I 

108TH CONGRESS 

1ST SESSION H. R. 2490

To promote elder justice, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 17, 2003

Mr. EMANUEL (for himself, Mr. BLUNT, Mr. KING of New York, Mr. HOYER, 

Mr. REYNOLDS, Mr. RANGEL, Mr. SHIMKUS, Ms. DELAURO, Mr. WALSH, 

Mr. FROST, Mr. BEAUPREZ, Mr. STARK, Mrs. MILLER of Michigan, Mr. 

GEORGE MILLER of California, Mr. COLE, Mr. WAXMAN, Ms. HARRIS, 

Mr. JOHN, Mr. RENZI, Mr. KILDEE, Mr. KIRK, Mr. EVANS, Ms. GINNY

BROWN-WAITE of Florida, Mr. FALEOMAVAEGA, Mr. MCHUGH, Mr. 

CROWLEY, Mr. ACKERMAN, Mr. HINOJOSA, Mr. GRIJALVA, Mr. ISRAEL, 

Mr. CRAMER, Mrs. MCCARTHY of New York, Mr. BISHOP of New York, 

Mr. ROSS, Mr. DAVIS of Alabama, Mr. WEINER, Ms. WATSON, Mr. CARSON of Oklahoma, Mr. ACEVEDO-VILA ́, Ms. JACKSON-LEE of Texas, Mrs. 

MALONEY, Mr. MCNULTY, Mr. NADLER, Mr. OWENS, Mr. BELL, Ms. 

LINDA T. SA ́NCHEZ of California, and Mr. SCHIFF) introduced the following bill; which was referred to the Committee on Ways and Means, 

and in addition to the Committees on the Judiciary, Energy and Commerce, and Education and the Workforce, for a period to be subsequently 

determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL

To promote elder justice, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

2 (a) SHORT TITLE.—This Act may be cited as the 

3 ‘‘Elder Justice Act’’. 

4 (b) TABLE OF CONTENTS.—The table of contents of 

5 this Act is as follows:

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. Purposes. 

TITLE I—DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Sec. 101. Amendment to the Social Security Act. 

Sec. 102. Patient abuse prevention. 

Sec. 103. Increasing the number of health care professionals with geriatric 

training. 

Sec. 104. Supporting the long-term care ombudsman program. 

Sec. 105. Establishment of Office of Adult Protective Services. 

Sec. 106. Assuring safety of residents when nursing facilities close. 

TITLE II—DEPARTMENT OF JUSTICE 

Sec. 201. Definitions; rule. 

Sec. 202. Model State laws and practices. 

Sec. 203. Office of Elder Justice of the Department of Justice. 

Sec. 204. Grants under the Social Security Act. 

Sec. 205. Victim advocacy grants. 

Sec. 206. Supporting local prosecutors in elder justice matters. 

Sec. 207. Supporting State prosecutors in elder justice matters. 

Sec. 208. Supporting Federal cases involving elder justice. 

Sec. 209. Community policing. 

Sec. 210. Supporting law enforcement in elder justice matters. 

Sec. 211. Evaluations. 

Sec. 212. Authorization of appropriations. 

Sec. 213. Cause of action for elder abuse and neglect. 

Sec. 214. Civil actions for elder abuse and neglect. 

TITLE III—TAX PROVISIONS 

Sec. 301. Long-term care facility worker employment tax credit.

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) The proportion of the United States popu9 lation age 60 years or older will drastically increase 
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1 in the next 30 years as 77,000,000 baby boomers 

2 approach retirement and old age. 

3 (2) Each year, anywhere between 500,000 and 

4 5,000,000 elders in the United States are abused, 

5 neglected, or exploited. 

6 (3) Elder abuse, neglect, and exploitation have 

7 no boundaries, and cross all racial, social class, gen8 der, and geographic lines. 

9 (4) Victims of elder abuse, neglect, and exploi10 tation are not only subject to injury from mistreat11 ment and neglect, they are also 3.1 times more likely 

12 to die at an earlier age than expected than elders 

13 who were not victims of elder abuse, neglect, and ex14 ploitation. 

15 (5) There is a general dearth of data as to the 

16 nature and scope of elder abuse, neglect, and exploi17 tation. 

18 (6) Despite the dearth of data in the field, ex19 perts agree that most cases of elder abuse, neglect, 

20 and exploitation are never reported and that abuse 

21 and neglect shorten a victim’s life, often triggering 

22 a downward spiral of an otherwise productive, self23 sufficient elder’s life. Programs addressing other dif24 ficult issues such as domestic violence and child 

25 abuse and neglect have demonstrated the need for a 
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1 multi-faceted law, combining public health, social 

2 service, and law enforcement approaches. 

3 (7) For over 20 years, Congress has been pre4 sented with facts and testimony calling for a coordi5 nated Federal effort to combat elder abuse, neglect, 

6 and exploitation. 

7 (8) The Federal Government has been slow to 

8 respond to the needs of victims of elder abuse, ne9 glect, and exploitation or to undertake prevention ef10 forts. 

11 (9) No Federal law has been enacted that ade12 quately and comprehensively addresses the issues of 

13 elder abuse, neglect, and exploitation and there are 

14 very limited resources available to those in the field 

15 directly dealing with these issues. 

16 (10) Differences in State laws and practices in 

17 the areas of elder abuse, neglect, and exploitation 

18 lead to significant disparities in prevention, protec19 tive and social services, treatment systems, and law 

20 enforcement, and lead to other inequities. 

21 (11) The Federal Government has played an 

22 important role in promoting research, training, pub23 lic safety, data collection, the identification, develop24 ment, and dissemination of promising health care, 

25 social, and protective services, and law enforcement 
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1 practices, relating to child abuse and neglect, domes2 tic violence, and violence against women. The Fed3 eral Government should promote similar efforts and 

4 protections relating to elder abuse, neglect, and ex5 ploitation. 

6 (12) The Federal Government should provide 

7 leadership and assist States and communities in

8 their efforts to protect elders in the United States 

9 by—

10 (A) promoting coordinated planning among 

11 all levels of government; 

12 (B) generating and sharing knowledge rel13 evant to protecting elders; 

14 (C) providing leadership to combat the 

15 abuse, neglect, and exploitation of the Nation’s 

16 elders; and 

17 (D) providing resources to States and com18 munities to promote elder justice. 

