42 U.S.C. § 3002 — Definitions

Page 5675 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 3002 Policy Committee shall publish and deliver to the chief executive officers of the States a preliminary report on the Conference. Comments on the preliminary report of the Conference shall be accepted by the Policy Com- mittee. ‘‘(b) FINAL REPORT.—Not later than 6 months after the date on which the Conference adjourns, the Policy Committee shall publish and transmit to the President and to Congress recommendations resulting from the Conference and suggestions for any administrative ac- tion and legislation necessary to implement the rec- ommendations contained within the report. ‘‘SEC. 205. DEFINITIONS. ‘‘For the purposes of this title— ‘‘(1) the term ‘area agency on aging’ has the mean- ing given the term in section 102 of the Older Ameri- cans Act of 1965 (42 U.S.C. 3002), ‘‘(2) the term ‘State agency on aging’ means the State agency designated under section 305(a)(1) of the Act, ‘‘(3) the term ‘Secretary’ means the Secretary of Health and Human Services, ‘‘(4) the term ‘Conference’ means the White House Conference on Aging, and ‘‘(5) the term ‘State’ means any of the several States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, American Samoa, the Virgin Islands of the United States, the Trust Territory of the Pacific Islands, or the Commonwealth of the Northern Mariana Islands. ‘‘SEC. 206. AUTHORIZATION OF APPROPRIATIONS. ‘‘(a) AUTHORIZATION.— ‘‘(1) IN GENERAL.—There are authorized to be appro- priated to carry out this section [title]— ‘‘(A) such sums as may be necessary for the first fiscal year in which the Policy Committee plans the Conference and for the following fiscal year; and ‘‘(B) such sums as may be necessary for the fiscal year in which the Conference is held. ‘‘(2) CONTRACTS.—Authority to enter into contracts under this title shall be effective only to the extent, or in such amounts as are, provided in advance in ap- propriations Acts. ‘‘(b) AVAILABILITY OF FUNDS.— ‘‘(1) IN GENERAL.—Except as provided in paragraph (3), funds appropriated to carry out this title and funds received as gifts under section 202(c) shall re- main available for obligation or expenditure until the expiration of the one-year period beginning on the date the Conference adjourns. ‘‘(2) UNOBLIGATED FUNDS.—Except as provided in paragraph (3), any such funds neither expended nor obligated before the expiration of the one-year period beginning on the date the Conference adjourns shall be available to carry out the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.). ‘‘(3) CONFERENCE NOT CONVENED.—If the Conference is not convened before December 31, 2005, such funds neither expended nor obligated before such date shall be available to carry out the Older Americans Act of 1965.’’ [For reference to maximum rate under section 5376 of Title 5, Government Organization and Employees, see section 2(d)(3) of Pub. L. 110–372, set out as an Effective Date of 2008 Amendment note under section 5376 of Title 5.] [For termination of Trust Territory of the Pacific Is- lands, see note set out preceding section 1681 of Title 48, Territories and Insular Possessions.] [Pub. L. 102–375, title VIII, § 837, Sept. 30, 1992, 106 Stat. 1304, provided that: ‘‘All personnel assigned or en- gaged under [former] section 202(b) or section 203(a)(5) [now section 202(a)(5)] of the Older Americans Act Amendments of 1987 [Pub. L. 100–175, set out above] (42 U.S.C. 3001 note) as in effect immediately before the date of the enactment of this Act [Sept. 30, 1992] shall continue to be assigned or engaged under such section after such date notwithstanding the amendments made by this subtitle [amending title II of Pub. L. 100–175, set out above].’’] Pub. L. 95–478, title II, §§ 201–207, Oct. 18, 1978, 92 Stat. 1551–1554, as amended by Pub. L. 96–88, title V, § 509(b), Oct. 17, 1979, 93 Stat. 695, authorized the President to call a White House Conference on Aging in 1981 to de- velop recommendations relating to economic well- being, health care, housing, social services, and em- ployment of the aging. DEFINITIONS Pub. L. 116–131, § 4, Mar. 25, 2020, 134 Stat. 241, pro- vided that: ‘‘In this Act [see Short Title of 2020 Amend- ment note set out above], the terms ‘area agency on aging’, ‘Assistant Secretary’, ‘greatest social need’, ‘older individual’, and ‘Secretary’ have the meanings given such terms in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002).’’ Executive Documents EXECUTIVE ORDER NO. 11022 Ex. Ord. No. 11022, May 14, 1962, 27 F.R. 4659, as amended by Ex. Ord. No. 11376, Oct. 17, 1967, 32 F.R. 14545; Ex. Ord. No. 12106, Dec. 28, 1978, 44 F.R. 1053, which established the President’s Council on Aging and provided for its membership, functions, etc., was re- voked by Ex. Ord. No. 12379, § 12, Aug. 17, 1982, 47 F.R. 36099, formerly set out as a note under section 1013 of Title 5, Government Organization and Employees. § 3002. Definitions For the purposes of this chapter— (1) The term ‘‘abuse’’ means the knowing in- fliction of physical or psychological harm or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm. (2) The term ‘‘Administration’’ means the Administration on Aging. (3) The term ‘‘adult protective services’’ means such services provided to adults as the Secretary may specify and includes services such as— (A) receiving reports of adult abuse, ne- glect, or exploitation; (B) investigating the reports described in subparagraph (A); (C) case planning, monitoring, evaluation, and other casework and services; and (D) providing, arranging for, or facilitating the provision of medical, social service, eco- nomic, legal, housing, law enforcement, or other protective, emergency, or support services. (4) The term ‘‘Aging and Disability Resource Center’’ means an entity, network, or consor- tium established by a State as part of the State system of long-term care, to provide a coordinated and integrated system for older individuals and individuals with disabilities (as defined in section 12102 of this title), and the caregivers of older individuals and individ- uals with disabilities, that provides, in col- laboration with (as appropriate) area agencies on aging, centers