Positive Aging Act of 2005

        [Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2629 Introduced in House (IH)]

109th CONGRESS
1st Session
H. R. 2629

To amend the Older Americans Act of 1965 to provide for mental health
screening and treatment services, to amend the Public Health Service
Act to provide for integration of mental health services and mental
health treatment outreach teams, and for other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

May 25, 2005

Mr. Kennedy of Rhode Island (for himself, Ms. Ros-Lehtinen, Mr.
McDermott, Ms. Wasserman Schultz, Mr. Stark, and Mr. Owens) introduced
the following bill; which was referred to the Committee on Education
and the Workforce, and in addition to the Committee on Energy and
Commerce, for a period to be subsequently determined by the Speaker, in
each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned

_______________________________________________________________________

A BILL

To amend the Older Americans Act of 1965 to provide for mental health
screening and treatment services, to amend the Public Health Service
Act to provide for integration of mental health services and mental
health treatment outreach teams, and for other purposes.

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Positive Aging Act of 2005''.

TITLE I--AMENDMENTS TO THE OLDER AMERICANS ACT OF 1965

SEC. 101. DEFINITIONS.

Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is
amended by adding at the end the following:
``(44) Mental health screening and treatment services.--The
term `mental health screening and treatment services' means
patient screening, diagnostic services, care planning and
oversight, therapeutic interventions, and referrals that are--
``(A) provided pursuant to evidence-based
intervention and treatment protocols (to the extent
such protocols are available) for mental disorders
prevalent in older individuals (including, but not
limited to, mood and anxiety disorders, dementias of
all kinds, psychotic disorders, and substances and
alcohol abuse), relying to the greatest extent feasible
on protocols that have been developed--
``(i) by or under the auspices of the
Secretary; or
``(ii) by academicians with expertise in
mental health and aging; and
``(B) coordinated and integrated with the services
of social service, mental health, and health care
providers in an area in order to--
``(i) improve patient outcomes; and
``(ii) assure, to the maximum extent
feasible, the continuing independence of older
individuals who are residing in the area.''.

SEC. 102. OFFICE OF OLDER ADULT MENTAL HEALTH SERVICES.

Section 301(b) of the Older Americans Act of 1965 (42 U.S.C.
3021(b)) is amended by adding at the end the following:
``(3) The Assistant Secretary shall establish within the
Administration an Office of Older Adult Mental Health Services, which
shall be responsible for the development and implementation of
initiatives to address the mental health needs of older individuals.''.

SEC. 103. GRANTS TO STATES FOR THE DEVELOPMENT AND OPERATION OF SYSTEMS
FOR PROVIDING MENTAL HEALTH SCREENING AND TREATMENT
SERVICES TO OLDER INDIVIDUALS LACKING ACCESS TO SUCH
SERVICES.

Title III of the Older Americans Act of 1965 (42 U.S.C. 3021 et
seq.) is amended--
(1) in section 303, by adding at the end the following:
``(f) There are authorized to be appropriated to carry out part F
(relating to grants for programs providing mental health screening and
treatment services) such sums as may be necessary for fiscal year 2006
and each of the 5 succeeding fiscal years.'';
(2) in section 304(a)(1), by inserting ``and subsection
(f)'' after ``through (d)''; and
(3) by adding at the end the following:

``PART F--MENTAL HEALTH SCREENING AND TREATMENT SERVICES FOR OLDER
INDIVIDUALS

``SEC. 381. GRANTS TO STATES FOR PROGRAMS PROVIDING MENTAL HEALTH
SCREENING AND TREATMENT SERVICES FOR OLDER INDIVIDUALS.