19 (13) The problem of elder abuse, neglect, and 

20 exploitation requires a comprehensive approach 

21 that—

22 (A) integrates the work of health, legal, 

23 and social service agencies and organizations; 

24 (B) emphasizes the need for prevention, re25 porting, investigation, assessment, treatment, 
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1 and prosecution of elder abuse, neglect, and ex2 ploitation at all levels of government; 

3 (C) ensures that sufficient numbers of 

4 properly trained personnel with specialized 

5 knowledge are in place to treat, assess, and pro6 vide services relating to elder abuse, neglect, 

7 and exploitation, and carry out elder and vul8 nerable adult protection duties;

9 (D) is sensitive to ethnic and cultural di10 versity; 

11 (E) recognizes the role of mental health, 

12 disability, dementia, substance abuse, medica13 tion mismanagement, and family dysfunction 

14 problems in increasing and exacerbating elder 

15 abuse, neglect, and exploitation; and 

16 (F) balances adults’ right to self-deter17 mination with society’s responsibility to protect 

18 elders and vulnerable adults. 

19 (14) The human, social, and economic cost of 

20 elder abuse, neglect, and exploitation is high and in21 cludes unnecessary expenditures of medicare and 

22 medicaid funds. 

23 (15) The failure to coordinate activities relating 

24 to, and comprehensively prevent and treat, elder 

25 abuse, neglect, and exploitation threatens the future 
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1 and well-being of millions of elders in the United 

2 States. 

3 (16) All elements of society in the United 

4 States have a shared responsibility in responding to 

5 a national problem of elder abuse, neglect, and ex6 ploitation. 

7 SEC. 3. PURPOSES. 

8 The purposes of this Act are as follows: 

9 (1) To bring a comprehensive approach to pre10 venting and combating elder abuse, neglect, and ex11 ploitation, a long invisible problem that afflicts the 

12 most vulnerable among the aging population of the 

13 United States. 

14 (2) To raise the issue of elder abuse, neglect, 

15 and exploitation to national attention, and to create 

16 the infrastructure at the Federal, State, and local 

17 levels, to assure that individuals and organizations 

18 on the front lines, who are fighting elder abuse, ne19 glect, and exploitation with scarce resources and 

20 fragmented systems, have the resources and infor21 mation needed to carry out their fight. 

22 (3) To bring a comprehensive multi-disciplinary 

23 approach to elder justice. 
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1 (4) To set in motion research and data collec2 tion to fill gaps in knowledge about elder abuse, ne3 glect, and exploitation. 

4 (5) To supplement the activities of service pro5 viders and programs, to enhance training, and to le6 verage scarce resources efficiently to ensure that 

7 elder justice receives the attention it deserves as the 

8 Nation’s population ages. 

9 (6) To examine the many different laws and 

10 practices relating to elder justice in different States 

11 and jurisdictions to ascertain which among those 

12 laws and practices are the most effective. 

13 (7) To promote the development of an effective 

14 adult fiduciary system, including an adult guardian15 ship system, that protects individuals with dimin16 ished capacity, maximizes their autonomy, and devel17 ops effective resources and an elder rights system. 

18 (8) To recognize and address the role of mental 

19 health, disability, dementia, substance abuse, medi20 cation mismanagement, and family dysfunction prob21 lems in increasing and exacerbating elder abuse, ne22 glect and exploitation. 

23 (9) To create a short- and long-term strategic 

24 plan for the development and coordination of elder 
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1 justice research, programs, studies, training, and 

2 other efforts nationwide. 

3 (10) To promote collaborative efforts and di4 minish overlap and gaps in efforts in developing the 

5 important field of elder justice.

6 TITLE I—DEPARTMENT OF 

7 HEALTH AND HUMAN SERVICES 

8 SEC. 101. AMENDMENT TO THE SOCIAL SECURITY ACT. 

9 The Social Security Act (42 U.S.C. 301 et seq.) is 

10 amended by adding at the end the following: 

11 ‘‘TITLE XXII—ELDER JUSTICE 

12 ‘‘SEC. 2201. DEFINITIONS; RULE. 

13 ‘‘(a) DEFINITIONS.—In this title: 

14 ‘‘(1) ABUSE.—The term ‘abuse’ means the 

15 knowing infliction of physical or psychological harm 

16 or the knowing deprivation of goods or services that 

17 are necessary to meet essential needs or to avoid 

18 physical or psychological harm. 

19 ‘‘(2) ADULT PROTECTIVE SERVICES.—The term 

20 ‘adult protective services’ means those services pro21 vided to elders and to people age 18 and older with 

22 disabilities who are, or who are in danger of being, 

23 abused, neglected, or exploited, who are unable to 

24 protect themselves, or who have no one to assist 

25 them adequately. The term includes services such as 
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1 disseminating reports of adult abuse, neglect or ex2 ploitation, investigating those reports, case planning, 

3 monitoring, evaluation, providing other case work 

4 and services, and providing, arranging for, or facili5 tating the provision of medical, social service, eco6 nomic, legal, housing, law enforcement, or other pro7 tective, emergency, or support services. 

8 ‘‘(3) CAREGIVER.—The term ‘caregiver’ means 

9 an individual who has the responsibility for the care 

10 of an elder, either voluntarily, by contract, by receipt 

11 of payment for care, or as a result of the operation 

12 of law and means a family member or other indi13 vidual who provides (on behalf of such individual or 

14 of a public or private agency, organization, or insti15 tution) compensated or uncompensated care to an 

16 elder who needs supportive services in any setting. 

17 ‘‘(4) DIRECT CARE.—The term ‘direct care’ 

18 means care by an employee or contractor who pro19 vides assistance or long-term care services to a re20 cipient. 

21 ‘‘(5) ELDER.—The term ‘elder’ means an indi22 vidual age 60 or older. 

23 ‘‘(6) ELDER JUSTICE.—The term ‘elder justice’ 

24 means—
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1 ‘‘(A) from a societal perspective, efforts to 

2 prevent, detect, treat, intervene in, and pros3 ecute elder abuse, neglect, and exploitation and 

4 to protect elders with diminished capacity while 

5 maximizing their autonomy; and 

6 ‘‘(B) from an individual perspective, the 

7 recognition of an elder’s rights, including the 

8 right to be free of abuse, neglect, and exploi9 tation. 

10 ‘‘(7) ELIGIBLE ENTITY.—The term ‘eligible en11 tity’ means a State or local government agency, In12 dian tribe, or any other public or private entity that 

13 is engaged in and has expertise in issues relating to 

14 elder justice or in a field necessary to promote elder 

15 justice efforts. 

16 ‘‘(8) EXPLOITATION.—The term ‘exploitation’ 

17 means the fraudulent or otherwise illegal, unauthor18 ized, or improper act or process of an individual, in19 cluding a caregiver or fiduciary, that uses the re20 sources of an elder for monetary or personal benefit, 

21 profit, gain, or that results in depriving an elder of 

22 rightful access to, or use of, benefits, resources, be23 longings, or assets. 