for independent living (as de- scribed in part C of chapter 1 of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f et seq.)), and other aging or disability entities— (A) comprehensive information on the full range of available public and private long- term care programs, options, service pro- viders, and resources within a community, Page 5676 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 3002 including information on the availability of integrated long-term care services, and Fed- eral or State programs that provide long- term care services and supports through home and community-based service pro- grams; (B) person-centered counseling to assist in- dividuals in assessing their existing or an- ticipated long-term care needs and goals, and developing and implementing a person- centered plan for long-term services, sup- ports, and care that is consistent with the desires and choices of such an individual and designed to meet the individual’s specific needs, goals, and circumstances; (C) access for individuals to the full range of publicly-supported long-term care serv- ices and supports for which the individuals may be eligible, including home and commu- nity-based service options, by serving as a convenient point of entry for such programs and supports; and (D) in cooperation with area agencies on aging, centers for independent living de- scribed in part C of chapter 1 of title VII of the Rehabilitation Act of 1973, and other community-based entities, including other aging or disability entities, information and referrals regarding available home and com- munity-based services for individuals who are at risk for residing in, or who reside in, institutional settings, so that the individ- uals have the choice to remain in or to re- turn to the community. (5) The term ‘‘aging network’’ means the network of— (A) State agencies, area agencies on aging, title VI [subchapter X of this chapter] grant- ees, and the Administration; and (B) organizations that— (i)(I) are providers of direct services to older individuals; or (II) are institutions of higher education; and (ii) receive funding under this chapter. (6) The term ‘‘area agency on aging’’ means an area agency on aging designated under sec- tion 3025(a)(2)(A) of this title or a State agen- cy performing the functions of an area agency on aging under section 3025(b)(5) of this title. (7) The term ‘‘Assistant Secretary’’ means the Assistant Secretary for Aging. (8)(A) The term ‘‘assistive device’’ includes an assistive technology device. (B) The terms ‘‘assistive technology’’, ‘‘as- sistive technology device’’, and ‘‘assistive technology service’’ have the meanings given such terms in section 3002 of title 29. (C) The term ‘‘State assistive technology en- tity’’ means the agency, office, or other entity designated under subsection (c)(1) of section 3003 of title 29 to carry out State activities under such section. (9) The term ‘‘at risk for institutional place- ment’’ means, with respect to an older indi- vidual, that such individual is unable to per- form at least 2 activities of daily living with- out substantial assistance (including verbal reminding, physical cuing, or supervision) and is determined by the State involved to be in need of placement in a long-term care facility. (10) The term ‘‘board and care facility’’ means an institution regulated by a State pur- suant to section 1382e(e) of this title. (11) The term ‘‘case management service’’— (A) means a service provided to an older individual, at the direction of the older indi- vidual or a family member of the indi- vidual— (i) by an individual who is trained or ex- perienced in the case management skills that are required to deliver the services and coordination described in subpara- graph (B); and (ii) to assess the needs, and to arrange, coordinate, and monitor an optimum pack- age of services to meet the needs, of the older individual; and (B) includes services and coordination such as— (i) comprehensive assessment of the older individual (including the physical, psychological, and social needs of the indi- vidual); (ii) development and implementation of a service plan with the older individual to mobilize the formal and informal resources and services identified in the assessment to meet the needs of the older individual, including coordination of the resources and services— (I) with any other plans that exist for various formal services, such as hospital discharge plans; and (II) with the information and assist- ance services provided under this chap- ter; (iii) coordination and monitoring of for- mal and informal service delivery, includ- ing coordination and monitoring to ensure that services specified in the plan are being provided; (iv) periodic reassessment and revision of the status of the older individual with— (I) the older individual; or (II) if necessary, a primary caregiver or family member of the older indi- vidual; and (v) in accordance with the wishes of the older individual, advocacy on behalf of the older individual for needed services or re- sources. (12) The term ‘‘civic engagement’’ means an individual or collective action designed to ad- dress a public concern or an unmet human, educational, health care, environmental, or public safety need. (13) The term ‘‘disability’’ means (except when such term is used in the phrase ‘‘severe disability’’, ‘‘developmental disabilities’’, ‘‘physical or mental disability’’, ‘‘physical and mental disabilities’’, or ‘‘physical disabil- ities’’) a disability attributable to mental or physical impairment, or a combination of mental and physical impairments, that results in substantial functional limitations in 1 or more of the following areas of major life activ- ity: (A) self-care, (B) receptive and expressive language, (C) learning, (D) mobility, (E) self- direction, (F) capacity for independent living, Page 5677 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 3002 1 See References in Text note below. (G) economic self-sufficiency, (H) cognitive functioning, and (I) emotional adjustment. (14) The term ‘‘disease prevention and health promotion services’’ means— (A) health risk assessments; (B) routine health screening, which may include