Findings and purposes
The Congress finds that—
(A) the effective provision of congregate services may require the redesign of units and buildings to meet the special physical needs of the frail elderly persons and the creation of congregate space to accommodate services that enhance independent living;
(B) congregate housing, coordinated with the delivery of supportive services, offers an innovative, proven, and cost-effective means of enabling frail older persons and persons with disabilities to maintain their dignity and independence;
(C) independent living with assistance is a preferable housing alternative to institutionalization for many frail older persons and persons with disabilities;
(D) 365,000 persons in federally assisted housing experience some form of frailty, and the number is expected to increase as the general population ages;
(E) an estimated 20 to 30 percent of older adults living in federally assisted housing experience some form of frailty;
(F) a large and growing number of frail elderly residents face premature or unnecessary institutionalization because of the absence of or deficiencies in the availability, adequacy, coordination, or delivery of supportive services;
(G) the support service needs of frail residents of assisted housing are beyond the resources and experience that housing managers have for meeting such needs;
(H) supportive services would promote the invaluable option of independent living for nonelderly persons with disabilities in federally assisted housing;
(I) approximately 25 percent of congregate housing services program sites provide congregate services to young individuals with disabilities;
(J) to the extent that institutionalized older adults do not need the full costly support provided by such care, public moneys could be more effectively spent providing the necessary services in a noninstitutional setting; and
(K) the Congregate Housing Services Program, established by Congress in 1978, and similar programs providing in-home services have been effective in preventing unnecessary institutionalization and encouraging deinstitutionalization.
The purposes of this section are—
(A) to provide assistance to retrofit individual dwelling units and renovate public and common areas in eligible housing to meet the special physical needs of eligible residents;
(B) to create and rehabilitate congregate space in or adjacent to such housing to accommodate supportive services that enhance independent living;
(C) to improve the capacity of management to assess the service needs of eligible residents, coordinate the provision of supportive services that meet the needs of eligible residents and ensure the long-term provision of such services;
(E) to provide readily available and efficient supportive services that provide a choice in supported living arrangements by utilizing the services of an on-site coordinator, with emphasis on maintaining a continuum of care for the vulnerable elderly;
(F) to improve the quality of life of older Americans living in federally assisted housing;
(G) to preserve the viability of existing affordable housing projects for lower-income older residents who are aging in place by assisting managers of such housing with the difficulties and challenges created by serving older residents;
(H) to develop partnerships between the Federal Government and State governments in providing services to the frail elderly and persons with disabilities; and
(I) to utilize Federal and State funds in a more cost-effective and humane way in serving the needs of older adults.
A congregate services program under this section shall provide meal and other services for eligible project residents (and other residents and nonresidents, as provided in subsection (e)), as provided in this section, that are coordinated on site.
Congregate services programs assisted under this section shall include meal service adequate to meet at least one-third of the daily nutritional needs of eligible project residents, as follows:
Supplemental nutrition assistance program benefits and agricultural commodities
In providing meal services under this paragraph, each congregate services program—
shall—(I) apply for approval as a retail food store under section 2018 of title 7; and(II) if approved under such section, accept benefits as payment from individuals to whom such meal services are provided; and
(ii) shall request, and use to provide such meal services, agricultural commodities made available without charge by the Secretary of Agriculture.
Preference for nutrition providers
In contracting for or otherwise providing for meal services under this paragraph, each congregate services program shall give preference to any provider of meal services who—
(i) receives assistance under title III of the Older Americans Act of 1965 [42 U.S.C. 3021 et seq.]; or (ii) has experience, according to standards as the Secretary shall require, in providing meal services in a housing project under the Congregate Housing Services Act of 1978 [42 U.S.C. 8001 et seq.] or any other program for congregate services. (3)
Retrofit and renovation
Assistance under this section may be provided with respect to eligible housing for the elderly for—
retrofitting of individual dwelling units to meet the special physical needs of current or future residents who are or are expected to be eligible residents, which retrofitting may include—
(i) widening of doors to allow passage by persons with disabilities in wheelchairs into and within units in the project;
(ii) placement of light switches, electrical outlets, thermostats and other environmental controls in accessible locations;
(iii) installation of grab bars in bathrooms or the placement of reinforcements in bathroom walls to allow later installation of grab bars;
(iv) redesign of usable kitchens and bathrooms to permit a person in a wheelchair to maneuver about the space; and
(v) such other features of adaptive design that the Secretary finds are appropriate to meet the special needs of such residents;
(B) such renovation as is necessary to ensure that public and common areas are readily accessible to and usable by eligible residents;
(C) renovation, conversion, or combination of vacant dwelling units to create congregate space to accommodate the provision of supportive services to eligible residents;
(D) renovation of existing congregate space to accommodate the provision of supportive services to eligible residents; and
(E) construction or renovation of facilities to create conveniently located congregate space to accommodate the provision of supportive services to eligible residents.