24 ‘‘(9) FIDUCIARY.—The term ‘fiduciary’—
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1 ‘‘(A) means a person or entity with the 

2 legal responsibility—

3 ‘‘(i) to make decisions on behalf of 

4 and for the benefit of another person; and 

5 ‘‘(ii) to act in good faith and with 

6 fairness; and 

7 ‘‘(B) includes a trustee, a guardian, a con8 servator, an executor, an agent under a finan9 cial power of attorney or health care power of 

10 attorney, or a representative payee. 

11 ‘‘(10) GRANT.—The term ‘grant’ includes a 

12 contract, cooperative agreement, or other mechanism 

13 for providing financial assistance. 

14 ‘‘(11) GRANTING AUTHORITY.—The term 

15 ‘granting authority’ means the Secretary of Health 

16 and Human Services, the Attorney General, or the 

17 Secretary of Health and Human Services and the 

18 Attorney General jointly, as appropriate. 

19 ‘‘(12) GUARDIANSHIP.—The term ‘guardian20 ship’ means—

21 ‘‘(A) the process by which a State court 

22 determines that an adult individual lacks capac23 ity to make decisions about self-care and prop24 erty, and appoints another individual or entity 
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1 known as a guardian, as a conservator, or by a 

2 similar term, as surrogate decisionmaker; 

3 ‘‘(B) the manner in which the court-ap4 pointed surrogate carries out duties to the indi5 vidual and the court; or 

6 ‘‘(C) the manner in which the court exer7 cises oversight of the surrogate. 

8 ‘‘(13) INDIAN.—The term ‘Indian’ means a per9 son who is a member of an Indian tribe. 

10 ‘‘(14) INDIAN TRIBE.—The term ‘Indian tribe’ 

11 means any Indian tribe, band, nation, or other orga12 nized group or community, including any Alaska Na13 tive village or regional corporation as defined in or 

14 established pursuant to the Alaska Native Claims 

15 Settlement Act (43 U.S.C. 1601 et seq.), that is rec16 ognized as eligible for the special programs and serv17 ices provided by the United States to Indians be18 cause of their status as Indians. 

19 ‘‘(15) KNOWINGLY.—The term ‘knowingly’ has 

20 the meaning given such term in section 3729(b) of 

21 title 31, United States Code. 

22 ‘‘(16) LAW ENFORCEMENT.—The term ‘law en23 forcement’ means the full range of potential re24 sponders to elder abuse, neglect, and exploitation in25 cluding—
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1 ‘‘(A) police, sheriffs, detectives, public safe2 ty officers, and corrections personnel; 

3 ‘‘(B) prosecutors; 

4 ‘‘(C) medical examiners; 

5 ‘‘(D) investigators; and 

6 ‘‘(E) coroners. 

7 ‘‘(17) LONG-TERM CARE.—

8 ‘‘(A) IN GENERAL.—The term ‘long-term 

9 care’ means a wide range of supportive and 

10 health services for individuals who need assist11 ance because the individuals have a loss of ca12 pacity for self-care due to illness, disability, or 

13 vulnerability. 

14 ‘‘(B) NEED FOR ASSISTANCE.—For pur15 poses of subparagraph (A), a need for assist16 ance is often measured in terms of the capa17 bility to engage in activities of daily living, in18 cluding eating, dressing, bathing, and manage19 ment of one’s financial affairs. 

20 ‘‘(18) LONG-TERM CARE FACILITY.—The term 

21 ‘long-term care facility’ means a residential care pro22 vider that arranges for, or directly provides, long23 term care. 

24 ‘‘(19) NEGLECT.—The term ‘neglect’ means—
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1 ‘‘(A) the failure of a caregiver or fiduciary 

2 to provide the goods or services that are nec3 essary to maintain the health or safety of an 

4 elder; or 

5 ‘‘(B) self-neglect. 

6 ‘‘(20) NURSING FACILITY.—The term ‘nursing 

7 facility’ has the meaning given such term under sec8 tion 1919(a). 

9 ‘‘(21) SELF-NEGLECT.—The term ‘self-neglect’ 

10 means an adult’s inability, due to physical or mental 

11 impairment or diminished capacity, to perform es12 sential self-care tasks including—

13 (A) obtaining essential food, clothing, shel14 ter, and medical care; 

15 (B) obtaining goods and services necessary 

16 to maintain physical health, mental health, or 

17 general safety; or 

18 (C) managing one’s own financial affairs. 

19 ‘‘(22) SERIOUS BODILY INJURY.—

20 ‘‘(A) IN GENERAL.—The term ‘serious 

21 bodily injury’ means an injury—

22 ‘‘(i) involving extreme physical pain; 

23 ‘‘(ii) involving substantial risk of 

24 death; 
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1 ‘‘(iii) involving protracted loss or im2 pairment of the function of a bodily mem3 ber, organ, or mental faculty; or 

4 ‘‘(iv) requiring medical intervention 

5 such as surgery, hospitalization, or phys6 ical rehabilitation. 

7 ‘‘(B) CRIMINAL SEXUAL ABUSE.—Serious 

8 bodily injury shall be considered to have oc9 curred if the conduct causing the injury is con10 duct constituting aggravated sexual abuse 

11 under section 2241, or sexual abuse under sec12 tion 2242, of title 18, United States Code, or 

13 any similar offense under State law. 

14 ‘‘(23) SOCIAL.—The term ‘social’, when used 

15 with respect to a service, includes adult protective 

16 services. 

17 ‘‘(24) STATE.—The term ‘State’ means any of 

18 the several States, the District of Columbia, the 

19 Commonwealth of Puerto Rico, and any other pos20 session or territory of the United States. 

21 ‘‘(25) STATE LONG-TERM CARE OMBUDSMAN.—

22 The term ‘State Long-Term Care Ombudsman’ 

23 means the State Long-Term Care Ombudsman de24 scribed in section 712(a)(2) of the Older Americans 

25 Act of 1965 (42 U.S.C. 3058g(a)(2)). 
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1 ‘‘(26) UNDERSERVED POPULATION.—The term 

2 ‘underserved population’ means the population of an 

3 area designated by the Secretary as an area with a 

4 shortage of elder justice programs or a population 

5 group designated by the Secretary as having a short6 age of such programs. Such areas or groups des7 ignated by the Secretary may include— 

8 ‘‘(A) areas or groups that are geographi9 cally isolated (such as isolated in a rural area); 

10 ‘‘(B) racial and ethnic minority popu11 lations; and 

12 ‘‘(C) populations underserved because of 

13 special needs (such as language barriers, dis14 abilities, alien status, or age). 