hypertension, glaucoma, cholesterol, cancer, vision, hearing, diabetes, bone den- sity, oral health, immunization status, and nutrition screening (including screening for malnutrition); (C) nutritional counseling and educational services for individuals and their primary caregivers; (D) evidence-based health promotion pro- grams, including programs related to the prevention and mitigation of the effects of chronic disease (including osteoporosis, hy- pertension, obesity, diabetes, and cardio- vascular disease), infectious disease, and vaccine-preventable disease, prevention of sexually transmitted diseases, as well as al- cohol and substance abuse reduction, chron- ic pain management, smoking cessation, weight loss and control, stress management, falls prevention, physical activity, and im- proved nutrition; (E) programs regarding physical fitness, group exercise, and music therapy, art ther- apy, and dance-movement therapy, including programs for multigenerational participa- tion that are provided by— (i) an institution of higher education; (ii) a local educational agency, as de- fined in section 8801 1 of title 20; or (iii) a community-based organization; (F) home injury control services, including screening of high-risk home environments and provision of educational programs on in- jury prevention (including fall and fracture prevention) in the home environment; (G) screening for the prevention of depres- sion and screening for suicide risk, coordina- tion of community mental and behavioral health services, provision of educational ac- tivities, and referral to psychiatric and psy- chological services; (H) screening for fall-related traumatic brain injury and other fall-related injuries, coordination of treatment, rehabilitation and related services, and referral services re- lated to such injury or injuries; (I) educational programs on the avail- ability, benefits, and appropriate use of pre- ventive health services covered under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.); (J) medication management screening and education to prevent incorrect medication and adverse drug reactions; (K) information concerning diagnosis, pre- vention, treatment, and rehabilitation con- cerning age-related diseases and chronic dis- abling conditions, including osteoporosis, cardiovascular diseases, diabetes, and Alz- heimer’s disease and related disorders with neurological and organic brain dysfunction; (L) services that are a part of responses to a public health emergency or emerging health threat; (M) gerontological counseling; (N) screening for the prevention of nega- tive health effects associated with social iso- lation and coordination of supportive serv- ices and health care to address negative health effects associated with social isola- tion; and (O) counseling regarding social services and followup health services based on any of the services described in subparagraphs (A) through (N). The term shall not include services for which payment may be made under titles XVIII and XIX of the Social Security Act (42 U.S.C. 1395 et seq., 1396 et seq.). (15) The term ‘‘elder abuse’’ means abuse of an older individual. (16) The term ‘‘elder abuse, neglect, and ex- ploitation’’ means abuse, neglect, and exploi- tation, of an older individual. (17) The term ‘‘elder justice’’ means— (A) from a societal perspective, efforts to— (i) prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and ex- ploitation; and (ii) protect older individuals with dimin- ished capacity while maximizing their au- tonomy; and (B) from an individual perspective, the rec- ognition of an older individual’s rights, in- cluding the right to be free of abuse, neglect, and exploitation. (18)(A) The terms ‘‘exploitation’’ and ‘‘finan- cial exploitation’’ mean the fraudulent or oth- erwise illegal, unauthorized, or improper act or process of an individual, including a care- giver or fiduciary, that uses the resources of an older individual for monetary or personal benefit, profit, or gain, or that results in de- priving an older individual of rightful access to, or use of, benefits, resources, belongings, or assets. (B) In subparagraph (A), the term ‘‘care- giver’’ means an individual who has the re- sponsibility for the care of an older individual, either voluntarily, by contract, by receipt of payment for care, or as a result of the oper- ation of law and means a family member or other individual who provides (on behalf of such individual or of a public or private agen- cy, organization, or institution) compensated or uncompensated care to an older individual. (19) The term ‘‘family violence’’ has the same meaning given the term in the Family Violence Prevention and Services Act [42 U.S.C. 10401 et seq.]. (20) The term ‘‘fiduciary’’— (A) means a person or entity with the legal responsibility— (i) to make decisions on behalf of and for the benefit of another person; and (ii) to act in good faith and with fairness; and (B) includes a trustee, a guardian, a con- servator, an executor, an agent under a fi- nancial power of attorney or health care power of attorney, or a representative payee. (21) The term ‘‘focal point’’ means a facility established to encourage the maximum col- Page 5678 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 3002 location and coordination of services for older individuals. (22) The term ‘‘frail’’ means, with respect to an older individual in a State, that the older individual is determined to be functionally impaired because the individual— (A)(i) is unable to perform at least two ac- tivities of daily living without substantial human assistance, including verbal remind- ing, physical cueing, or supervision; or (ii) at the option of the State, is unable to perform at least three such activities with- out such assistance; or (B) due to a cognitive or other mental im- pairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual. (23) The term ‘‘greatest economic need’’ means the need resulting from an income level at or below the poverty line. (24) The term ‘‘greatest social need’’ means the need caused by noneconomic factors, which include— (A) physical and mental disabilities; (B) language barriers; and (C) cultural, social, or geographical isola- tion, including