``(a) Program Authorized.--The Assistant Secretary shall carry out
a program for making grants to States under State plans approved under
section 307 for the development and operation of--
``(1) systems for the delivery of mental health screening
and treatment services for older individuals who lack access to
such services; and
``(2) programs to--
``(A) increase public awareness regarding the
benefits of prevention and treatment of mental
disorders;
``(B) reduce the stigma associated with mental
disorders and other barriers to the diagnosis and
treatment of the disorders; and
``(C) reduce age-related prejudice and
discrimination.
``(b) State Allocation and Priorities.--A State agency that
receives funds through a grant made under this section shall allocate
the funds to area agencies on aging to carry out this part in planning
and service areas in the State. In allocating the funds, the State
agency shall give priority to planning and service areas in the State--
``(1) that are medically underserved; and
``(2) in which there are a large number of older
individuals.
``(c) Area Coordination of Services With Other Providers.--In
carrying out this part, to more efficiently and effectively deliver
services to older individuals, each area agency on aging shall--
``(1) coordinate services described in subsection (a) with
other community agencies, and voluntary organizations,
providing similar or related services; and
``(2) to the greatest extent practicable, integrate
outreach and educational activities with existing (as of the
date of the integration) health care and social service
providers serving older individuals in the planning and service
area involved.
``(d) Relationship to Other Funding Sources.--Funds made available
under this part shall supplement, and not supplant, any Federal, State,
and local funds expended by a State or unit of general purpose local
government (including an area agency on aging) to provide the services
described in subsection (a).''.

SEC. 104. DEMONSTRATION PROJECTS PROVIDING MENTAL HEALTH SCREENING AND
TREATMENT SERVICES TO OLDER INDIVIDUALS LIVING IN RURAL
AREAS.

The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is
amended--
(1) by inserting before section 401 the following:

``TITLE IV--GRANTS FOR EDUCATION, TRAINING, AND RESEARCH'';

and
(2) in part A of title IV, by adding at the end the
following:

``SEC. 422. DEMONSTRATION PROJECTS PROVIDING MENTAL HEALTH SCREENING
AND TREATMENT SERVICES TO OLDER INDIVIDUALS LIVING IN
RURAL AREAS.

``(a) Definition.--In this section, the term `rural area' means--
``(1) any area that is outside a metropolitan statistical
area (as defined by the Director of the Office of Management
and Budget); or
``(2) such similar area as the Secretary specifies in a
regulation issued under section 1886(d)(2)(D) of the Social
Security Act (42 U.S.C. 1395ww(d)(2)(D)).
``(b) Authority.--The Assistant Secretary shall make grants to
eligible public agencies and nonprofit private organizations to pay
part or all of the cost of developing or operating model health care
service projects involving the provision of mental health screening and
treatment services to older individuals residing in rural areas.
``(c) Duration.--Grants made under this section shall be made for
3-year periods.
``(d) Application.--To be eligible to receive a grant under this
section, a public agency or nonprofit private organization shall submit
to the Assistant Secretary an application containing such information
and assurances as the Assistant Secretary may require, including--
``(1) information describing--
``(A) the geographic area and target population
(including the racial and ethnic composition of the
target population) to be served by the project; and
``(B) the nature and extent of the applicant's
experience in providing mental health screening and
treatment services of the type to be provided in the
project;
``(2) assurances that the applicant will carry out the
project--
``(A) through a multidisciplinary team of licensed
mental health professionals;
``(B) using evidence-based intervention and
treatment protocols to the extent such protocols are
available;
``(C) using telecommunications technologies as
appropriate and available; and
``(D) in coordination with other providers of
health care and social services (such as senior centers
and adult day care providers) serving the area; and
``(3) assurances that the applicant will conduct and submit
to the Assistant Secretary such evaluations and reports as the
Assistant Secretary may require.
``(e) Reports.--The Assistant Secretary shall prepare and submit to
the appropriate committees of Congress a report that includes summaries
of the evaluations and reports required under subsection (d)(3).
``(f) Coordination.--The Assistant Secretary shall provide for
appropriate coordination of programs and activities receiving funds
pursuant to a grant under this section with programs and activities
receiving funds pursuant to grants under sections 381 and 423, and
sections 520K and 520L of the Public Health Service Act.''.

SEC. 105. DEMONSTRATION PROJECTS PROVIDING MENTAL HEALTH SCREENING AND
TREATMENT SERVICES TO OLDER INDIVIDUALS LIVING IN
NATURALLY OCCURRING RETIREMENT COMMUNITIES IN URBAN
AREAS.

