Current through Register Vol. 48, No. 38, September 20, 2024
The following requirements shall apply to services provided
under this subpart.
a) Multipurpose
Senior Centers
1) An Area Agency on Aging may
award social service funds under this Part to a public or private nonprofit
agency for the following purposes:
A)
Acquiring, altering, leasing, or renovating a facility, including a mobile
facility, for use as a multipurpose senior center;
B) Constructing a facility, including a
mobile facility, for use as a multipurpose senior center;
C) The costs of professional and technical
personnel required to operate a center.
2) In making awards for the purposes
specified in this Section, the Area Agency on Aging shall give preference to
facilities located in communities with the greatest incidence of older persons
with the greatest economic or social need.
3) The following health, safety and
construction requirements shall apply:
A) A
recipient of any award for multipurpose senior center activities shall comply
with all applicable State and local health, fire, safety, building, zoning and
sanitation laws, ordinances or codes.
B) The plans and specifications for an award
for acquiring, altering, renovating or constructing a multipurpose senior
center facility must comply with regulations relating to minimum standards of
construction, particularly with the requirements of the Architectural Barriers
Act of 1968 (
42 U.S.C.
4151 -
4157);
C) The Department shall assure the technical
adequacy of any proposed alteration or renovation of a multipurpose senior
center. The Department assures technical adequacy by requiring that any
alteration or renovation of a multipurpose senior center that affects the load
bearing members of the facility is structurally sound and complies with all
applicable local or State ordinances, laws, or building codes.
4) A recipient of an award for
altering, renovating or constructing a facility to be used as a multipurpose
senior center must comply with the requirements of the Davis-Bacon Act ( 40
U.S.C. 276(a) et seq.) and other mandatory Federal labor standards.
5) The following special conditions for
acquiring by purchase, or constructing a facility shall apply:
A) An Area Agency on Aging shall obtain the
approval of the Department before making an award for constructing a
facility.
B) The Department may
approve the construction of a facility after considering the views of the Area
Agency on Aging, relative to subsections
230.250(a)(2), (3)
and (4), if it is found that there is no
other suitable facility available to be a focal point for service
delivery.
C) The Area Agency on
Aging may make an award for purchasing or constructing a facility only if there
are no suitable facilities for leasing.
6) A facility altered, acquired, renovated,
or constructed using funds under this Part, to be used as a multipurpose senior
center may not be used and may not be intended to be used for sectarian
instruction or as a place for religious worship.
7) The following funding and use requirements
shall apply:
A) Sufficient funds must be
available to meet the non-Federal share of the award;
B) Sufficient funds must be available to
effectively use the facility as a multipurpose senior center;
C) In a facility that is shared with other
age groups, funds received under this rule may support only:
i) That part of the facility used by older
persons; or
ii) A proportionate
share of the costs based on the extent of use of the facility by older persons;
and
D) A multipurpose
senior center program must be operated in the facility.
b) Nutrition Services
1) The Area Agency on Aging may award
nutrition services funds received, under Title III of the Older Americans Act (
42 U.S.C.
3001 et seq.), to provide meals and other
nutrition services, including outreach, and nutrition education, to older
persons. In making these awards the Area Agency on Aging shall assure that
congregate meals are provided and home-delivered meals are provided based on an
assessment of need by the Area Agency on Aging and nutrition service providers.
A) The following eligibility requirements
shall be applicable to persons receiving nutrition services:
i) Congregate nutrition services: A person
age 60 or older, and the spouse of the person regardless of age, are eligible
to participate in congregate nutrition services.
ii) Home-delivered nutrition services: A
person age 60 or over who is homebound by reason of illness, incapacitating
disability or is otherwise isolated is eligible to receive a home-delivered
meal. The spouse of the older person, regardless of age or condition, may
receive a home-delivered meal if, according to criteria determined by the Area
Agency on Aging, receipt of the meal is in the best interest of the homebound
older person.
B) The
Area Agency on Aging must assess the level of need for congregate and
home-delivered meals within the planning and service area.
2) The Area Agency on Aging may make awards
for congregate and home-delivered nutrition services to a provider that
furnishes either or both type(s) of service(s).