isolation caused by racial or ethnic status, that— (i) restricts the ability of an individual to perform normal daily tasks; or (ii) threatens the capacity of the indi- vidual to live independently. (25) The term ‘‘Hispanic-serving institution’’ has the meaning given the term in section 1101a of title 20. (26) The term ‘‘Indian’’ means a person who is a member of an Indian tribe. (27) Except for the purposes of subchapter X of this chapter, the term ‘‘Indian tribe’’ means any tribe, band, nation, or other organized group or community of Indians (including any Alaska Native village or regional or village corporation as defined in or established pursu- ant to the Alaska Native Claims Settlement Act (Public Law 92–203; 85 Stat. 688) [43 U.S.C. 1601 et seq.]) which (A) is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians; or (B) is located on, or in proximity to, a Federal or State reservation or rancheria. (28) The term ‘‘information and assistance service’’ means a service for older individuals that— (A) provides the individuals with current information on opportunities and services available to the individuals within their communities, including information relating to assistive technology; (B) assesses the problems and capacities of the individuals; (C) links the individuals to the opportuni- ties and services that are available; (D) to the maximum extent practicable, ensures that the individuals receive the services needed by the individuals, and are aware of the opportunities available to the individuals, by establishing adequate fol- lowup procedures; and (E) serves the entire community of older individuals, particularly— (i) older individuals with greatest social need; (ii) older individuals with greatest eco- nomic need; and (iii) older individuals at risk for institu- tional placement. (29) The term ‘‘information and referral’’ in- cludes information relating to assistive tech- nology. (30) The term ‘‘in-home services’’ includes— (A) services of homemakers and home health aides; (B) visiting and telephone reassurance; (C) chore maintenance; (D) in-home respite care for families, and adult day care as a respite service for fami- lies; (E) minor modification of homes that is necessary to facilitate the ability of older individuals to remain at home and that is not available under another program (other than a program carried out under this chap- ter); (F) personal care services; and (G) other in-home services as defined— (i) by the State agency in the State plan submitted in accordance with section 3027 of this title; and (ii) by the area agency on aging in the area plan submitted in accordance with section 3026 of this title. (31) The term ‘‘institution of higher edu- cation’’ has the meaning given the term in section 1001 of title 20. (32) The term ‘‘integrated long-term care’’— (A) means items and services that consist of— (i) with respect to long-term care— (I) long-term care items or services provided under a State plan for medical assistance under the Medicaid program established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), in- cluding nursing facility services, home and community-based services, personal care services, and case management services provided under the plan; and (II) any other supports, items, or serv- ices that are available under any feder- ally funded long-term care program; and (ii) with respect to other health care, items and services covered under— (I) the Medicare program established under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.); (II) the State plan for medical assist- ance under the Medicaid program; or (III) any other federally funded health care program; and (B) includes items or services described in subparagraph (A) that are provided under a public or private managed care plan or through any other service provider. (33) The term ‘‘legal assistance’’— (A) means legal advice and representation provided by an attorney to older individuals with economic or social needs; and Page 5679 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 3002 2 So in original. A closing parenthesis probably should follow ‘‘this title’’. (B) includes— (i) to the extent feasible, counseling or other appropriate assistance by a para- legal or law student under the direct su- pervision of an attorney; and (ii) counseling or representation by a nonlawyer where permitted by law. (34) The term ‘‘long-term care’’ means any service, care, or item (including an assistive device), including a disease prevention and health promotion service, an in-home service, and a case management service— (A) intended to assist individuals in coping with, and to the extent practicable com- pensate for, a functional impairment in car- rying out activities of daily living; (B) furnished at home, in a community care setting (including a small community care setting as defined in subsection (g)(1), and a large community care setting as de- fined in subsection (h)(1), of section 1929 of the Social Security Act (42 U.S.C. 1396t)), or in a long-term care facility; and (C) not furnished to prevent, diagnose, treat, or cure a medical disease or condition. (35) The term ‘‘long-term care facility’’ means— (A) any skilled nursing facility, as defined in section 1819(a) of the Social Security Act (42 U.S.C. 1395i–3(a)); (B) any nursing facility, as defined in sec- tion 1919(a) of the Social Security Act (42 U.S.C. 1396r(a)); (C) a board and care facility; and (D) any other adult care home, including an assisted living facility, similar to a facil- ity or institution described in subparagraphs (A) through (C). (36) The term ‘‘multipurpose senior center’’ means a community facility for the organiza- tion and provision of a broad spectrum of serv- ices, which shall include provision of health (including mental and behavioral health), so- cial, nutritional, and educational services and the provision of facilities for recreational ac- tivities for older individuals. (37) The term ‘‘Native American’’ means— (A) an Indian as defined in paragraph (26); and (B) a Native Hawaiian, as defined in sec- tion 3057k of this title. (38) The term ‘‘neglect’’ means— (A) the failure of a caregiver (as defined in paragraph (18)(B)) or fiduciary to