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C.
3032 et seq.), as amended by section 104, is further amended by adding
at the end the following:

``SEC. 423. DEMONSTRATION PROJECTS PROVIDING MENTAL HEALTH SCREENING
AND TREATMENT SERVICES TO OLDER INDIVIDUALS LIVING IN
NATURALLY OCCURRING RETIREMENT COMMUNITIES IN URBAN
AREAS.

``(a) Definitions.--In this section:
``(1) Naturally occurring retirement community.--The term
`naturally occurring retirement community' means a residential
area (such as an apartment building, housing complex or
development, or neighborhood) not originally built for older
individuals but in which a substantial number of individuals
have aged in place (and become older individuals) while
residing in such area.
``(2) Urban area.--The term `urban area' means--
``(A) a metropolitan statistical area (as defined
by the Director of the Office of Management and
Budget); or
``(B) such similar area as the Secretary specifies
in a regulation issued under section 1886(d)(2)(D) of
the Social Security Act (42 U.S.C. 1395ww(d)(2)(D)).
``(b) Authority.--The Assistant Secretary shall make grants to
eligible public agencies and nonprofit private organizations to pay
part or all of the cost of developing or operating model health care
service projects involving the provision of mental health screening and
treatment services to older individuals residing in naturally occurring
retirement communities located in urban areas.
``(c) Duration.--Grants made under this section shall be made for
3-year periods.
``(d) Application.--To be eligible to receive a grant under this
section, a public agency or nonprofit private organization shall submit
to the Assistant Secretary an application containing such information
and assurances as the Assistant Secretary may require, including--
``(1) information describing--
``(A) the naturally occurring retirement community
and target population (including the racial and ethnic
composition of the target population) to be served by
the project; and
``(B) the nature and extent of the applicant's
experience in providing mental health screening and
treatment services of the type to be provided in the
project;
``(2) assurances that the applicant will carry out the
project--
``(A) through a multidisciplinary team of licensed
mental health professionals;
``(B) using evidence-based intervention and
treatment protocols to the extent such protocols are
available; and
``(C) in coordination with other providers of
health care and social services serving the retirement
community; and
``(3) assurances that the applicant will conduct and submit
to the Assistant Secretary such evaluations and reports as the
Assistant Secretary may require.
``(e) Reports.--The Assistant Secretary shall prepare and submit to
the appropriate committees of Congress a report that includes summaries
of the evaluations and reports required under subsection (d)(3).
``(f) Coordination.--The Assistant Secretary shall provide for
appropriate coordination of programs and activities receiving funds
pursuant to grants made under this section with programs and activities
receiving funds pursuant to grants made under sections 381 and 422, and
sections 520K and 520L of the Public Health Service Act.''.

TITLE II--PUBLIC HEALTH SERVICE ACT AMENDMENTS

SEC. 201. DEMONSTRATION PROJECTS TO SUPPORT INTEGRATION OF MENTAL
HEALTH SERVICES IN PRIMARY CARE SETTINGS.

Subpart 3 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-31 et seq.) is amended--
(1) in section 520(b)--
(A) in paragraph (14), by striking ``and'' after
the semicolon;
(B) in paragraph (15), by striking the period at
the end and inserting ``; and''; and
(C) by adding at the end the following:
``(16) conduct the demonstration projects specified in
section 520K.''; and
(2) by adding at the end the following:

``SEC. 520K. PROJECTS TO DEMONSTRATE INTEGRATION OF MENTAL HEALTH
SERVICES IN PRIMARY CARE SETTINGS.

