
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document affected by Public Law 106-501 Section 706]
[CITE: 42USC3058k]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                CHAPTER 35--PROGRAMS FOR OLDER AMERICANS
 
    SUBCHAPTER XI--ALLOTMENTS FOR VULNERABLE ELDER RIGHTS PROTECTION 
                               ACTIVITIES
 
                        Part A--State Provisions
 
         subpart v--outreach, counseling, and assistance program
 
Sec. 3058k. State outreach, counseling, and assistance program 
        for insurance and public benefits
        

(a) Definitions

    As used in this section:

                        (1) Insurance benefit

        The term ``insurance benefit'' means a benefit under--
            (A) the medicare program established under title XVIII of 
        the Social Security Act (42 U.S.C. 1395 et seq.);
            (B) the medicaid program established under title XIX of the 
        Social Security Act (42 U.S.C. 1396 et seq.);
            (C) a public or private insurance program;
            (D) a medicare supplemental policy; or
            (E) a pension plan.

                  (2) Medicare supplemental policy

        The term ``medicare supplemental policy'' has the meaning given 
    the term in section 1882(g)(1) of the Social Security Act (42 U.S.C. 
    1395ss(g)(1)).

                          (3) Pension plan

        The term ``pension plan'' means an employee pension benefit 
    plan, as defined in section 1002(2) of title 29.

                         (4) Public benefit

        The term ``public benefit'' means a benefit under--
            (A) the Federal Old-Age, Survivors, and Disability Insurance 
        Benefits programs under title II of the Social Security Act (42 
        U.S.C. 401 et seq.);
            (B) the medicare program established under title XVIII of 
        the Social Security Act [42 U.S.C. 1395 et seq.], including 
        benefits as a qualified medicare beneficiary, as defined in 
        section 1905(p) of the Social Security Act [42 U.S.C. 1396d(p)];
            (C) the medicaid program established under title XIX of the 
        Social Security Act [42 U.S.C. 1396 et seq.];
            (D) the program established under the Food Stamp Act of 1977 
        (7 U.S.C. 2011 et seq.);
            (E) the program established under the Low-Income Home Energy 
        Assistance Act of 1981 (42 U.S.C. 8621 et seq.);
            (F) the supplemental security income program established 
        under title XVI of the Social Security Act (42 U.S.C. 1381 et 
        seq.); or
            (G) a program determined to be appropriate by the Assistant 
        Secretary.

               (5) State insurance assistance program

        The term ``State insurance assistance program'' means the 
    program established under subsection (b)(1) of this section.

             (6) State public benefit assistance program

        The term ``State public benefit assistance program'' means the 
    program established under subsection (b)(2) of this section.

(b) Establishment

    In order to receive an allotment under section 3058b of this title 
from funds appropriated under section 3058a(d) of this title, a State 
agency shall, in coordination with area agencies on aging and in 
accordance with this section, establish--
        (1) a program to provide to older individuals outreach, 
    counseling, and assistance related to obtaining insurance benefits; 
    and
        (2) a program to provide outreach, counseling, and assistance to 
    older individuals who may be eligible for, but who are not 
    receiving, public benefits.

(c) Insurance and public benefits

    The State agency shall--
        (1) in carrying out a State insurance assistance program--
            (A) provide information and counseling to assist older 
        individuals--
                (i) in filing claims and obtaining benefits under title 
            XVIII and title XIX of the Social Security Act [42 U.S.C. 
            1395 et seq., 1396 et seq.];
                (ii) in comparing medicare supplemental policies and in 
            filing claims and obtaining benefits under such policies;
                (iii) in comparing long-term care insurance policies and 
            in filing claims and obtaining benefits under such policies;
                (iv) in comparing other types of health insurance 
            policies not described in clause (iii) and in filing claims 
            and obtaining benefits under such policies;
                (v) in comparing life insurance policies and in filing 
            claims and obtaining benefits under such policies;
                (vi) in comparing other forms of insurance policies not 
            described in clause (v), in comparing pension plans, and in 
            filing claims and obtaining benefits under such policies and 
            plans as the State agency may determine to be necessary; and
                (vii) in comparing current and future health and post-
            retirement needs related to pension plans, and the 
            relationship of benefits under such plans to insurance 
            benefits and public benefits;

            (B) establish a system of referrals to appropriate providers 
        of legal assistance, and to appropriate agencies of the Federal 
        or State government regarding the problems of older individuals 
        related to health insurance benefits, other insurance benefits, 
        and public benefits;
            (C) give priority to providing assistance to older 
        individuals with greatest economic need;
            (D) ensure that services provided under the program will be 
        coordinated with programs established under subparts II, III, 
        and IV of this part, and under subchapter III of this chapter;
            (E) provide for adequate and trained staff (including 
        volunteers) necessary to carry out the program;
            (F) ensure that staff (including volunteers) of the agency 
        and of any agency or organization described in subsection (d) of 
        this section will not be subject to a conflict of interest in 
        providing services under the program;
            (G) provide for the collection and dissemination of timely 
        and accurate information to staff (including volunteers) related 
        to insurance benefits and public benefits;
            (H) provide for the coordination of information on insurance 
        benefits between the staff of departments and agencies of the 
        State government and the staff (including volunteers) of the 
        program; and
            (I) make recommendations related to consumer protection that 
        may affect individuals eligible for, or receiving, health or 
        other insurance benefits; and