For purposes of this paragraph, the term “congregate space” shall include space for cafeterias or dining halls, community rooms or buildings, workshops, adult day health facilities, or other outpatient health facilities, or other essential service facilities.
Assistance under this section may be provided with respect to the employment of one or more individuals (hereinafter referred to as “service coordinator”) who may be responsible for—
(A) working with the professional assessment committee established under subsection (f) 2
2 So in original. Probably should be subsection “(e)”. on an ongoing basis to assess the service needs of eligible residents;
(B) working with service providers and the professional assessment committee to tailor the provision of services to the needs and characteristics of eligible residents;
(C) mobilizing public and private resources to ensure that the qualifying supportive services identified pursuant to subsection (d) can be funded over the time period identified under such subsection;
(D) monitoring and evaluating the impact and effectiveness of any supportive service program receiving capital or operating assistance under this section; and
(E) performing such other duties and functions that the Secretary deems appropriate to enable frail elderly persons residing in federally assisted housing to live with dignity and independence.
The Secretary shall establish such minimum qualifications and standards for the position of service coordinator that the Secretary deems necessary to ensure sound management. Such qualifications and standards shall include requiring each service coordinator to be trained in the aging process, elder services, disability services, eligibility for and procedures of Federal and applicable State entitlement programs, legal liability issues relating to providing service coordination, drug and alcohol use and abuse by the elderly, and mental health issues. The Secretary may fund the employment of service coordinators by using amounts appropriated under this section and by permitting owners to use existing sources of funds, including excess project reserves.
Congregate services programs assisted under this section may include services for transportation, personal care, dressing, bathing, toileting, housekeeping, chore assistance, nonmedical counseling, assessment of the safety of housing units, group and socialization activities, assistance with medications (in accordance with any applicable State law), case management, personal emergency response, and other services to prevent premature and unnecessary institutionalization of eligible project residents.
Determination of needs
In determining the services to be provided to eligible project residents under a congregate services program assisted under this section, the program shall provide for consideration of the needs and wants of eligible project residents.
Eligible project residents
The owner of each eligible housing project shall establish fees for meals and other services provided under a congregate services program to eligible project residents, which shall be sufficient to provide 10 percent of the costs of the services provided. The Secretary concerned shall provide for the waiver of fees under this paragraph for individuals whose incomes are insufficient to provide for any payment. The fees for meals shall be in the following amounts:
Full meal services
The fees for residents receiving more than 1 meal per day, 7 days per week, shall be reasonable and shall equal between 10 and 20 percent of the adjusted income of the project resident (as such income is determined under section 3(b) of the United States Housing Act of 1937 [42 U.S.C. 1437a(b)]), or the cost of providing the services, whichever is less.
Less than full meal services
The fees for residents receiving meal services less frequently than as described in the preceding sentence shall be in an amount equal to 10 percent of such adjusted income of the project resident or the cost of providing the services, whichever is less.
Other residents and nonresidents
Fees shall be established under this paragraph for residents of eligible housing projects (other than eligible project residents) and for nonresidents that receive services from a congregate services program pursuant to subsection (e). Such fees shall be in an amount equal to the cost of providing the services.
Direct and indirect provision of services
Any State, Indian tribe, unit of general local government, or nonprofit housing sponsor that receives assistance under this section may provide congregate services directly to eligible project residents or may, by contract or lease, provide such services through other appropriate agencies or providers.
