONS. 23 Section 102 of the Older Americans Act of 1965 (42 24 U.S.C. 3002) is amended— 25 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 8 •S 2179 IS (1) in paragraph (24)— 1 (A) in subparagraph (B), by striking 2 ‘‘and’’; 3 (B) in subparagraph (C)(ii), by striking 4 the period at the end and inserting ‘‘; and’’; 5 and 6 (C) by adding at the end the following: 7 ‘‘(D) status as a Holocaust survivor.’’; 8 (2) by redesignating paragraphs (26) through 9 (40) and paragraphs (41) through (54) as para- 10 graphs (27) through (41) and paragraphs (43) 11 through (56), respectively; 12 (3) by inserting after paragraph (25) the fol- 13 lowing: 14 ‘‘(26) The term ‘Holocaust survivor’ means an 15 individual who— 16 ‘‘(A)(i) lived in a country in a year not 17 earlier than 1933 and not later than 1945 18 under a Nazi regime, under Nazi occupation, or 19 under the control of Nazi collaborators; or 20 ‘‘(ii) fled from a country in a year de- 21 scribed in clause (i) under a Nazi regime, under 22 Nazi occupation, or under the control of Nazi 23 collaborators; 24 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 9 •S 2179 IS ‘‘(B) was persecuted in a year described in 1 clause (i) on the basis of race, religion, physical 2 or mental disability, sexual orientation, political 3 affiliation, ethnicity, or other basis; and 4 ‘‘(C) was a member of a group that was 5 persecuted by the Nazis.’’; and 6 (4) by inserting after paragraph (41) the fol- 7 lowing: 8 ‘‘(42) The term ‘person-centered, trauma-in- 9 formed’, used with respect to care, means care pro- 10 vided through an aging program, policy, or proce- 11 dure, that uses a holistic approach to service provi- 12 sion that promotes the dignity, strength, and em- 13 powerment of trauma victims by incorporating 14 knowledge about the role of trauma in trauma vic- 15 tims’ lives.’’. 16 SEC. 102. ORGANIZATION. 17 Section 305(a) of the Older Americans Act of 1965 18 (42 U.S.C. 3025(a)) is amended— 19 (1) in paragraph (1)(E), by inserting ‘‘older in- 20 dividuals who are Holocaust survivors,’’ after ‘‘pro- 21 ficiency,’’ each place it appears; and 22 (2) in paragraph (2)(E), by inserting ‘‘older in- 23 dividuals who are Holocaust survivors,’’ after ‘‘pro- 24 ficiency,’’. 25 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 10 •S 2179 IS SEC. 103. AREA PLANS. 1 Section 306 of the Older Americans Act of 1965 (42 2 U.S.C. 3026) is amended— 3 (1) in subsection (a)— 4 (A) in paragraph (1), by inserting ‘‘older 5 individuals who are Holocaust survivors,’’ after 6 ‘‘proficiency,’’ each place it appears; 7 (B) in paragraph (4)— 8 (i) in subparagraph (A)— 9 (I) in clause (i)(I)(bb), by insert- 10 ing ‘‘older individuals who are Holo- 11 caust survivors,’’ after ‘‘proficiency,’’; 12 and 13 (II) in clause (ii), by inserting 14 ‘‘older individuals who are Holocaust 15 survivors,’’ after ‘‘proficiency,’’ each 16 place it appears; 17 (ii) in subparagraph (B)(i)— 18 (I) in subclause (VI), by striking 19 ‘‘and’’ at the end; and 20 (II) by inserting after subclause 21 (VII) the following: 22 ‘‘(VIII) older individuals who are 23 Holocaust survivors; and’’; and 24 (iii) in subparagraph (B)(ii), by strik- 25 ing ‘‘subclauses (I) through (VI)’’ and in- 26 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 11 •S 2179 IS serting ‘‘subclauses (I) through (VIII)’’; 1 and 2 (C) in paragraph (7)(B)(iii), by inserting 3 ‘‘, in particular, older individuals who are Holo- 4 caust survivors,’’ after ‘‘placement’’; and 5 (2) in subsection (b)(2)(B), by inserting ‘‘older 6 individuals who are Holocaust survivors,’’ after 7 ‘‘areas,’’. 8 SEC. 104. STATE PLANS. 9 Section 307(a) of the Older Americans Act of 1965 10 (42 U.S.C. 3027(a)) is amended— 11 (1) in paragraph (4), by inserting ‘‘older indi- 12 viduals who are Holocaust survivors,’’ after ‘‘pro- 13 ficiency,’’; 14 (2) in paragraph (16)— 15 (A) in subparagraph (A)— 16 (i) in clause (v), by striking ‘‘and’’ at 17 the end; and 18 (ii) by adding at the end the fol- 19 lowing: 20 ‘‘(vii) older individuals who are Holo- 21 caust survivors; and’’; and 22 (B) in subparagraph (B), by striking 23 ‘‘clauses (i) through (vi)’’ and inserting 24 ‘‘clauses (i) through (vii)’’; and 25 VerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179 jbell on DSK3GLQ082PROD with BILLS 12 •S 2179 IS (3) in paragraph (28)(B)(ii), by inserting 1 ‘‘older individuals who are Holocaust survivors,’’ 2 after ‘‘areas,’’. 3 SEC. 105. CONSUMER CONTRIBUTIONS. 4 Section 315 of the Older Americans Act of 1965 (42 5 U.S.C. 3030c–2) is amended— 6 (1) in subsection (c)(2), by inserting ‘‘older in- 7 dividuals who are Holocaust survivors,’’ after ‘‘pro- 8 ficiency,’’; and 9 (2) in subsection (d), by inserting ‘‘older indi- 10 viduals who are Holocaust survivors,’’ after ‘‘pro- 11 ficiency,’’. 12 SEC. 106. NATIONAL FAMILY CAREGIVER SUPPORT PRO- 13 GRAM AUTHORIZED. 14 Section 373(c)(2)(A) of the Older Americans Act of 15 1965 (42 U.S.C. 3030s–1(c)(2)(A)) is amended by strik- 16 ing ‘‘individuals)’’ and inserting ‘‘individuals and older in- 17 dividuals who are Holocaust survivors)’’. 18 SEC. 107. PREVENTION OF ELDER ABUSE, NEGLECT, AND 19 EXPLOITATION. 20 Section 721(b)(13) of the Older Americ [Text truncated for display. Full text available on Congress.gov.]