``(a) In General.--The Secretary, acting through the Director of
the Center for Mental Health Services, shall award grants to public and
private nonprofit entities for projects to demonstrate ways of
integrating mental health services for older patients into primary care
settings, such as health centers receiving a grant under section 330
(or determined by the Secretary to meet the requirements for receiving
such a grant), other Federally qualified health centers, primary care
clinics, and private practice sites.
``(b) Requirements.--In order to be eligible for a grant under this
section, the project to be carried out by the entity shall provide for
collaborative care within a primary care setting, involving
psychiatrists, psychologists, and other licensed mental health
professionals (such as social workers and advanced practice nurses)
with appropriate training and experience in the treatment of older
adults, in which screening, assessment, and intervention services are
combined into an integrated service delivery model, including--
``(1) screening services by a mental health professional
with at least a masters degree in an appropriate field of
training;
``(2) referrals for necessary prevention, intervention,
follow-up care, consultations, and care planning oversight for
mental health and other service needs, as indicated; and
``(3) adoption and implementation of evidence-based
protocols, to the extent available, for prevalent mental health
disorders, including depression, anxiety, behavioral and
psychological symptoms of dementia, psychosis, and misuse of,
or dependence on, alcohol or medication.
``(c) Considerations in Awarding Grants.--In awarding grants under
this section, the Secretary, to the extent feasible, shall ensure
that--
``(1) projects are funded in a variety of geographic areas,
including urban and rural areas; and
``(2) a variety of populations, including racial and ethnic
minorities and low-income populations, are served by projects
funded under this section.
``(d) Duration.--A project may receive funding pursuant to a grant
under this section for a period of up to 3 years, with an extension
period of 2 additional years at the discretion of the Secretary.
``(e) Application.--To be eligible to receive a grant under this
section, a public or private nonprofit entity shall--
``(1) submit an application to the Secretary (in such form,
containing such information, and at such time as the Secretary
may specify); and
``(2) agree to report to the Secretary standardized
clinical and behavioral data necessary to evaluate patient
outcomes and to facilitate evaluations across participating
projects.
``(f) Evaluation.--Not later than July 31 of each calendar year,
the Secretary shall submit to Congress a report evaluating the projects
receiving awards under this section for such year.
``(g) Supplement, not Supplant.--Funds made available under this
section shall supplement, and not supplant, other Federal, State, or
local funds available to an entity to carry out activities described in
this section.
``(h) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section
for fiscal year 2006 and each fiscal year thereafter.''.

SEC. 202. GRANTS FOR COMMUNITY-BASED MENTAL HEALTH TREATMENT OUTREACH
TEAMS.

Subpart 3 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-31 et seq.), as amended by section 201, is further amended
by adding at the end the following:

``SEC. 520L. GRANTS FOR COMMUNITY-BASED MENTAL HEALTH TREATMENT
OUTREACH TEAMS.

``(a) In General.--The Secretary, acting through the Director of
the Center for Mental Health Services, shall award grants to public or
private nonprofit entities that are community-based providers of
geriatric mental health services, to support the establishment and
maintenance by such entities of multi-disciplinary geriatric mental
health outreach teams in community settings where older adults reside
or receive social services. Entities eligible for such grants include--
``(1) mental health service providers of a State or local
government;
``(2) outpatient programs of private, nonprofit hospitals;
``(3) community mental health centers meeting the criteria
specified in section 1913(c); and
``(4) other community-based providers of mental health
services.
``(b) Requirements.--To be eligible to receive a grant under this
section, an entity shall--
``(1) adopt and implement, for use by its mental health
outreach team, evidence-based intervention and treatment
protocols (to the extent such protocols are available) for
mental disorders prevalent in older individuals (including, but
not limited to, mood and anxiety disorders, dementias of all
kinds, psychotic disorders, and substance and alcohol abuse),
relying to the greatest extent feasible on protocols that have
been developed--
``(A) by or under the auspices of the Secretary; or
``(B) by academicians with expertise in mental
health and aging;
``(2) provide screening for mental disorders, diagnostic
services, referrals for treatment, and case management and
coordination through such teams; and
``(3) coordinate and integrate the services provided by
such team with the services of social service, mental health,
and medical providers at the site or sites where the team is
based in order to--
``(A) improve patient outcomes; and
``(B) to assure, to the maximum extent feasible,
the continuing independence of older adults who are
residing in the community.
``(c) Cooperative Arrangements With Sites Serving as Bases for
Outreach.--An entity receiving a grant under this section may enter
into an agreement with a person operating a site at which a geriatric
mental health outreach team of the entity is based, including--
``(1) senior centers;
``(2) adult day care programs;
``(3) assisted living facilities; and
``(4) recipients of grants to provide services to senior
citizens under the Older Americans Act of 1965, under which
such person provides (and is reimbursed by the entity, out of
funds received under the grant, for) any supportive services,
such as transportation and administrative support, that such
person provides to an outreach team of such entity.
``(d) Considerations in Awarding Grants.--In awarding grants under
this section, the Secretary, to the extent feasible, shall ensure
that--
``(1) projects are funded in a variety of geographic areas,
including urban and rural areas; and
``(2) a variety of populations, including racial and ethnic
minorities and low-income populations, are served by projects
funded under this section.
``(e) Application.--To be eligible to receive a grant under this
section, an entity shall--
``(1) submit an application to the Secretary (in such form,
containing such information, at such time as the Secretary may
specify); and
``(2) agree to report to the Secretary standardized
clinical and behavioral data necessary to evaluate patient
outcomes and to facilitate evaluations across participating
projects.
``(f) Coordination.--The Secretary shall provide for appropriate
coordination of programs and activities receiving funds pursuant to a
grant under this section with programs and activities receiving funds
pursuant to grants under section 520K and sections 381, 422, and 423 of
the Older Americans Act of 1965.
``(g) Evaluation.--Not later than July 31 of each calendar year,
the Secretary shall submit to Congress a report evaluating the projects
receiving awards under this section for such year.
``(h) Supplement, not Supplant.--Funds made available under this
section shall supplement, and not supplant, other Federal, State, or
local funds available to an entity to carry out activities described in
this section.
``(i) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section
for fiscal year 2006 and each fiscal year thereafter.''.