15 ‘‘(27) VULNERABLE ADULT.—The term ‘vulner16 able adult’ means an adult, age 18 or older, who 

17 needs protections and programs that are the same 

18 as or similar to protections and programs for elders, 

19 including an adult who, due to a developmental, cog20 nitive, psychological, physical, or other type of dis21 ability, may be abused, neglected, or exploited. 

22 ‘‘(b) RULE.—The Secretary may determine, in an ap23 propriate case, that a provision of this title that applies 

24 to elders also applies to vulnerable adults. 
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1 ‘‘Subtitle A—Federal Elder Justice 

2 System 

3 ‘‘SEC. 2211. OFFICE OF ELDER JUSTICE OF THE DEPART4 MENT OF HEALTH AND HUMAN SERVICES. 

5 ‘‘(a) ESTABLISHMENT.—There is established within 

6 the Department of Health and Human Services under the 

7 Assistant Secretary for Aging an Office of Elder Justice. 

8 ‘‘(b) DIRECTOR.—

9 ‘‘(1) APPOINTMENT.—The President, with the 

10 advice and consent of the Senate, shall appoint a Di11 rector of the Office of Elder Justice, from among in12 dividuals with experience and expertise in elder jus13 tice issues, to manage the Office of Elder Justice es14 tablished under this section. 

15 ‘‘(2) DUTIES.—The Director of the Office of 

16 Elder Justice shall—

17 ‘‘(A)(i) develop objectives, priorities, policy, 

18 and a long-term plan for elder justice programs 

19 and activities relating to prevention, detection, 

20 training, treatment, evaluation, intervention, re21 search, and improvement of the elder justice 

22 system in the United States; 

23 ‘‘(ii) implement the overall policy and a 

24 strategy to carry out the plan described in 

25 clause (i); and 
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1 ‘‘(iii) hire personnel to assist the director 

2 in carrying out the policy, program, and admin3 istrative activities related to the duties under 

4 clauses (i) and (ii); 

5 ‘‘(B) provide advice to the Secretary on 

6 elder justice issues; and 

7 ‘‘(C) coordinate activities with the Senior 

8 Advisor on Elder Justice.

9 ‘‘(3) REPORTING RELATIONSHIP.—The Director 

10 of the Office of Elder Justice shall report to the As11 sistant Secretary for Aging. 

12 ‘‘(4) COMPENSATION.—The Director shall be 

13 compensated at a rate that shall not exceed the rate 

14 established for level I of the Executive Schedule 

15 under section 5312 of title 5, United States Code. 

16 ‘‘(c) SENIOR ADVISOR.—

17 ‘‘(1) APPOINTMENT.—The Secretary shall ap18 point a Senior Advisor on Elder Justice, from 

19 among individuals with experience and expertise in 

20 elder justice issues. 

21 ‘‘(2) DUTIES.—The Senior Advisor on Elder 

22 Justice shall—

23 ‘‘(A) coordinate elder justice activities 

24 among all relevant divisions, offices, and compo-
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1 nents of the Department of Health and Human 

2 Services; 

3 ‘‘(B) serve as the chairperson of the Intra4 Agency Elder Justice Steering Committee es5 tablished under section 2212; and 

6 ‘‘(C) provide advice to the Secretary on 

7 elder justice issues. 

8 ‘‘(3) LOCATION.—The Senior Advisor on Elder 

9 Justice shall be located in the Office of the Sec10 retary. 

11 ‘‘(4) POSITION.—The position of the Senior Ad12 visor on Elder Justice shall be a Senior Executive 

13 Service position, as defined in section 3132 of title 

14 5, United States Code. 

15 ‘‘SEC. 2212. HEALTH AND HUMAN SERVICES INTRA-AGENCY 

16 ELDER JUSTICE STEERING COMMITTEE. 

17 ‘‘(a) IN GENERAL.—There is established within the 

18 Department of Health and Human Services an Intra19 Agency Elder Justice Steering Committee (in this section 

20 referred to as the ‘steering committee’) to coordinate the 

21 elder justice programs and policy of the Department of 

22 Health and Human Services. 

23 ‘‘(b) MEMBERSHIP.—The steering committee shall be 

24 composed of representatives, appointed by the Secretary, 

25 from—
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1 ‘‘(1) the Administration on Aging; 

2 ‘‘(2) the National Institute on Aging; 

3 ‘‘(3) the Centers for Medicare & Medicaid Serv4 ices; 

5 ‘‘(4) the Centers for Disease Control and Pre6 vention; 

7 ‘‘(5) the Agency for Healthcare Research and 

8 Quality; 

9 ‘‘(6) the Administration for Children and Fami10 lies, including a representative who works in adult 

11 protective services; 

12 ‘‘(7) the Office of the Assistant Secretary for 

13 Planning and Evaluation; 

14 ‘‘(8) the Health Resources and Services Admin15 istration; 

16 ‘‘(9) the Substance Abuse and Mental Health 

17 Services Administration; 

18 ‘‘(10) the Indian Health Service; and 

19 ‘‘(11) such other offices or divisions within the 

20 Department of Health and Human Services as the 

21 Secretary determines appropriate. 

22 ‘‘(c) DUTIES.—The steering committee shall coordi23 nate elder justice matters for the Department of Health 

24 and Human Services to enhance programs and collabora25 tions and to avoid unnecessary duplication of efforts. 
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1 ‘‘SEC. 2213. ELDER JUSTICE COORDINATING COUNCIL. 

2 ‘‘(a) ESTABLISHMENT.—There is established a com3 mittee to be known as the Elder Justice Coordinating 

4 Council (in this section referred to as the ‘Council’). 

5 ‘‘(b) MEMBERSHIP.—The Council shall be composed 

6 of the following: 

7 ‘‘(1) The Secretary (or the Secretary’s des8 ignee). 