provide the goods or services that are necessary to maintain the health or safety of an older in- dividual; or (B) self-neglect. (39) The term ‘‘nonprofit’’ as applied to any agency, institution, or organization means an agency, institution, or organization which is, or is owned and operated by, one or more cor- porations or associations no part of the net earnings of which inures, or may lawfully inure, to the benefit of any private share- holder or individual. (40) The term ‘‘older individual’’ means an individual who is 60 years of age or older. (41) The term ‘‘person-centered, trauma-in- formed’’, with respect to services, means serv- ices provided through an aging program that— (A) use a holistic approach to providing services or care; (B) promote the dignity, strength, and em- powerment of victims of trauma; and (C) incorporate evidence-based practices based on knowledge about the role of trauma in trauma victims’ lives. (42) The term ‘‘physical harm’’ means bodily injury, impairment, or disease. (43) The term ‘‘planning and service area’’ means an area designated by a State agency under section 3025(a)(1)(E) of this title, includ- ing a single planning and service area de- scribed in section 3025(b)(5)(A) of this title. (44) The term ‘‘poverty line’’ means the offi- cial poverty line (as defined by the Office of Management and Budget, and adjusted by the Secretary in accordance with section 9902(2) of this title.2 (45) The term ‘‘representative payee’’ means a person who is appointed by a governmental entity to receive, on behalf of an older indi- vidual who is unable to manage funds by rea- son of a physical or mental incapacity, any funds owed to such individual by such entity. (46) The term ‘‘Secretary’’ means the Sec- retary of Health and Human Services, except that for purposes of subchapter IX such term means the Secretary of Labor. (47) The term ‘‘self-directed care’’ means an approach to providing services (including pro- grams, benefits, supports, and technology) under this chapter intended to assist an indi- vidual with activities of daily living, in which— (A) such services (including the amount, duration, scope, provider, and location of such services) are planned, budgeted, and purchased under the direction and control of such individual; (B) such individual is provided with such information and assistance as are necessary and appropriate to enable such individual to make informed decisions about the individ- ual’s care options; (C) the needs, capabilities, and preferences of such individual with respect to such serv- ices, and such individual’s ability to direct and control the individual’s receipt of such services, are assessed by the area agency on aging (or other agency designated by the area agency on aging) involved; (D) based on the assessment made under subparagraph (C), the area agency on aging (or other agency designated by the area agency on aging) develops together with such individual and the individual’s family, caregiver (as defined in paragraph (18)(B)), or legal representative— (i) a plan of services for such individual that specifies which services such indi- vidual will be responsible for directing; (ii) a determination of the role of family members (and others whose participation is sought by such individual) in providing services under such plan; and (iii) a budget for such services; and (E) the area agency on aging or State agency provides for oversight of such indi- Page 5680 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 3002 3 So in original. Probably should refer to paragraph (13). vidual’s self-directed receipt of services, in- cluding steps to ensure the quality of serv- ices provided and the appropriate use of funds under this chapter. (48) The term ‘‘self-neglect’’ means an adult’s inability, due to physical or mental impairment or diminished capacity, to per- form essential self-care tasks including— (A) obtaining essential food, clothing, shelter, and medical care; (B) obtaining goods and services necessary to maintain physical health, mental and be- havioral health, or general safety; or (C) managing one’s own financial affairs. (49) The term ‘‘severe disability’’ means a se- vere, chronic disability attributable to mental or physical impairment, or a combination of mental and physical impairments, that— (A) is likely to continue indefinitely; and (B) results in substantial functional limi- tation in 3 or more of the major life activi- ties specified in subparagraphs (A) through (G) of paragraph (8).3 (50) The term ‘‘sexual assault’’ has the meaning given the term in section 10447 of title 34.1 (51) The term ‘‘State’’ means any of the sev- eral States, the District of Columbia, the Vir- gin Islands of the United States, the Common- wealth of Puerto Rico, Guam, American Samoa, and the Commonwealth of the North- ern Mariana Islands. (52) The term ‘‘State agency’’ means the agency designated under section 3025(a)(1) of this title. (53) The term ‘‘State system of long-term care’’ means the Federal, State, and local pro- grams and activities administered by a State that provide, support, or facilitate access to long-term care for individuals in such State. (54) The term ‘‘supportive service’’ means a service described in section 3030d(a) of this title. (55) The term ‘‘traumatic brain injury’’ has the meaning given such term in section 280b–1c(d) of this title. (56) Except for the purposes of subchapter X of this chapter, the term ‘‘tribal organization’’ means the recognized governing body of any Indian tribe, or any legally established organi- zation of Indians which is controlled, sanc- tioned, or chartered by such governing body. In any case in which a contract is let or grant made to an organization to perform services benefiting more than one Indian tribe, the ap- proval of each such Indian tribe shall be a pre- requisite to the letting or making of such con- tract or grant. (Pub. L. 89–73, title I, § 102, July 14, 1965, 79 Stat. 219; Pub. L. 90–42, § 5(a), July 1, 1967, 81 Stat. 107; Pub. L. 91–69, § 10(a), Sept. 17, 1969, 83 Stat. 114; Pub. L. 94–135, title I, §§ 104(b), 114(a), Nov. 28, 1975, 89 Stat. 714, 725; Pub. L. 95–478, title V, § 503(a), Oct. 18, 1978, 92 Stat. 1559; Pub. L. 