SEC. 203. DESIGNATION OF DEPUTY DIRECTOR FOR OLDER ADULT MENTAL HEALTH
SERVICES IN CENTER FOR MENTAL HEALTH SERVICES.

Section 520 of the Public Health Service Act (42 U.S.C. 290bb-31)
is amended--
(1) by redesignating subsection (c) as subsection (d); and
(2) by inserting after subsection (b) the following:
``(c) Deputy Director for Older Adult Mental Health Services in
Center for Mental Health Services.--The Director, after consultation
with the Administrator, shall designate a Deputy Director for Older
Adult Mental Health Services, who shall be responsible for the
development and implementation of initiatives of the Center to address
the mental health needs of older adults. Such initiatives shall
include--
``(1) research on prevention and identification of mental
disorders in the geriatric population;
``(2) innovative demonstration projects for the delivery of
community-based mental health services for older Americans;
``(3) support for the development and dissemination of
evidence-based practice models, including models to address
dependence on, and misuse of, alcohol and medication in older
adults; and
``(4) development of model training programs for mental
health professionals and care givers serving older adults.''.

SEC. 204. MEMBERSHIP OF ADVISORY COUNCIL FOR THE CENTER FOR MENTAL
HEALTH SERVICES.

Section 502(b)(3) of the Public Health Service Act (42 U.S.C.
290aa-1(b)(3)) is amended by adding at the end the following:
``(C) In the case of the advisory council for the
Center for Mental Health Services, the members
appointed pursuant to subparagraphs (A) and (B) shall
include representatives of older Americans, their
families, and geriatric mental health specialists.''.

SEC. 205. PROJECTS OF NATIONAL SIGNIFICANCE TARGETING SUBSTANCE ABUSE
IN OLDER ADULTS.

Section 509(b)(2) of the Public Health Service Act (42 U.S.C.
290bb-2(b)(2)) is amended by inserting before the period the following:
``, and to providing treatment for older adults with alcohol or
substance abuse or addiction, including medication misuse or
dependence''.

SEC. 206. CRITERIA FOR STATE PLANS UNDER COMMUNITY MENTAL HEALTH
SERVICES BLOCK GRANTS.

(a) In General.--Section 1912(b)(4)of the Public Health Service Act
(42 U.S.C. 300x-2(b)(4)) is amended to read as follows:
``(4) Targeted services to older individuals, individuals
who are homeless, and individuals living in rural areas.--The
plan describes the State's outreach to and services for older
individuals, individuals who are homeless, and individuals
living in rural areas, and how community-based services will be
provided to these individuals.''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to State plans submitted on or after the date that is 180 days
after the date of enactment of this Act.
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