9 ‘‘(2) The Attorney General (or the Attorney 

10 General’s designee). 

11 ‘‘(3) A representative, appointed by the head of 

12 the Federal department or agency, or other entity, 

13 involved from— 

14 ‘‘(A) the Department of Housing and 

15 Urban Development; 

16 ‘‘(B) the Department of Education; 

17 ‘‘(C) the Department of Labor; 

18 ‘‘(D) the Department of Transportation; 

19 ‘‘(E) the Department of the Treasury; 

20 ‘‘(F) the Office of Management and Budg21 et; 

22 ‘‘(G) the Office of the Surgeon General; 

23 ‘‘(H) the Social Security Administration; 

24 ‘‘(I) the Food and Drug Administration; 

25 ‘‘(J) the Federal Trade Commission; 

26 ‘‘(K) the Department of Commerce; 
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1 ‘‘(L) the Pension Benefit Guaranty Cor2 poration; 

3 ‘‘(M) the Securities and Exchange Com4 mission; 

5 ‘‘(N) the Commodity Futures Trading 

6 Commission; 

7 ‘‘(O) the Board of Governors of the Fed8 eral Reserve System; 

9 ‘‘(P) the Office of the Comptroller of the 

10 Currency; 

11 ‘‘(Q) the Federal Deposit Insurance Cor12 poration; 

13 ‘‘(R) the Federal Bureau of Investigation; 

14 ‘‘(S) the Centers for Disease Control and 

15 Prevention; 

16 ‘‘(T) the Secret Service; 

17 ‘‘(U) the National Institute on Aging; 

18 ‘‘(V) the Internal Revenue Service; and 

19 ‘‘(W) the United States Postal Service. 

20 ‘‘(4) A representative appointed by the Board 

21 of Directors of the Legal Services Corporation from 

22 the Legal Services Corporation. 

23 ‘‘(5) A representative appointed by the Presi24 dent from—

25 ‘‘(A) the State Justice Institute; 
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1 ‘‘(B) the National Research Council of the 

2 National Academy of Sciences; and 

3 ‘‘(C) the Institute of Medicine of the Na4 tional Academy of Sciences.

5 ‘‘(6) Representatives from other Federal agen6 cies, appointed by the heads of the Federal agencies 

7 with responsibilities or programs relating to elder 

8 abuse, neglect, and exploitation as determined ap9 propriate by the Secretary and the Attorney Gen10 eral. 

11 ‘‘(7) One representative from each State, rep12 resenting State and local governments, appointed by 

13 the President from among persons designated by the 

14 Governor of such State due to expertise in, and ac15 tive work in, the area of elder justice. 

16 ‘‘(8) The members of the advisory board estab17 lished under section 2214. 

18 ‘‘(c) PERIOD OF APPOINTMENT; VACANCIES.—Mem19 bers shall be appointed for terms of 3 years. Any vacancy 

20 in the Council shall not affect its powers, but shall be filled 

21 in the same manner as the original appointment was 

22 made. 

23 ‘‘(d) CO-CHAIRPERSONS.—The Council shall be co24 chaired by the Secretary and the Attorney General (or 

25 their designees). 
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1 ‘‘(e) MEETINGS.—

2 ‘‘(1) IN GENERAL.—The Council shall meet at 

3 least 2 times per year as determined by the co-chair4 persons. 

5 ‘‘(2) ELDER JUSTICE SUMMIT.—

6 ‘‘(A) IN GENERAL.—One of the meetings 

7 described in paragraph (1) shall be an Elder 

8 Justice Summit to review the state of elder jus9 tice, including—

10 ‘‘(i) a summary presentation directly 

11 to the Secretary and the Attorney General 

12 regarding—

13 ‘‘(I) the nature and dimension of 

14 the problems of elder abuse, neglect, 

15 and exploitation; 

16 ‘‘(II) Federal, State, local, and 

17 private efforts in elder justice; 

18 ‘‘(III) challenges to be faced in 

19 elder justice; 

20 ‘‘(IV) promising practices in 

21 elder justice; and 

22 ‘‘(V) plans and priorities for the 

23 future in elder justice; 
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1 ‘‘(ii) additional presentations to ad2 dress in greater detail those topics de3 scribed in clause (i); and 

4 ‘‘(iii) presentations on such other top5 ics as the Council determines appropriate. 

6 ‘‘(B) PARTICIPANTS.—Additional partici7 pants, in addition to the members of the Coun8 cil, to be invited to the Elder Justice Summit 

9 shall include—

10 ‘‘(i) experts in the fields of elder 

11 abuse, neglect, and exploitation, selected by 

12 the co-chairpersons; 

13 ‘‘(ii) the chairman and ranking mem14 ber of the Special Committee on Aging of 

15 the Senate; 

16 ‘‘(iii) designees of the Speaker of the 

17 House of Representatives and the minority 

18 leader of the House of Representatives; 

19 and 

20 ‘‘(iv) governmental representatives in21 vited jointly by the co-chairpersons, includ22 ing—

23 ‘‘(I) 1 representative from the 

24 Federal Government; 
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1 ‘‘(II) 1 representative from a 

2 State government; and 

3 ‘‘(III) 1 representative from a 

4 local government. 

5 ‘‘(C) ADDITIONAL OBSERVERS.—Addi6 tional observers of the Elder Justice Summit 

7 may include representatives of Federal, State, 

8 and local public and private entities, as well as 

9 experts and members of the public designated 

10 by the Council to be observers. 

11 ‘‘(3) OTHER MEETINGS.—In addition to the 

12 meeting described in paragraph (2), the Council 

13 shall have at least 1 additional meeting per year in 

14 order to—

15 ‘‘(A) conduct an in-depth analysis of the 

16 numerous phenomena that make up elder 

17 abuse, neglect, and exploitation; 

18 ‘‘(B) permit participants to highlight 

19 promising practices, exchange information 

20 about addressing challenges, and identify needs 

21 and priorities; and 

22 ‘‘(C) determine a procedure for examining 

23 and eliciting national elder justice issues and 

24 priorities in order to guide the Council. 

25 ‘‘(f) DUTIES.—
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1 ‘‘(1) IN GENERAL.—The Council shall make 

2 recommendations for the coordination of activities, 

3 relating to elder abuse, neglect, and exploitation and 

4 other crimes against elders, to the Department of 

5 Health and Human Services, the Department of 

6 Justice, and other relevant Federal, State, local, and 

7 private agencies and entities. 

8 ‘‘(2) REPORT.—Not later than 2 years after the 

9 date of enactment of the Elder Justice Act and 

10 every 2 years thereafter, the Council shall provide to 

11 Congress a report that—

12 ‘‘(A) describes the activities of, accomplish13 ments of, and challenges faced by—

14 ‘‘(i) the Council; and 

15 ‘‘(ii) the entities represented on the 

16 Council; and 

17 ‘‘(B) makes recommendations for legisla18 tion, model laws, or other appropriate action. 