A) The Area Agency on Aging shall award funds
to a nutrition services provider that:
i) Was
a nutrition project receiving funds under the former Title VII of the Older
Americans Act on September 30, 1978. For purposes of this requirement,
"nutrition project" means the recipient of a subgrant or contract to provide
nutrition services, other than the Area Agency on Aging, which met the
requirements for a project specified in the former Title VII of the Older
Americans Act and implementing regulations;
ii) Meets the requirements of this Section;
and
iii) Has carried out its
nutrition service activities with demonstrated effectiveness.
B) Except as provided in 45 CFR
74, Subpart M, the Area Agency on Aging shall not discontinue funding to a
nutrition project specified in subsection (b)(2)(A)(i) of this Section unless
the Department:
i) Has given the project an
opportunity for a hearing, in accordance with Section
230.40 of this
Part; and
ii) Has determined that
the project does not meet the requirements of this Section; or has not carried
out nutrition services activities with demonstrated effectiveness. The
Department shall not set criteria for demonstrated effectiveness that are
different from the requirements imposed on projects during the period for which
their performance is being measured.
C) Consistent with the requirements of
subsection (b)(2)(A) of this Section and, to the extent feasible, the Area
Agency on Aging must give preference in making awards for home-delivered meals
to public, private nonprofit, and voluntary organizations which:
i) Have demonstrated an ability to provide
home-delivered meals efficiently and reasonably; and
ii) Have furnished assurances to maintain
efforts to solicit voluntary support and not to use funds received under this
Part to supplant funds from non-Federal sources.
3) Each congregate provider shall:
A) Provide hot or other appropriate meals in
a congregate setting at least once a day, five or more days a week;
B) Locate congregate nutrition services as
close as possible and, where feasible and appropriate, within walking distance
to the majority of eligible older persons; and
C) Assess the need for home-delivered meals
among participants at its congregate sites.
4) Each home-delivered meals provider shall:
A) Assess the need for home-delivered meals
among the participants for whom it has responsibility;
B) Provide for home-delivered meals at least
once a day, five or more days a week. Meals may be hot, cold, frozen, dried,
canned or supplemental foods with a satisfactory storage life;
C) With the consent of the older person, or
his or her representative, bring to the attention of appropriate officials for
follow-up, conditions or circumstances which place the older person or the
household in imminent danger; and
D) Where feasible and appropriate, make
arrangements for the availability of meals to older persons in weather related
emergencies.
5) The
following food requirements shall apply for all nutrition service providers:
A) In purchasing food, and preparing and
delivering meals, the nutrition services providers must follow appropriate
procedures to preserve nutritional value and food safety.
B) The nutrition services providers must
comply with all State and local health laws and ordinances concerning
preparation, handling and serving food.
C) The nutrition services provider must
provide special menus, where feasible and appropriate, to meet the particular
dietary needs arising from the health requirements, religious requirements, or
ethnic backgrounds of eligible individuals.
D) The nutrition services provider must have
available for use upon request appropriate food containers and utensils for
blind and handicapped participants.
E) Each meal served by the nutrition services
provider must contain at least one-third of the current Recommended Dietary
Allowances as established by the Food and Nutrition Board of the National
Academy of Sciences - National Research Council.
F) A nutrition services provider shall spend
U.S.D.A. food assistance cash only for buying United States Agriculture
commodities and other food.
G) The
nutrition services providers shall assist participants in taking advantage of
benefits available to them under the food stamp program. The nutrition services
provider must coordinate its activities with agencies responsible for
administering the food stamp program to facilitate participation of eligible
older persons in the program.
c) Legal Services
1) The Area Agency on Aging shall award
social services funds under this Part for legal services to older persons with
the greatest economic or social needs. The purpose of awards under this
subsection is to increase the availability of legal services with a priority on
older persons with the greatest economic or social need in order to assist them
to secure their rights, benefits and entitlements, and to assist them in
achieving the objectives of the Older Americans Act. Legal services provided
with funds under this Part must be in addition to any legal services already
being provided to older persons in the planning and service area.
"Legal services" means legal advice and representation by an
attorney (including, to the extent feasible, counseling or other appropriate
assistance by a paralegal or law student under the supervision of an attorney),
and includes counseling or representation by a non-lawyer where permitted by
law, to older persons with economic or social needs.
2) A legal service provider shall be either:
A) An organization that receives funds under
the Legal Services Corporation Act ( 42 U.S.C. 2969); or
B) An organization that has a legal services
program or the capacity to develop one.