The funds made available under this section shall be allocated by the Secretary among approvable applications submitted by or on behalf of owners. Applications for assistance under this section shall be submitted in such form and in accordance with such procedures as the Secretary shall establish. Applications for assistance shall contain—
(1) a description of the type of assistance the applicant is applying for;
(2) in the case of an application involving rehabilitation or retrofit, a description of the activities to be carried out, the number of elderly persons to be served, the costs of such activities, and evidence of a commitment for the services to be associated with the project;
(3) a description of qualifying supportive services that can reasonably be expected to be made available to eligible residents over a 5-year period;
(4) a firm commitment from one or more sources of assistance ensuring that some or all of the qualifying supportive services identified under paragraph (3) will be provided for not less than 1 year following the completion of activities assisted under subsection (d);
(5) a description of public or private sources of assistance that are likely to fund or provide qualifying supportive services, including evidence of any intention to provide assistance expressed by State and local governments, private foundations, and other organizations (including for-profit and nonprofit organizations);
a certifications 3
3 So in original. Probably should be “certification”.
from the appropriate State or local agency (as determined by the Secretary) that—
(A) the provision of the qualifying supportive services identified under paragraph (3) will enable eligible residents to live independently and avoid unnecessary institutionalization,
(B) there is a reasonable likelihood that such services will be funded or provided for the entire period specified under paragraph (3), and
(C) the agency and the applicant will, during the term of the contract, actively seek assistance for such services from other sources;
(7) a description of any fees that would be established pursuant to subsection (d); and
(8) such other information or certifications that the Secretary determines to be necessary or appropriate to achieve the purposes of this section.
The Secretary shall act on each application within 60 days of its submission.
Selection and evaluation of applications and programs
(A) the extent to which the activities described in subsection (d)(3) will foster independent living and the provision of such services;
(B) the types and priorities of the basic services proposed to be provided, the appropriateness of the targeting of services, the methods of providing for deinstitutionalized older individuals and individuals with disabilities, and the relationship of the proposal to the needs and characteristics of the eligible residents of the projects where the services are to be provided;
(C) the schedule for establishment of services following approval of the application;
(D) the degree to which local social services are adequate for the purpose of assisting eligible project residents to maintain independent living and avoid unnecessary institutionalization;
(E) the professional qualifications of the members of the professional assessment committee;
(F) the reasonableness and application of fees schedules established for congregate services;
(G) the adequacy and accuracy of the proposed budgets; and
(H) the extent to which the owner will provide funds from other services in excess of that required by this section.
Evaluation of provision of congregate services programs
The Secretary of Housing and Urban Development and the Secretary of Agriculture shall, by regulation under subsection (n),4
4 So in original. Probably should be subsection “(m),”.
establish procedures for States, Indian tribes, and units of general local government receiving assistance under this section—
(A) to review and evaluate the performance of the congregate services programs of eligible housing projects receiving assistance under this section in such State; and
(B) to submit annually, to the Secretary concerned, a report evaluating the impact and effectiveness of congregate services programs in the entity assisted under this section.
For purposes of this section:
(1) The term “activity of daily living” means an activity regularly necessary for personal care and includes bathing, dressing, eating, getting in and out of bed and chairs, walking, going outdoors, and using the toilet.
(2) The term “case management” means assessment of the needs of a resident, ensuring access to and coordination of services for the resident, monitoring delivery of services to the resident, and periodic reassessment to ensure that services provided are appropriate to the needs and wants of the resident.
(3) The term “congregate housing” means low-rent housing that is connected to a central dining facility where wholesome and economical meals can be served to the residents.
(4) The term “congregate services” means services described in subsection (d) of this section.
(5) The term “congregate services program” means a program assisted under this section undertaken by an eligible housing project to provide congregate services to eligible residents.
The term “eligible housing project” means—
(A) public housing (as such term is defined in section 3(b) of the United States Housing Act of 1937 [42 U.S.C. 1437a(b)]) and lower income housing developed or operated pursuant to a contract between the Secretary of Housing and Urban Development and an Indian housing authority under title II 8
8 See References in Text note below. of the United States Housing Act of 1937;
(B) housing assisted under section 8 of the United States Housing Act of 1937 [42 U.S.C. 1437f] with a contract that is attached to the structure under subsection (d)(2) of such section or with a contract entered into in connection with the new construction or moderate rehabilitation of the structure under section 8(b)(2) of the United States Housing Act,8 as such section existed before October 1, 1983;
(C) housing assisted under section 1701q of title 12;
(D) housing assisted under section 1715l(d) or 1715z–1 of title 12, with respect to which the owner has made a binding commitment to the Secretary of Housing and Urban Development not to prepay the mortgage or terminate the insurance contract under section 1715t of title 12 (unless the binding commitments have been made to extend the low-income use restrictions relating to such housing for the remaining useful life of the housing);
(E) housing assisted under section 1484 or 1485 of this title, with respect to which the owner has made a binding commitment to the Secretary of Agriculture not to prepay or refinance the mortgage (unless the binding commitments have been made to extend the low-income use restrictions relating to such housing for not less than the 20-year period under section 1472(c)(4) of this title); and
(F) housing assisted under section 1486 of this title.