19 ‘‘(g) POWERS OF THE COUNCIL.—

20 ‘‘(1) HEARINGS.—The Council may hold such 

21 hearings, sit and act at such times and places, take 

22 such testimony, and receive such evidence as the 

23 Council considers advisable to carry out this section. 

24 ‘‘(2) INFORMATION FROM FEDERAL AGEN25 CIES.—The Council may secure directly from any 
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1 Federal department or agency such information as 

2 the Council considers necessary to carry out this sec3 tion. Upon request of the co-chairpersons of the 

4 Council, the head of such department or agency 

5 shall furnish such information to the Council.

6 ‘‘(3) POSTAL SERVICES.—The Council may use 

7 the United States mails in the same manner and 

8 under the same conditions as other departments and 

9 agencies of the Federal Government. 

10 ‘‘(h) TRAVEL EXPENSES.—The members of the 

11 Council, and the participants in and observers of the Elder 

12 Justice Summit shall not receive compensation for the per13 formance of services for the council. The members shall 

14 be allowed, and the participants may be allowed, travel 

15 expenses, including per diem in lieu of subsistence, at 

16 rates authorized for employees of agencies under sub17 chapter I of chapter 57 of title 5, United States Code, 

18 while away from their homes or regular places of business 

19 in the performance of services for the Council. Notwith20 standing section 1342 of title 31, United States Code, the 

21 Secretary and the Attorney General may accept the vol22 untary and uncompensated services of the members and 

23 the participants. 

24 ‘‘(i) DETAIL OF GOVERNMENT EMPLOYEES.—Any 

25 Federal Government employee may be detailed to the 
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1 Council without reimbursement, and such detail shall be 

2 without interruption or loss of civil service status or privi3 lege. 

4 ‘‘(j) EFFECTIVE DATE.—Section 14 of the Federal 

5 Advisory Committee Act (5 U.S.C. App.) shall not apply 

6 to the Council.

7 ‘‘SEC. 2214. ADVISORY BOARD ON ELDER ABUSE, NEGLECT, 

8 AND EXPLOITATION. 

9 ‘‘(a) ESTABLISHMENT.—There is established a board 

10 to be known as the ‘Advisory Board on Elder Abuse, Ne11 glect, and Exploitation’ (in this section referred to as the 

12 ‘advisory board’) to create a short- and long-term multi13 disciplinary strategic plan for the development of the field 

14 of elder justice, and to make recommendations to the Sec15 retary, the Attorney General, the Elder Justice Coordi16 nating Council established under section 2213, and the ap17 propriate committees of Congress. 

18 ‘‘(b) SOLICITATION OF NOMINATIONS.—The Sec19 retary and the Attorney General shall jointly publish a no20 tice in the Federal Register soliciting nominations for the 

21 appointment of members of the advisory board under sub22 section (c). 

23 ‘‘(c) COMPOSITION.—The advisory board shall be 

24 composed of members appointed jointly by the Secretary 

25 and the Attorney General, from the general public who 
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1 are individuals with experience and expertise in elder 

2 abuse, neglect, and exploitation prevention, intervention, 

3 treatment, law enforcement, or research, with due consid4 eration to representation of ethnic or racial minorities and 

5 diverse geographic areas, including individuals who rep6 resent—

7 ‘‘(1) social service providers (including State 

8 and local agencies with the statutory responsibility 

9 for adult protective services); 

10 ‘‘(2) health care providers (including geriatrics, 

11 emergency medicine, and nursing and mental health 

12 professionals); 

13 ‘‘(3) legal professionals (including law enforce14 ment and the judiciary); 

15 ‘‘(4) gerontologists; 

16 ‘‘(5) psychologists; 

17 ‘‘(6) State and local government; 

18 ‘‘(7) organizations providing services to elders 

19 and disabled persons; 

20 ‘‘(8) volunteer groups; 

21 ‘‘(9) elder rights advocates; 

22 ‘‘(10) family groups; 

23 ‘‘(11) experts in adult fiduciary relationships, 

24 and those serving as or monitoring fiduciaries, in25 cluding guardians; and 
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1 ‘‘(12) individuals in forensics-related positions 

2 (including coroners and forensic pathologists). 

3 ‘‘(d) VACANCIES.—Members shall be appointed for 

4 terms of 3 years. Any vacancy in the advisory board shall 

5 not affect its powers, but shall be filled in the same man6 ner as the original appointment was made. 

7 ‘‘(e) ELECTION OF OFFICERS.—The advisory board 

8 shall elect a chairperson and vice chairperson from among 

9 the members of the advisory board. The advisory board 

10 shall elect its initial chairperson and vice chairperson at 

11 its initial meeting. 

12 ‘‘(f) DUTIES.—Not later than 18 months after the 

13 establishment of the advisory board under subsection (a), 

14 and annually thereafter, the advisory board shall prepare 

15 and submit to the Secretary, the Attorney General, and 

16 the appropriate committees of Congress a report con17 taining—

18 ‘‘(1) information on the status of Federal, 

19 State, and local public and private elder justice ac20 tivities; 

21 ‘‘(2) recommendations (including recommended 

22 priorities) regarding—

23 ‘‘(A) elder justice programs, research, 

24 training, services, practice, enforcement, and 

25 coordination; 
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1 ‘‘(B) coordination between entities pur2 suing elder justice efforts and those involved in 

3 related areas that may inform or overlap with 

4 elder justice efforts, such as activities to combat 

5 violence against women and child abuse and ne6 glect; and 

7 ‘‘(C) activities relating to adult fiduciary 

8 systems, including guardianship and other fidu9 ciary arrangements; 

10 ‘‘(3) recommendations for specific modifications 

11 needed in Federal and State laws (including regula12 tions) or for programs, research, and training to en13 hance prevention, detection, diagnosis, treatment, 

14 intervention in, investigation, and prosecution of 

15 elder abuse, neglect, and exploitation; 

16 ‘‘(4) recommendations for the most effective co17 ordinated national data collection with respect to 

18 elder justice, and elder abuse, neglect, and exploi19 tation; and 

20 ‘‘(5) recommendations for a multidisciplinary 

21 strategic plan to guide the effective and efficient de22 velopment of the elder justice area. 

23 ‘‘(g) POWERS OF THE ADVISORY BOARD.—

24 ‘‘(1) HEARINGS.—The advisory board may hold 

25 such hearings, sit and act at such times and places, 
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1 take such testimony, and receive such evidence as

2 the advisory board considers advisable to carry out 

3 this section. 

4 ‘‘(2) INFORMATION FROM FEDERAL AGEN5 CIES.—The advisory board may secure directly from 

6 any Federal department or agency such information 

7 as the advisory board considers necessary to carry 

8 out this section. Upon request of the co-chairpersons 

9 of the advisory board, the head of such department 

10 or agency shall furnish such information to the advi11 sory board. 