97–115, § 2(a)(2), (3), Dec. 29, 1981, 95 Stat. 1595; Pub. L. 100–175, title I, §§ 136(a)(1), 146(a), 182(a), (b)(1), Nov. 29, 1987, 101 Stat. 942, 950, 964; Pub. L. 100–628, title VII, § 705(1), Nov. 7, 1988, 102 Stat. 3247; Pub. L. 102–375, title I, § 102(a), (b)(1)(A), title IX, § 904(a)(2), Sept. 30, 1992, 106 Stat. 1197, 1200, 1306; Pub. L. 103–171, §§ 2(1), 3(a)(1), Dec. 2, 1993, 107 Stat. 1988, 1989; Pub. L. 105–244, title I, § 102(a)(13)(C), Oct. 7, 1998, 112 Stat. 1620; Pub. L. 106–501, title I, § 101, title VIII, § 801(a), Nov. 13, 2000, 114 Stat. 2227, 2291; Pub. L. 108–36, title IV, § 416, June 25, 2003, 117 Stat. 831; Pub. L. 109–365, title I, § 101, Oct. 17, 2006, 120 Stat. 2523; Pub. L. 114–144, §§ 2, 9(1), Apr. 19, 2016, 130 Stat. 334, 351; Pub. L. 116–131, title I, §§ 103, 104(1), 105, 106(1), 107–113, title VII, § 701(1), Mar. 25, 2020, 134 Stat. 242–245, 271.) Editorial Notes REFERENCES IN TEXT The Rehabilitation Act of 1973, referred to in par. (4), is Pub. L. 93–112, Sept. 26, 1973, 87 Stat. 355. Part C of title VII of the Act is classified generally to subpart 3 (§ 796f et seq.) of part A of subchapter VII of chapter 16 of Title 29, Labor. For complete classification of this Act to the Code, see Short Title note set out under sec- tion 701 of Title 29 and Tables. The Social Security Act, referred to in pars. (14) and (32), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Titles XVIII and XIX of the Act are classified generally to subchapters XVIII (§ 1395 et seq.) and XIX (§ 1396 et seq.), respectively, of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables. Section 8801 of title 20, referred to in par. (14)(E)(ii), was repealed by Pub. L. 107–110, title X, § 1011(5)(C), Jan. 8, 2002, 115 Stat. 1986. See section 7801 of Title 20, Edu- cation. The Family Violence Prevention and Services Act, referred to in par. (19), is title III of Pub. L. 98–457, as added Pub. L. 111–320, title II, § 201, Dec. 20, 2010, 124 Stat. 3484, which is classified generally to chapter 110 (§ 10401 et seq.) of this title. For complete classification of this Act to the Code, see section 10401(a) of this title and Tables. The Alaska Native Claims Settlement Act, referred to in par. (27), is Pub. L. 92–203, Dec. 18, 1971, 85 Stat. 688, which is classified generally to chapter 33 (§ 1601 et seq.) of Title 43, Public Lands. For complete classifica- tion of this Act of the Code, see Short Title note set out under section 1601 of Title 43 and Tables. Section 10447 of title 34, referred to in par. (50), was subsequently amended and no longer defines ‘‘sexual assault’’. However, it now refers to definitions in sec- tion 12291 of Title 34, Crime Control and Law Enforce- ment, which defines ‘‘sexual assault’’ in subsec. (a). AMENDMENTS 2020—Par. (4). Pub. L. 116–131, § 103(1), in introductory provisions, inserted ‘‘, in collaboration with (as appro- priate) area agencies on aging, centers for independent living (as described in part C of chapter 1 of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f et seq.)), and other aging or disability entities’’ after ‘‘provides’’. Par. (4)(B). Pub. L. 116–131, § 103(2), substituted ‘‘plan for long-term services, supports, and care that is con- sistent with the desires and choices’’ for ‘‘plan for long- term care that is consistent with the desires’’. Par. (4)(D). Pub. L. 116–131, § 103(3), substituted ‘‘part C of chapter 1 of title VII of the Rehabilitation Act of 1973, and other community-based entities, including other aging or disability entities,’’ for ‘‘part C of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f et seq.), and other community-based entities,’’. Par. (8)(C). Pub. L. 116–131, § 104(1), added subpar. (C). Par. (14)(B). Pub. L. 116–131, § 106(1), inserted ‘‘(includ- ing screening for malnutrition)’’ after ‘‘nutrition screening’’. Pub. L. 116–131, § 105(1), inserted ‘‘immunization sta- tus,’’ after ‘‘oral health,’’. Page 5681 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 3002 Par. (14)(D). Pub. L. 116–131, § 108, inserted ‘‘chronic pain management,’’ after ‘‘substance abuse reduction,’’. Pub. L. 116–131, § 107, inserted ‘‘prevention of sexually transmitted diseases,’’ after ‘‘vaccine-preventable dis- ease,’’. Pub. L. 116–131, § 105(2), inserted ‘‘infectious disease, and vaccine-preventable disease, as well as’’ after ‘‘car- diovascular disease),’’. Par. (14)(G). Pub. L. 116–131, § 109, inserted ‘‘and screening for suicide risk’’ after ‘‘depression’’. Par. (14)(H) to (O). Pub. L. 116–131, § 110, added sub- pars. (H), (L), and (N), redesignated former subpars. (H), (I), (J), (K), and (L) as (I), (J), (K), (M), and (O), respec- tively, and, in subpar. (O), substituted ‘‘(A) through (N)’’ for ‘‘(A) through (K)’’. Par. (35)(C). Pub. L. 116–131, § 111, struck out ‘‘for pur- poses of sections 3027(a)(12) and 3058g of this title,’’ be- fore ‘‘a board’’. Par. (37)(A). Pub. L. 116–131, § 701(1), substituted ‘‘paragraph (26)’’ for ‘‘paragraph (5)’’. Par. (41). Pub. L. 116–131, § 112(2), added par. (41). Former par. (41) redesignated (42). Pars. (42) to (54). Pub. L. 116–131, § 112(1), redesignated pars. (41) to (53) as (42) to (54), respectively. Former par. (54) redesignated (55), then (56). Par. (55). Pub. L. 116–131, § 113(2), added par. (55). Par. (56). Pub. L. 116–131, §§ 112(1), 113(1), redesignated par. (54) as (55), then (56). 2016—Par. (1). Pub. L. 114–144, § 2(1), added par. (1) and struck out former par. (1) which defined ‘‘abuse’’. Par. (3). Pub. L. 114–144, § 2(2), added par. (3) and struck out former par. (3) which defined ‘‘adult child with a disability’’. Par. (4). Pub. L. 114–144, § 2(3), added par. (4) and struck out former par. (4) which defined ‘‘Aging and Disability Resource Center’’. Par. (14)(B). Pub. L. 114–144, § 2(4), inserted ‘‘oral health,’’ after ‘‘bone density,’’. Par. (14)(G). Pub. L. 114–144, § 9(1)(A), inserted ‘‘and behavioral’’ after ‘‘mental’’. Par. (17). Pub. L. 114–144, § 2(5), added par. (17) and struck out former par. (17) which defined ‘‘elder jus- tice’’. Par. (18)(A). Pub. L. 114–144, § 2(6), substituted ‘‘terms ‘exploitation’ and ‘financial exploitation’ mean’’ for ‘‘term ‘exploitation’ means’’. Par. (36). Pub. L. 114–144, § 9(1)(B), inserted ‘‘and be- havioral’’ after ‘‘mental’’. Par. (47)(B). Pub. L. 114–144, § 9(1)(C), inserted ‘‘and behavioral’’ after ‘‘mental’’. 