HR 468 — Retooling the Health Care Workforce for an Aging America Act of 2009

(a) Collaboration To be eligible to receive assistance under this part, an academic institution shall use such assistance in collaboration with 2 or more disciplines. (b) Activities An entity shall use assistance under this part to carry out innovative demonstration projects for strategic workforce supplementation activities as needed to meet national goals for interdisciplinary, community-based linkages. Such assistance may be used consistent with this part— (1) to develop and support training programs; (2) for faculty development; (3) for model demonstration programs; (4) for the provision of stipends for fellowship trainees; (5) to provide technical assistance; and (6) for other activities that will produce outcomes consistent with the purposes of this part.

(a) Program authorized The Secretary shall award grants to eligible entities to develop and implement, in coordination with programs under section 294c of this title, programs and initiatives to train and educate individuals in providing geriatric care for the elderly. (b) Use of funds An eligible entity that receives a grant under subsection (a) shall use funds under such grant to— (1) provide training to individuals who will provide geriatric care for the elderly; (2) develop and disseminate curricula relating to the treatment of the health problems of elderly individuals; (3) train faculty members in geriatrics; (4) provide continuing education to individuals who provide geriatric care; or (5) establish traineeships for individuals who are preparing for advanced education nursing degrees in geriatric nursing, long-term care, gero-psychiatric nursing or other nursing areas that specialize in the care of the elderly population. (c) Application An eligible entity desiring a grant under subsection (a) shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require. (d) Eligible entity For purposes of this section, the term “eligible entity” includes a school of nursing, a health care facility, a program leading to certification as a certified nurse assistant, a partnership of such a school and facility, or a partnership of such a program and facility. (e) Authorization of appropriations There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2010 through 2014.

(a) Activities deemed as compliance A State shall not be deemed to be out of compliance with the requirements of paragraphs (1), (10), or (23) of section 1396a(a) of this title solely by reason of the fact that the State (or any political subdivision thereof)— (1) has entered into— (A) a contract with an organization which has agreed to provide care and services in addition to those offered under the State plan to individuals eligible for medical assistance who reside in the geographic area served by such organization and who elect to obtain such care and services from such organization, or by reason of the fact that the plan provides for payment for rural health clinic services only if those services are provided by a rural health clinic; or (B) arrangements through a competitive bidding process or otherwise for the purchase of laboratory services referred to in section 1396d(a)(3) of this title or medical devices if the Secretary has found that— (i) adequate services or devices will be available under such arrangements, and (ii) any such laboratory services will be provided only through laboratories— (I) which meet the applicable requirements of section 1395x(e)(9) of this title or paragraphs (16) and (17) of section 1395x(s) of this title, and such additional requirements as the Secretary may require, and (II) no more than 75 percent of whose charges for such services are for services provided to individuals who are entitled to benefits under this subchapter or under part A or part B of subchapter XVIII; or (2) restricts for a reasonable period of time the provider or providers from which an individual (eligible for medical assistance for items or services under the State plan) can receive such items or services, if— (A) the State has found, after notice and opportunity for a hearing (in accordance with procedures established by the State), that the individual has utilized such items or services at a frequency or amount not medically necessary (as determined in accordance with utilization guidelines established by the State), and (B) under such restriction, individuals eligible for medical assistance for such services have reasonable access (taking into account geographic location and reasonable travel time) to such services of adequate quality. (b) Waivers to promote cost-effectiveness and efficiency The Secretary, to the extent he finds it to be cost-effective and efficient and not inconsistent with the purposes of this subchapter, may waive such requirements of section 1396a of this title (other than subsection (s)) (other than sections 1396a(a)(15), 1396a(bb), and 1396a(a)(10)(A) of this title insofar as it requires provision of the care and services described in section 1396d(a)(2)(C) of this title) as may be necessary for a State— (1) to implement a primary care case-management system or a specialty physician services arrangement which restricts the provider from (or through) whom an individual (eligible for medical assistance under this subchapter) can obtain medical care services (other than in emergency circumstances), if such restriction does not substantially impair access to such services of adequate quality where medically necessary, (2) to allow a locality to act as a central broker in assisting individuals (eligible for medical assistance under this subchapter) in selecting among competing health care plans, if such restriction does not substantially impair access to services of adequate quality where medically necessary, (3) to share (through provision of additional services) with recipients of medical assistance under the State plan cost savings resulting from use by the recipient of more cost-effective medical care, and (4) to restrict the provider from (or through) whom an individual (eligible for medical assistance under this subchapter) can obtain services (other than in emergency circumstances) to providers or practitioners who undertake to provide such services and who meet, accept, and comply with...