12 ‘‘(3) SHARING OF DATA AND REPORTS.—The 

13 advisory board may secure from any entity pursuing 

14 elder justice activities under the Elder Justice Act or 

15 an amendment made by that Act, any data, reports, 

16 or recommendations generated in connection with 

17 such activities. 

18 ‘‘(4) POSTAL SERVICES.—The advisory board 

19 may use the United States mails in the same man20 ner and under the same conditions as other depart21 ments and agencies of the Federal Government. 

22 ‘‘(h) TRAVEL EXPENSES.—The members of the advi23 sory board shall not receive compensation for the perform24 ance of services for the advisory board, but shall be al25 lowed travel expenses, including per diem in lieu of sub-
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1 sistence, at rates authorized for employees of agencies 

2 under subchapter I of chapter 57 of title 5, United States 

3 Code, while away from their homes or regular places of 

4 business in the performance of services for the advisory 

5 board. Notwithstanding section 1342 of title 31, United 

6 States Code, the Secretary and the Attorney General may 

7 accept the voluntary and uncompensated services of the 

8 members of the advisory board. 

9 ‘‘(i) DETAIL OF GOVERNMENT EMPLOYEES.—Any 

10 Federal Government employee may be detailed to the advi11 sory board without reimbursement, and such detail shall 

12 be without interruption or loss of civil service status or 

13 privilege. 

14 ‘‘(j) EFFECTIVE DATE.—Section 14 of the Federal 

15 Advisory Committee Act (5 U.S.C. App.) shall not apply 

16 to the advisory board. 

17 ‘‘Subtitle B—Activities to Promote 

18 Elder Justice 

19 ‘‘SEC. 2221. DATA COLLECTION AND DISSEMINATION. 

20 ‘‘(a) ELDER JUSTICE RESOURCE CENTER.—

21 ‘‘(1) ESTABLISHMENT.—The Secretary, after 

22 consultation with the Attorney General, shall estab23 lish within the Office of Elder Justice (established 

24 under this title), an Elder Justice Resource Center 

25 (in this section referred to as the ‘Center’) to be the 
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1 central repository for information regarding elder 

2 abuse, neglect, and exploitation. 

3 ‘‘(2) DUTIES.—The Center shall—

4 ‘‘(A) develop the capacity and procedures 

5 to collect, maintain, and disseminate informa6 tion relevant to consumers, families, providers, 

7 clinicians, advocates, regulators, law enforce8 ment, policymakers, researchers, fiduciaries in9 cluding guardians, judges, and lawyers, relevant 

10 to the prevention, detection, assessment, identi11 fication, and treatment of, intervention in, and 

12 prosecution of, elder abuse, neglect, and exploi13 tation; 

14 ‘‘(B) provide, in a user-friendly manner, 

15 information on—

16 ‘‘(i) ways to promote autonomy in the 

17 face of aging or diminishing capacity and 

18 mobility; 

19 ‘‘(ii) how to avoid becoming a victim 

20 of elder abuse, neglect, or exploitation; and 

21 ‘‘(iii) advance planning and how to 

22 avoid the need for a fiduciary; 

23 ‘‘(C) provide links and references to other 

24 sources of information; 
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1 ‘‘(D) compile, analyze, and publish a sum2 mary of research conducted on elder abuse, ne3 glect, and exploitation and information on how 

4 to obtain the original research materials; 

5 ‘‘(E) solicit public comment and comment 

6 from the advisory board established under sec7 tion 2214 on the activities of the Center; 

8 ‘‘(F) establish a toll-free number for infor9 mation and referrals; 

10 ‘‘(G) coordinate activities with resource 

11 centers and clearinghouses on elder justice top12 ics; and 

13 ‘‘(H) provide funding to public and private 

14 agencies and entities to develop or continue the 

15 efforts of specialized elder justice-related clear16 inghouses and information repositories, to be 

17 linked to the Center, that address topics such 

18 as those enumerated in subparagraphs (A) and 

19 (B) and that provide effective services. 

20 ‘‘(3) COORDINATION OF AVAILABLE RE21 SOURCES.—In establishing the Center under this 

22 subsection the Secretary, after consultation with the 

23 Attorney General, shall—

24 ‘‘(A) consult with other Federal agencies 

25 that operate similar resource centers; 
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1 ‘‘(B) consult with private entities that op2 erate resource centers or clearinghouses on 

3 elder justice related topics; 

4 ‘‘(C) consult with the head of each agency 

5 participating in the Elder Justice Coordinating 

6 Council established under section 2213, as well 

7 as other agencies with clearinghouses com8 parable to the Center, such as clearinghouses 

9 relating to child abuse and neglect, to deter10 mine the most efficient and effective manner for 

11 collecting, maintaining, and disseminating in12 formation on elder abuse, neglect, and exploi13 tation; and 

14 ‘‘(D) solicit public comment on the compo15 nents of such Center. 

16 ‘‘(4) NATIONAL ELDER JUSTICE LIBRARY.—

17 ‘‘(A) ESTABLISHMENT.—The Secretary 

18 shall establish within the Center, a National 

19 Elder Justice Library (in this paragraph re20 ferred to as the ‘Library’) to serve as a central21 ized repository for all types of appropriate ma22 terials concerning training, technical assistance, 

23 and promising practices relating to elder justice 

24 including—

25 ‘‘(i) brochures and pamphlets;
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1 ‘‘(ii) video and computer-based re2 sources; 

3 ‘‘(iii) books; and 

4 ‘‘(iv) training materials. 

5 ‘‘(B) INDEX.—The Library shall create 

6 and maintain an up-to-date index of the mate7 rials described in subparagraph (A) by title, au8 thor, date, subject, and type of material, and a 

9 brief description of such materials. Such index 

10 shall be available on the Internet as well as in 

11 printed form in order to be easily accessible to 

12 the general public. 

13 ‘‘(C) AVAILABILITY.—The materials held 

14 by the Library shall be available for copying by 

15 individuals and entities nationwide and shall be 

16 disseminated at a nominal or no fee. The mate17 rials shall be copied and disseminated in ac18 cordance with the applicable provisions of title 

19 17, United States Code. 

20 ‘‘(D) DUTIES.—

21 ‘‘(i) ADDITIONAL MATERIALS.—The 

22 Library shall—

23 ‘‘(I) collect data on materials 

24 that would be appropriate for such li25 brary; 
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1 ‘‘(II) make efforts to identify and 

2 obtain appropriate materials; and 

3 ‘‘(III) identify and obtain mate4 rials relating to effective methods of 

5 conducting training and providing 

6 technical assistance relating to elder 

7 justice, including conducting the 

8 training and providing the assistance 

9 for underserved populations. 