3) The Area Agency on Aging shall award funds
to the legal service provider(s) that most fully meet(s) the following
standards. The legal services provider(s):
A)
Has staff with expertise in specific areas of law affecting older persons in
economic or social need;
B)
Demonstrates the capacity to provide effective administrative and judicial
representation in the areas of law affecting older persons with social or
economic need;
C) Demonstrates the
capacity to provide support to other advocacy efforts;
D) Demonstrates the capacity to effectively
deliver legal services to institutionalized, isolated, and homebound
individuals;
E) Has offices and/or
outreach sites which are convenient and accessible to older persons in the
community;
F) Demonstrates the
capacity to provide legal services in a cost effective manner; and
G) Demonstrates the capacity to obtain other
resources to provide legal services to older persons.
4) Each legal services provider shall:
A) Make efforts to involve the private bar in
legal services provided under this Part, including groups within the private
bar that furnish legal services to older persons on a pro bono and reduced fee
basis;
B) Ensure that no attorney
of the provider engages in any outside practice of law if the director of the
provider has determined that the practice is inconsistent with the attorney's
full time responsibilities;
C)
Ensure that while employed under this Part, no employee and no staff attorney
of the provider at any time:
i) Uses official
authority or influence for the purpose of interfering with or affecting the
results of an election or nomination for office, whether partisan or
nonpartisan;
ii) Directly or
indirectly coerces, attempts to coerce, command or advise an employee of any
provider to pay, lend, or contribute anything of value to a political party, or
committee, organization, agency or person for political purposes;
iii) Is a candidate for partisan elective
public office; or
iv) Engages in
any voter registration activity.
D) In areas where a significant number of
clients do not speak English as their principal language, adopt employment
policies that ensure that legal assistance will be provided in the language
spoken by those clients;
E) Adopt a
procedure for affording the public appropriate access to the Older Americans
Act, regulations and guidelines of 45 CFR Part 1321, the provider's written
policies, procedures, and guidelines, the names and addresses of the members of
the governing body, and other materials that the provider determines should be
disclosed. The procedure adopted must be approved by the Area Agency on
Aging;
F) Ensure that legal
services are not provided in fee generating cases, as defined in
45
CFR 1609.2, unless adequate representation is
unavailable from private attorneys;
G) Ensure that no employee and no staff
attorney of the provider shall directly or indirectly engage in activities
intended to influence the passage or defeat of any legislation by the Congress
of United States or by any State or local legislative body or State proposals
by initiative petition except where:
i)
Representation by a provider for a client is necessary with respect to such
client's rights and responsibilities (except that no employee shall solicit a
client in violation of professional responsibilities for the purpose of making
such representation possible); or
ii) A governmental agency, legislative body,
committee or member thereof requests the provider to testify, draft or review
measures or to make representations to such agency, body, committee or member,
or is considering a measure directly affecting the activities of a provider
under this Part; and
H)
Ensure that, while providing legal services, no employee and no staff attorney
of the provider engages in demonstrations, picketing, boycotts, or rioting or
civil disturbance or any illegal activities as defined at
45 CFR
1612.1,
1612.2 and
1612.3.
5) Each legal services provider
that is not a Legal Services Corporation grantee shall agree to coordinate its
services with Legal Services Corporation grantees in order to concentrate legal
services funded under the Older Americans Act on older persons with the
greatest economic or social need who are not eligible for services under the
Legal Services Corporation Act. In carrying out this requirement, legal
services providers shall not use a means test or require older persons to apply
first for services through a Legal Services Corporation grantee.
6) A legal services provider under this Part
may with the approval of the Area Agency on Aging set priorities for the
categories of cases for which it will provide legal representation in order to
concentrate on older persons with the greatest economic or social need. In
setting case priorities, a legal services provider may consider the
availability of staff resources in determining the extent of legal advice and
representation to provide to individual older persons.
7) A legal services provider shall not
require an older person to disclose information about income or resources as a
condition for providing legal services under this Part. A legal services
provider may ask about the person's financial circumstances as a part of the
process of providing legal advice, counseling and representation, or for the
purpose of identifying additional resources and benefits for which an older
person may be eligible.
d) Information and Referral Services
1) The area plan shall provide for
information and referral services sufficient to ensure that all older persons
within the planning and service area have reasonably convenient access to the
service.