(7) The term “eligible resident” means a person residing in eligible housing for the elderly who qualifies under the definition of frail elderly, person with disabilities (regardless of whether the person is elderly), or temporarily disabled.
(8) The term “frail elderly” means an elderly person who is unable to perform at least 3 activities of daily living adopted by the Secretary for purposes of this program. Owners may establish additional eligibility requirements (acceptable to the Secretary) based on the standards in local supportive services programs.
(9) The term “Indian tribe” means any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or regional corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act [43 U.S.C. 1601 et seq.], that is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians.
(10) The term “instrumental activity of daily living” means a regularly necessary home management activity and includes preparing meals, shopping for personal items, managing money, using the telephone, and performing light or heavy housework.
(11) The term “local nonprofit housing sponsor” includes public housing agencies (as such term is defined in section 3(b)(6) of the United States Housing Act of 1937 [42 U.S.C. 1437a(b)(6)].9
9 So in original. Probably should be preceded by a closing parenthesis.
(12) The term “nonprofit”, as applied to an organization, means no part of the net earnings of the organization inures, or may lawfully inure, to the benefit of any private shareholder or individual.
(13) The term “elderly person” means a person who is at least 62 years of age.
(14) The term “person with disabilities” has the meaning given the term by section 8013 of this title.
(15) The term “professional assessment committee” means a committee established under subsection (e)(3)(B).
(16) The term “qualifying supportive services” means new or significantly expanded services that the Secretary deems essential to enable eligible residents to live independently and avoid unnecessary institutionalization. Such services may include but not be limited to (A) meal service adequate to meet nutritional need; (B) housekeeping aid; (C) personal assistance (which may include, but is not limited to, aid given to eligible residents in grooming, dressing, and other activities which maintain personal appearance and hygiene); (D) transportation services; (E) health-related services; and (F) personal emergency response systems; the owner may provide the qualifying services directly to eligible residents or may, by contract or lease, provide such services through other appropriate agencies or providers.
The term “Secretary concerned” means—
(A) the Secretary of Housing and Urban Development, with respect to eligible federally assisted housing administered by such Secretary; and
(B) the Secretary of Agriculture, with respect to eligible federally assisted housing administered by the Administrator of the Farmers Home Administration.
(18) The term “State” means the States of the United States, the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, Guam, the Virgin Islands, American Samoa, the Trust Territory of the Pacific Islands, and any other territory or possession of the United States.
The term “temporarily disabled” means having an impairment that—
(A) is expected to be of no more than 6 months duration; and
(B) impedes the ability of the individual to live independently unless the individual receives congregate services.
The term “unit of general local government”—
(A) means any city, town, township, county, parish, village, or other general purpose political subdivision of a State; and
(B) includes a unit of general government acting as an applicant for assistance under this section in cooperation with a nonprofit housing sponsor and a nonprofit housing sponsor acting as an applicant for assistance under this section in cooperation with a unit of general local government, as provided under subsection (g)(1)(B).10
10 So in original. Probably should be subsection “(h)(1)(B).”
(Pub. L. 101–625, title VIII, § 802, Nov. 28, 1990, 104 Stat. 4304; Pub. L. 102–550, title VI, §§ 604(a), (b), 672, Oct. 28, 1992, 106 Stat. 3805, 3826; Pub. L. 110–234, title IV, §§ 4002(b)(1)(B), (N), (2)(LL), 4115(c)(1)(A)(i), (B)(vi), (2)(I), May 22, 2008, 122 Stat. 1096, 1098, 1109, 1110; Pub. L. 110–246, § 4(a), title IV, §§ 4002(b)(1)(B), (N), (2)(LL), 4115(c)(1)(A)(i), (B)(vi), (2)(I), June 18, 2008, 122 Stat. 1664, 1857–1859, 1870, 1871.)