        (2) in carrying out a State public benefits assistance program--
            (A) carry out activities to identify older individuals with 
        greatest economic need who may be eligible for, but who are not 
        receiving, public benefits;
            (B) conduct outreach activities to inform older individuals 
        of the requirements for eligibility to receive such benefits;
            (C) assist older individuals in applying for such benefits;
            (D) establish a system of referrals to appropriate providers 
        of legal assistance, or to appropriate agencies of the Federal 
        or State government regarding the problems of older individuals 
        related to public benefits;
            (E) comply with the requirements specified in subparagraphs 
        (C) through (F) of paragraph (1) with respect to the State 
        public benefits assistance program;
            (F) provide for the collection and dissemination of timely 
        and accurate information to staff (including volunteers) related 
        to public benefits;
            (G) provide for the coordination of information on public 
        benefits between the staff of State entities and the staff 
        (including volunteers) of the State public benefits assistance 
        program; and
            (H) make recommendations related to consumer protection that 
        may affect individuals eligible for, or receiving, public 
        benefits.

(d) Administration

    The State agency may operate the State insurance assistance program 
and the State public benefits assistance program directly, in 
cooperation with other State agencies, or under an agreement with a 
statewide nonprofit organization, an area agency on aging, or another 
public or nonprofit agency or organization.

(e) Maintenance of effort

    Any funds appropriated for the activities under this subpart shall 
supplement, and shall not supplant, funds that are expended for similar 
purposes under any Federal, State, or local program providing insurance 
benefits or public benefits.

(f) Coordination

    A State that receives an allotment under section 3058b of this title 
and receives a grant to provide services under section 1395b-4 of this 
title shall coordinate the services with activities provided by the 
State agency through the programs described in paragraphs (1) and (2) of 
subsection (b) of this section.

(Pub. L. 89-73, title VII, Sec. 741, as added Pub. L. 102-375, title 
VII, Sec. 705(b), Sept. 30, 1992, 106 Stat. 1287; amended Pub. L. 103-
171, Sec. 3(a)(13), Dec. 2, 1993, 107 Stat. 1990.)

                       References in Text

    The Social Security Act, referred to in subsecs. (a)(1)(A), (B), 
(4)(A) to (C), (F), (c)(1)(A)(i), is act Aug. 14, 1935, ch. 531, 49 
Stat. 620, as amended. Titles II, XVI, XVIII, and XIX of the Act are 
classified generally to subchapters II (Sec. 401 et seq.), XVI 
(Sec. 1381 et seq.), XVIII (Sec. 1395 et seq.), and XIX (Sec. 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.
    The Food Stamp Act of 1977, referred to in subsec. (a)(4)(D), is 
Pub. L. 88-525, Aug. 31, 1964, 78 Stat. 703, as amended, which is 
classified generally to chapter 51 (Sec. 2011 et seq.) of Title 7, 
Agriculture. For complete classification of this Act to the Code, see 
Short Title note set out under section 2011 of Title 7 and Tables.
    The Low-Income Home Energy Assistance Act of 1981, referred to in 
subsec. (a)(4)(E), is title XXVI of Pub. L. 97-35, Aug. 13, 1981, 95 
Stat. 893, as amended, which is classified generally to subchapter II 
(Sec. 8621 et seq.) of chapter 94 of this title. For complete 
classification of this Act to the Code, see Short Title note set out 
under section 8621 of this title and Tables.


                               Amendments

    1993--Subsec. (a)(4)(G). Pub. L. 103-171 substituted ``Assistant 
Secretary'' for ``Commissioner''.


                         Declaration of Purpose

    Section 705(a) of Pub. L. 102-375 provided that: ``The purpose of 
this section [enacting this subpart] is to provide outreach, counseling, 
and assistance in order to assist older individuals in obtaining 
benefits under--
        ``(1) public and private health insurance, long-term care 
    insurance, life insurance, and pension plans; and
        ``(2) public programs under which the individuals are entitled 
    to benefits, including benefits under--
            ``(A) the supplemental security income program established 
        under title XVI of the Social Security Act (42 U.S.C. 1381 et 
        seq.);
            ``(B) the medicare program established under title XVIII of 
        the Social Security Act (42 U.S.C. 1395 et seq.);
            ``(C) the medicaid program established under title XIX of 
        the Social Security Act (42 U.S.C. 1396 et seq.);
            ``(D) the program established under the Food Stamp Act of 
        1977 (7 U.S.C. 2011 et seq.); and
            ``(E) the program established under the Low-Income Home 
        Energy Assistance Act of 1981 (42 U.S.C. 8621 et seq.).''