2006—Pub. L. 109–365, § 101(b), redesignated pars. (1) to (54) as (45), (7), (50), (39), (26), (27), (54), (13), (48), (8), (29), (14), (1), (2), (3), (5), (6), (10), (30), (37), (11), (15), (16), (18), (21), (22), (23), (24), (28), (31), (33), (35), (36), (38), (40), (41), (42), (43), (44), (51), (53), (19), (49), (4), (9), (12), (17), (20), (25), (34), (46), (47), (52), and (32), respectively. Par. (10). Pub. L. 109–365, § 101(a)(1), added par. (10) and struck out former par. (10) which read as follows: ‘‘The term ‘assistive technology’ means technology, engi- neering methodologies, or scientific principles appro- priate to meet the needs of, and address the barriers confronted by, older individuals with functional limita- tions.’’ Par. (12)(D). Pub. L. 109–365, § 101(a)(2), added subpar. (D) and struck out former subpar. (D) which read as fol- lows: ‘‘health promotion programs, including but not limited to programs relating to prevention and reduc- tion of effects of chronic disabling conditions (includ- ing osteoporosis and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, and stress management;’’. Par. (24). Pub. L. 109–365, § 101(a)(3), added par. (24) and struck out former par. (24) which read as follows: ‘‘The term ‘exploitation’ means the illegal or improper act or process of an individual, including a caregiver, using the resources of an older individual for monetary or personal benefit, profit, or gain.’’ Par. (29)(E)(iii). Pub. L. 109–365, § 101(a)(4), added cl. (iii). Par. (32)(D). Pub. L. 109–365, § 101(a)(5), inserted ‘‘, including an assisted living facility,’’ after ‘‘home’’. Par. (34). Pub. L. 109–365, § 101(a)(6), added par. (34) and struck out former par. (34) which read as follows: ‘‘The term ‘neglect’ means— ‘‘(A) the failure to provide for oneself the goods or services that are necessary to avoid physical harm, mental anguish, or mental illness; or ‘‘(B) the failure of a caregiver to provide the goods or services.’’ Pars. (44) to (54). Pub. L. 109–365, § 101(a)(7), added pars. (44) to (54). 2003—Par. (42). Pub. L. 108–36 struck out ‘‘(42 U.S.C. 10408)’’ before period at end. 2000—Par. (3). Pub. L. 106–501, § 101(1), substituted ‘‘and the Commonwealth of the Northern Mariana Is- lands’’ for ‘‘the Commonwealth of the Northern Mar- iana Islands, and the Trust Territory of the Pacific Is- lands’’. Par. (12). Pub. L. 106–501, § 101(2), added par. (12) and struck out former par. (12) which read as follows: ‘‘The term ‘Trust Territory of the Pacific Islands’ includes the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.’’ Par. (18). Pub. L. 106–501, § 101(3), redesignated par. (19) as (18) and struck out former par. (18) which read as follows: ‘‘The term ‘art therapy’ means the use of art and artistic processes specifically selected and adminis- tered by an art therapist, to accomplish the restora- tion, maintenance, or improvement of the mental, emo- tional, or social functioning of an older individual.’’ Par. (19). Pub. L. 106–501, § 101(4), added par. (19) and struck out former par. (19) which read as follows: ‘‘The term ‘caregiver’ means an individual who has the re- sponsibility for the care of an older individual, either voluntarily, by contract, by receipt of payment for care, or as a result of the operation of law.’’ Pub. L. 106–501, § 101(3), redesignated par. (20) as (19). Former par. (19) redesignated (18). Par. (20). Pub. L. 106–501, § 101(4), added par. (20) and struck out former par. (20) which read as follows: ‘‘The term ‘caretaker’ means a family member or other indi- vidual who provides (on behalf of such individual or of a public or private agency, organization, or institution) uncompensated care to an older individual who needs supportive services.’’ Pub. L. 106–501, § 101(3), redesignated par. (21) as (20). Former par. (20) redesignated (19). Par. (21). Pub. L. 106–501, § 101(3), redesignated par. (22) as (21). Former par. (21) redesignated (20). Par. (22). Pub. L. 106–501, § 101(5), redesignated par. (24) as (22). Former par. (22) redesignated (21). Par. (23). Pub. L. 106–501, § 101(5), redesignated par. (25) as (23) and struck out former par. (23) which read as follows: ‘‘The term ‘dance-movement therapy’ means the use of psychotherapeutic movement as a process fa- cilitated by a dance-movement therapist, to further the emotional, cognitive, or physical health of an older in- dividual.’’ Pars. (24) to (31). Pub. L. 106–501, § 101(5), redesignated pars. (26) to (33) as (24) to (31), respectively. Former pars. (24) and (25) redesignated (22) and (23), respec- tively. Par. (32). Pub. L. 106–501, § 101(5), redesignated par. (34) as (32). Former par. (32) redesignated (30). Par. (33). Pub. L. 106–501, § 101(5), redesignated par. (35) as (33). Former par. (33) redesignated (31). Par. (34). Pub. L. 106–501, § 101(6), redesignated par. (37) as (34). Former par. (34) redesignated (32). Par. (34)(C). Pub. L. 106–501, § 801(a), which directed that par. (34)(C) be amended by substituting ‘‘3027(a)(9)’’ for ‘‘3027(a)(12)’’, could not be executed be- cause ‘‘3027(a)(12)’’ did not appear in text. Par. (35). Pub. L. 106–501, § 101(6), redesignated par. (38) as (35). Former par. (35) redesignated (33). Par. (36). Pub. L. 106–501, § 101(6), redesignated par. (39) as (36) and struck out former par.(36) which read as follows: ‘‘The term ‘music therapy’ means the use of musical or rhythmic interventions specifically selected by a music therapist to accomplish the restoration, maintenance, or improvement of social or emotional functioning, mental processing, or physical health of an older individual.’’ Page 5682 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 3003 Pars. (37) to (41). Pub. L. 106–501, § 101(6), redesignated pars. (40) to (44) as (37) to (41), respectively. Former pars. (37) to (39) redesignated (34) to (36), respectively. Pars. (42), (43). Pub. L. 106–501, § 101(7), added pars. (42) and (43). Former pars. (42) and (43) redesignated (39) and (40), respectively. Par. (44). Pub. L. 106–501, § 101(6), redesignated par. (44) as (41). 