(a) (1) There are authorized to be appropriated to carry out part B (relating to supportive services) $412,029,180 for fiscal year 2020, $436,750,931 for fiscal year 2021, $462,955,987 for fiscal year 2022, $490,733,346 for fiscal year 2023, and $520,177,347 for fiscal year 2024. (2) Funds appropriated under paragraph (1) shall be available to carry out section 3058g of this title. (b) (1) There are authorized to be appropriated to carry out subpart I of part C (relating to congregate nutrition services) $530,015,940 for fiscal year 2020, $561,816,896 for fiscal year 2021, $595,525,910 for fiscal year 2022, $631,257,465 for fiscal year 2023, and $669,132,913 for fiscal year 2024. (2) There are authorized to be appropriated to carry out subpart II of part C (relating to home delivered nutrition services) $268,935,940 for fiscal year 2020, $285,072,096 for fiscal year 2021, $302,176,422 for fiscal year 2022, $320,307,008 for fiscal year 2023, and $339,525,428 for fiscal year 2024. (c) Grants made under part B, and subparts I and II of part C, of this subchapter may be used for paying part of the cost of— (1) the administration of area plans by area agencies on aging designated under section 3025(a)(2)(A) of this title, including the preparation of area plans on aging consistent with section 3026 of this title and the evaluation of activities carried out under such plans; and (2) the development of comprehensive and coordinated systems for supportive services, and congregate and home delivered nutrition services under subparts I and II of part C, the development and operation of multipurpose senior centers, and the delivery of legal assistance. (d) There are authorized to be appropriated to carry out part D (relating to disease prevention and health promotion services) $26,587,360 for fiscal year 2020, $28,182,602 for fiscal year 2021, $29,873,558 for fiscal year 2022, $31,665,971 for fiscal year 2023, and $33,565,929 for fiscal year 2024. (e) There are authorized to be appropriated to carry out part E (relating to family caregiver support) $193,869,020 for fiscal year 2020, $205,501,161 for fiscal year 2021, $217,831,231 for fiscal year 2022, $230,901,105 for fiscal year 2023, and $244,755,171 for fiscal year 2024.

(a) Grants and contracts The Assistant Secretary shall award grants to and enter into contracts with eligible organizations to carry out projects, serving individuals in younger generations and older individuals, to— (1) provide opportunities for older individuals to participate in multigenerational activities and civic engagement activities that contribute to the health and wellness of older individuals and individuals in younger generations by promoting— (A) meaningful roles for participants; (B) reciprocity in relationship building; (C) reduced social isolation and improved participant social connectedness; (D) improved economic well-being for older individuals; (E) increased lifelong learning; or (F) support for caregivers of families by— (i) providing support for older relative caregivers (as defined in section 3030s(a) of this title) raising children (such as support for kinship navigator programs); or (ii) involving volunteers who are older individuals who provide support and information to families who have a child with a disability or chronic illness, or other families in need of such family support; (2) coordinate multigenerational activities and civic engagement activities, including multigenerational nutrition and meal service programs; (3) promote volunteerism, including by providing opportunities for older individuals to become a mentor to individuals in younger generations; and (4) facilitate development of, and participation in, multigenerational activities and civic engagement activities. (b) Grant and contract periods Each grant awarded and contract entered into under subsection (a) shall be for a period of not less than 36 months. (c) Use of funds (1) In general An eligible organization shall use funds made available under a grant awarded, or a contract entered into, under this section to carry out a project described in subsection (a). (2) Provision of projects through grantees In awarding grants and entering into contracts under this section, the Assistant Secretary shall ensure that such grants and contracts are for the projects that satisfy each requirement under paragraphs (1) through (4) of subsection (a). (d) Preference In awarding grants and entering into contracts to carry out a project described in subsection (a), the Assistant Secretary shall give preference to— (1) eligible organizations with a demonstrated record of carrying out, intent to carry out, or intent to partner with local organizations or multiservice organizations to carry out, multigenerational activities or civic engagement activities; (2) eligible organizations proposing multigenerational activity projects that will serve older individuals and communities with the greatest need (with particular attention to low-income minority individuals, older individuals with limited English proficiency, older individuals residing in rural areas, and low-income minority communities); (3) eligible organizations proposing civic engagement projects that will serve communities with the greatest need; (4) eligible organizations with the capacity to develop meaningful roles and assignments that use the time, skills, and experience of older individuals to serve public and nonprofit organizations; and (5) eligible organizations proposing multigenerational activity projects that utilize shared site programs, such as collocated child care and long-term care facilities. (e) Application To be eligible to receive a grant or enter into a contract under subsection (a), an organization shall submit an application to the Assistant Secretary at such time, in such manner, and accompanied by such information as the Assistant Secretary may reasonably require. (f) Eligible organizations Organizations eligible to receive a grant or enter into a contract under subsection (a) shall— (1) be a State, an area agency on aging, or an organization that provides opportunities for older individuals to participate in activities described in such subsection; and (2) have the c...