A) In areas in which a significant
number of older persons do not speak English as their principal language, the
service provider shall provide information and referral services in the
language spoken by the older person.
B) "Information and referral service" means a
system to link people in need of service to appropriate resources.
2) A provider of information and
referral services shall:
A) Maintain current
information with respect to the opportunities and services available to older
persons;
B) Develop current lists
of older persons in need of services and opportunities; and
C) Employ a specially trained staff to inform
older persons of the opportunities and services which are available and to
assist older persons to take advantage of the opportunities and
services.
3) An
information and referral services provider may disclose information by name
about an older person only with the informed consent of the older person or his
or her authorized representative.
e) Transportation Services
The Area Agency on Aging may enter into transportation
agreements with agencies which administer programs under the Rehabilitation Act
of 1973 (
29 U.S.C.
701 et seq.) and Title XIX of the Social
Security Act to meet the common need for transportation of service participants
under the separate programs. Transportation programs are the only activities
funded under Title III of the Older Americans Act where the Area Agency on
Aging may delegate to another agency the authority to award or administer those
funds.
f) Home Health
Services
1) Home health care services
authorized under an approved area plan shall be provided by:
A) A Medicare-certified Home Health
agency.
B) A self-employed
registered nurse who provides services within the scope of his or her practice
as defined by the Illinois Nursing Act of 1987 (Ill. Rev. Stat., 1989, ch. 111,
par. 3501 et seq.).
C) A physical
therapist certified by the Council of Medical Education of the American Medical
Association and registered by the State of Illinois.
D) A speech therapist certified by the
American Speech and Hearing Association.
E) An occupational therapist registered with
the American Occupational Therapy Association.
2) Home health services that may be provided
are:
A) Skilled nursing
B) Home health aids
C) Speech therapy
D) Physical therapy
E) Occupational therapy
3) Home health agencies may provide covered
services for which they are certified to provide by Medicare.
4) Area agencies providing services shall
develop procedures that will insure that double payments will not be made from
the same service, that Title III funds will be used only to increase services,
and that rates paid for such services do not exceed the established Medicare
rate for the vendor providing the service, nor shall payment be made to
supplement payments made through Medicare or Medicaid when such supplement is
in excess of the established Medicare rate.
5) Payment to self-employed registered nurses
providing in-home nursing services is made at the community rate for such
services as determined for each case at the time prior approval is
given.
6) Payment to independent
therapists and community health agencies shall be at the provider's usual and
customary charge, not to exceed the maximum established by the Department at
$10 per half-hour clinical visit.
g) Homemaker Services
Homemaker services authorized under an approved area plan
shall meet the definitional requirements specified in 89 Ill. Adm. Code
240.410.
h) Chore and Housekeeping Services
Chore and housekeeping services authorized under an approved
area plan shall meet the definitional requirements specified in 89 Ill. Adm.
Code
240.420.
i) Case Management Services
The Department on Aging allows funds to be expended for
service entitled "Case Management". Activities directly associated with this
service shall be carried out in accordance with applicable provisions of 89
Ill. Adm. Code
220.600
et seq. and 89 Ill. Adm. Code 230 Subpart G once a procurement has been
conducted pursuant to 89 Ill. Adm. Code
220.610
et seq.
j) Other Services
Other service components of a comprehensive and coordinated
service delivery system that may be funded by an Area Agency on Aging
include:
1) Services which facilitate
access, such as outreach, escort, individual needs assessment and service
management;
2) Services provided in
the community, where permitted by 45 CFR 1321.131, such as continuing
education, health and health screening, program development and coordination
activities, individual needs assessment and service management, casework,
counseling and assistance (concerning taxes, financial problems, welfare, the
use of facilities and services, pre-retirement or second career), day care,
protective services, nutrition education, services designed for the unique
needs of the disabled, emergency services including disaster relief services,
residential repair and renovation, physical fitness and recreation services,
services in helping to obtain adequate housing;
3) Services provided in the home, such as
preinstitutional evaluations, casework, counseling, chore maintenance,
visiting, shopping, readers, letter writing, telephone reassurance, and
nutrition education;
4) Services
provided to residents of care providing facilities, such as casework,
counseling, placement and relocation assistance, group services, complaint and
grievance resolution and visiting. Care providing facilities include long-term
care facilities as defined in
45 CFR
1321.43(b), emergency
shelters, and other congregate living arrangements.