1998—Par. (32). Pub. L. 105–244 substituted ‘‘section 1001’’ for ‘‘section 1141(a)’’. 1993—Par. (2). Pub. L. 103–171, § 3(a)(1), amended par. (2) generally. Prior to amendment, par. (2) read as fol- lows: ‘‘The term ‘Commissioner’ means, unless the con- text otherwise requires, the Commissioner of the Ad- ministration.’’ Par. (3). Pub. L. 103–171, § 2(1), substituted ‘‘Virgin Is- lands of the United States’’ for ‘‘Virgin Islands’’. 1992—Par. (2). Pub. L. 102–375, § 904(a)(2), which di- rected amendment of par. (2) by substituting ‘‘United States Virgin Islands’’ for ‘‘Virgin Islands’’, could not be executed because ‘‘Virgin Islands’’ did not appear in par. (2). Pub. L. 102–375, § 102(b)(1)(A), substituted ‘‘Adminis- tration’’ for ‘‘Administration on Aging’’. Pars. (13) to (44). Pub. L. 102–375, § 102(a), added pars. (13) to (44). 1988—Par. (10). Pub. L. 100–628, § 705(1)(A), redesig- nated par. (8) defining ‘‘assistive technology’’ as (10). Par. (11). Pub. L. 100–628, § 705(1)(A), redesignated par. (9) defining ‘‘information and referral’’ as (11). Par. (12). Pub. L. 100–628, § 705(1)(B), redesignated par. (8) defining ‘‘Trust Territory of the Pacific Islands’’ as (12). 1987—Par. (1). Pub. L. 100–175, § 182(a), substituted ‘‘except that for purposes of subchapter IX such term means the Secretary of Labor’’ for ‘‘other than for pur- poses of subchapter IX’’. Par. (3). Pub. L. 100–175, § 182(b)(1)(A), substituted ‘‘means any of the several States,’’ for ‘‘includes’’ and ‘‘the Commonwealth of Puerto Rico’’ for ‘‘Puerto Rico’’. Par. (8). Pub. L. 100–175, § 182(b)(1)(B), added par. (8) defining ‘‘Trust Territory of the Pacific Islands’’. Pub. L. 100–175, § 146(a), added par. (8) defining ‘‘as- sistive technology’’. Pub. L. 100–175, § 136(a)(1), added par. (8) defining ‘‘dis- ability’’. Par. (9). Pub. L. 100–175, § 146(a), added par. (9) defin- ing ‘‘information and referral’’. Pub. L. 100–175, § 136(a)(1), added par. (9) defining ‘‘se- vere disability’’. 1981—Par. (1). Pub. L. 97–115, § 2(a)(2), substituted ‘‘Secretary of Health and Human Services’’ for ‘‘Sec- retary of Health, Education, and Welfare’’. Par. (3). Pub. L. 97–115, § 2(a)(3)(A), inserted reference to the Commonwealth of the Northern Mariana Islands. Pars. (6), (7). Pub. L. 97–115, § 2(a)(3)(B), (C), sub- stituted ‘‘Except for the purposes of subchapter X of this chapter, the term’’ for ‘‘The term’’. 1978—Par. (1). Pub. L. 95–478, § 503(a)(1), inserted ‘‘, other than for purposes of subchapter IX’’. Pars. (4) to (7). Pub. L. 95–478, § 503(a)(2), redesignated second par. (4), which was enacted by Pub. L. 94–135, § 104(b), as par. (5) and redesignated existing pars. (5) and (6) as (6) and (7), respectively. 1975—Par. (1). Pub. L. 94–135, § 114(a), substituted a pe- riod for the semicolon. Pars. (4) to (6). Pub. L. 94–135, § 104(b), added pars. (4) to (6). 1969—Par. (3). Pub. L. 91–69 enlarged term ‘‘State’’ to include the Trust Territory of the Pacific Islands. 1967—Par. (2). Pub. L. 90–42, § 5(a)(1), inserted ‘‘, unless the context otherwise requires,’’ after ‘‘means’’. Par. (4). Pub. L. 90–42, § 5(a)(2), enlarged term non- profit institution or organization to include nonprofit agencies. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1998 AMENDMENT Amendment by Pub. L. 105–244 effective Oct. 1, 1998, except as otherwise provided in Pub. L. 105–244, see sec- tion 3 of Pub. L. 105–244, set out as a note under section 1001 of Title 20, Education. EFFECTIVE DATE OF 1987 AMENDMENT Amendment by Pub. L. 100–175 effective Oct. 1, 1987, except not applicable with respect to any area plan sub- mitted under section 3026(a) of this title or any State plan submitted under section 3027(a) of this title and approved for any fiscal year beginning before Nov. 29, 1987, see section 701(a), (b) of Pub. L. 100–175, set out as a note under section 3001 of this title. EFFECTIVE DATE OF 1978 AMENDMENT Amendment by Pub. L. 95–478 effective at close of Sept. 30, 1978, see section 504 of Pub. L. 95–478, set out as a note under section 3001 of this title. § 3003. Congressional declaration of additional objectives The Congress finds that millions of older citi- zens in this Nation are suffering unnecessary harm from the lack of adequate services. It is therefore the purpose of this Act, in support of the objectives of the Older Americans Act of 1965 [42 U.S.C. 3001 et seq.], to— (1) make available comprehensive programs which include a full range of health, edu- cation, and supportive services to our older citizens who need them, (2) give full and special consideration to older citizens with special needs in planning such programs, and, pending the availability of such programs for all older citizens, give priority to the elderly with the greatest eco- nomic and social need. (3) provide comprehensive programs which will assure the coordinated delivery of a full range of essential services to our older citi- zens, and, where applicable, also furnish mean- ingful employment opportunities for many in- dividuals, including older persons, young per- sons, and volunteers from the community, and (4) insure that the planning and operation of such programs will be undertaken as a part- nership of older citizens, community agencies, and State and local governments, with appro- priate assistance from the Federal Govern- ment. (Pub. L. 93–29, title I, § 101, May 3, 1973, 87 Stat. 30; Pub. L. 97–115, § 3(d), Dec. 29, 1981, 95 Stat. 1597.) Editorial Notes REFERENCES IN TEXT This Act, referred to in text, means Pub. L. 93–29, May 3, 1973, 87 Stat. 30, known as the Older Americans Comprehensive Services Amendments of 1973. For com- plete classification of this Act to the Code, see Short Title of 1973 Amendment note set out under section 3001 of this title and Tables. The Older Americans Act of 1965, referred to in text, is Pub. L. 89–73, July 14, 1965, 79 Stat. 218, which is clas- sified generally to this chapter. For complete classi- fication of this Act to the Code, see Short Title note set out under section 3001 of this title and Tables. CODIFICATION Section was not enacted as part of the Older Ameri- cans Act of 1965 which comprises this chapter. AMENDMENTS 1981—Par. (1). Pub. L. 97–115 substituted ‘‘supportive services’’ for ‘‘social services’’.