The Patient Protection and Affordable Care Act (ACA) reauthorized new funding for numerous existing discretionary grant and other programs and activities. ACA also created multiple new discretionary grant programs and activities and provided for each an authorization of appropriations. Funding for all of these programs and activities is subject to action by congressional appropriators. This report summarizes all the discretionary spending provisions in ACA that authorized appropriations for grant programs and other activities. A companion product, CRS Report R41301, Appropriations and Fund Transfers in the Patient Protection and Affordable Care Act (PPACA), summarizes all the mandatory appropriations in the new law. Among the provisions that are intended to strengthen the nation's health care safety net and improve access to care, ACA permanently reauthorized the federal health centers program and the National Health Service Corps (NHSC). The NHSC provides scholarships and student loan repayments to individuals who agree to a period of service as a primary care provider in a federally designated Health Professional Shortage Area. In addition, the new law addressed concerns about the current size, specialty mix, and geographic distribution of the health care workforce. It reauthorized and expanded existing health workforce education and training programs under Titles VII and VIII of the Public Health Service Act (PHSA). Title VII supports the education and training of physicians, dentists, physician assistants, and public health workers through grants, scholarships, and loan repayment. ACA created several new programs to increase training experiences in primary care, in rural areas, and in community-based settings, and provided training opportunities to increase the supply of pediatric subspecialists and geriatricians. It also expanded the nursing workforce development programs authorized under PHSA Title VIII to bolster undergraduate and graduate nursing education and training. As part of a comprehensive framework for federal community-based (i.e., public health) prevention activities, including a national strategy and a national education and outreach campaign, ACA authorized several new grant programs with a focus on preventable or modifiable risk factors for disease (e.g., sedentary lifestyle, tobacco use). The new law also leveraged a number of mechanisms to improve the quality of health care, including new requirements for quality measure development, collection, analysis, and public reporting; programs to develop and disseminate innovative strategies for improving the quality of health care delivery; and support for care coordination programs such as medical homes, patient navigators, and the co-location of primary health care and mental health services. Additionally, ACA authorized funding for programs to prevent elder abuse, neglect, and exploitation; grants to expand trauma care services and improve regional coordination of emergency services; and demonstration projects to implement alternatives to current tort litigation for resolving medical malpractice claims, among other provisions. The Congressional Budget Office estimated that ACA's discretionary spending provisions, if fully funded by future appropriations acts, would result in appropriations of approximately $106 billion over the 10-year period FY2010-FY2019. Most of that funding would be for programs that existed prior to, and whose funding was reauthorized by, ACA. Few new programs created by ACA received funding in FY2011 or FY2012.

The Older Americans Act (OAA) is the major federal vehicle for the delivery of social and nutrition services for older persons. These include supportive services, congregate nutrition services (meals served at group sites such as senior centers, schools, churches, or senior housing complexes), home-delivered nutrition services, family caregiver support, community service employment, the long-term care ombudsman program, and services to prevent the abuse, neglect, and exploitation of older persons. The OAA also supports grants to older Native Americans and research, training, and demonstration activities. The Administration on Aging (AOA) in the newly established Administration for Community Living (ACL), within the U.S. Department of Health and Human Services (HHS) administers most OAA programs. The exception is the Community Service Employment for Older Americans (CSEOA) program, which is administered by the U.S. Department of Labor (DOL). The ACL also administers several aging services programs authorized under the Public Health Service Act, such as the Alzheimer's Disease Supportive Services Program and the Lifespan Respite Care Program. Funding for OAA programs and other aging services is provided through appropriations legislation for the Departments of Labor, Health and Human Services, and Education, and Related Agencies (Labor-HHS-Education). FY2012 funding for OAA programs totals $1.913 billion, 1% less than in FY2011. The President's FY2013 budget request proposes $1.907 billion for OAA programs, 0.3% less than the FY2012 level. The President's budget proposal would eliminate $6.5 million in discretionary OAA funding for Aging and Disability Resource Centers (ADRCs) also funded by the Patient Protection and Affordable Care Act (P.L. 111-148, as amended). The Continuing Appropriations Resolution, 2013 (CR; P.L. 112-175) became law on September 28, 2012. For most discretionary programs, including OAA programs, the CR continues funding at close to FY2012 levels. The CR provides funding for October 1, 2012, through March 27, 2013, although amounts may change depending on whether certain actions, such as sequestration, are taken pursuant to the Budget Control Act (P.L. 112-25) and the American Taxpayer Relief Act of 2012 (ATRA, P.L. 112-240). Since the enactment of OAA, Congress has reauthorized and amended the act numerous times. In the past, OAA reauthorization has included extending the act's authorization of appropriations for a five-year period. The last OAA reauthorization occurred in 2006, when Congress enacted the Older Americans Act Amendments of 2006 (P.L. 109-365), which extended the act's authorization of appropriations for FY2007 through FY2011. The authorization of appropriations for most OAA programs expired at the end of FY2011. However, Congress has continued to appropriate funding for OAA authorized activities. In the 112th Congress, comprehensive OAA reauthorization legislation was introduced which would extend the authorization of appropriations for most OAA programs through FY2017 and would make various amendments to existing OAA authorities. This report provides details of FY2011, FY2012, and FY2013 funding for OAA authorized activities, as well as for other aging services programs administered by ACL under other statutory authorities.