10 ‘‘(ii) INFORMATION PACKETS.—After 

11 evaluating the materials described in this 

12 paragraph, the Library shall compile and 

13 develop information packets for use by 

14 groups in various settings including groups 

15 who are underserved or have other special 

16 needs. Such information packets shall in17 clude information and materials on train18 ing, technical assistance, and promising 

19 practices targeted at specific topics, 

20 groups, and settings. 

21 ‘‘(b) COLLECTION OF UNIFORM NATIONAL DATA ON

22 ELDER ABUSE, NEGLECT, AND EXPLOITATION.— 

23 ‘‘(1) PURPOSE.—The purpose of this subsection 

24 is to improve, streamline, and promote uniform col25 lection, maintenance, and dissemination of national 
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1 data relating to elder abuse, neglect, and exploi2 tation. 

3 ‘‘(2) PHASE I.—

4 ‘‘(A) IN GENERAL.—Not later than 1 year 

5 after the date of enactment of the Elder Justice 

6 Act, the Director of the Centers for Disease 

7 Control and Prevention (in this subsection re8 ferred to as the ‘Director’), after consultation 

9 with the Attorney General and working with ex10 perts in relevant disciplines, shall—

11 ‘‘(i) develop a method for collecting 

12 national data regarding elder abuse, ne13 glect, and exploitation; and 

14 ‘‘(ii) develop uniform national data re15 porting forms adapted to each relevant en16 tity or discipline (such as health, public 

17 safety, social and protective services, and 

18 law) reflecting—

19 ‘‘(I) the distinct manner in which 

20 each discipline receives and maintains 

21 information; and 

22 ‘‘(II) the sequence and history of 

23 reports to or involvement of different 

24 disciplines, independently, or the se-
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1 quence and history of reports from 

2 one discipline to another over time. 

3 ‘‘(B) FORMS.—The national data reporting 

4 forms described in subparagraph (A)(ii) shall 

5 incorporate the definitions of this title, for use 

6 in determining what is considered a reportable 

7 event. 

8 ‘‘(3) PHASE II.—

9 ‘‘(A) IN GENERAL.—Not later than 1 year 

10 after the completion of the activities described 

11 in paragraph (2), the Director shall ensure that 

12 the national data reporting forms and data col13 lection methods developed in accordance with 

14 such paragraph are pilot tested in 6 States de15 termined by the Director. 

16 ‘‘(B) ADJUSTMENTS TO THE FORM AND

17 METHODS.—The Director, after considering the 

18 results of the pilot testing described in subpara19 graph (A), and after consultation with the At20 torney General and relevant experts shall adjust 

21 the national data reporting forms and data col22 lection methods as necessary. 

23 ‘‘(4) PHASE III.—

24 ‘‘(A) DISTRIBUTION OF NATIONAL DATA

25 REPORTING FORMS.—After completion of the 
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1 adjustment to the national data reporting forms 

2 under paragraph (3)(B), the Director shall sub3 mit the national data reporting forms along 

4 with instructions to—

5 ‘‘(i) the heads of the relevant compo6 nents of the Department of Health and 

7 Human Services, the Department of Jus8 tice, and the Department of the Treasury, 

9 and such other Federal entities as may be 

10 appropriate; and 

11 ‘‘(ii) the Governor’s office of each 

12 State for collection from all relevant State 

13 entities of data, including health care, so14 cial services, and law enforcement data. 

15 ‘‘(B) DATA COLLECTION GRANTS.—

16 ‘‘(i) AUTHORIZATION.—The Director 

17 is authorized to award grants to States to 

18 improve data collection activities relating 

19 to elder abuse, neglect, and exploitation. 

20 ‘‘(ii) AMOUNT.—The amount of funds 

21 provided under each grant awarded to a 

22 State under this subsection shall not ex23 ceed $200,000, to be distributed in accord24 ance with clause (v).
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1 ‘‘(iii) APPLICATION.—Each State de2 siring a grant under this subparagraph 

3 shall submit to the Director an application 

4 at such time, in such manner, and con5 taining such information as the Director 

6 may require. 

7 ‘‘(iv) REQUIREMENTS.—Each State 

8 receiving a grant under this subparagraph 

9 for a fiscal year is required to report data 

10 for the calendar year that begins during 

11 that fiscal year, using the national data re12 porting forms described in subparagraph 

13 (A). 

14 ‘‘(v) FUNDING.—

15 ‘‘(I) FIRST YEAR.—For the first 

16 fiscal year in which a State receives 

17 grant funds under this subsection the 

18 Director shall initially distribute 50 

19 percent of such funds. The Director 

20 shall distribute the remaining funds at 

21 the end of the calendar year that be22 gins during that fiscal year, if the Di23 rector determines that the State has 

24 properly reported data required under 

25 this subsection for the calendar year. 
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1 ‘‘(II) SUBSEQUENT YEARS.—Ex2 cept as provided in subclause (I), the 

3 Director shall distribute grant funds 

4 to a State under this subsection for a 

5 fiscal year if the Director determines 

6 that the State properly reported data 

7 required under this subsection for the 

8 calendar year that ends during that 

9 fiscal year. 

10 ‘‘(C) REQUIRED INFORMATION.—Each re11 port submitted under this paragraph shall re12 ceive an identifier beginning with a 2-letter 

13 State code, and a 2-letter year code, and such 

14 numbers as the Director determines to be ap15 propriate. Each individual report shall be as16 signed a new identifier, even if a victim de17 scribed in the report is reported to have been 

18 victimized more than once. If the State submits 

19 a report for more than one discipline, the State 

20 shall submit a combined report to avoid double 

21 counting. The State shall note in each report 

22 whether an event was ongoing or occurred in 

23 distinct separate episodes. 

24 ‘‘(5) REPORT.—Not later than 1 year after the 

25 date of enactment of the Elder Justice Act and an-
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1 nually thereafter, the Director shall prepare and 

2 submit to the appropriate committees of Congress, 

3 including to the Special Committee on Aging of the 

4 Senate, a report regarding activities conducted 

5 under this subsection. 

6 ‘‘(6) REGULATIONS.—The Secretary shall pro7 mulgate such regulations as are necessary to carry 

8 out this subsection.

9 ‘‘SEC. 2222. ENHANCING RESEARCH AND TRAINING AND 

10 STRENGTHENING SERVICES, SYSTEMS, AND 

11 PREVENTION. 

12 ‘‘(a) GRANTS.—The Secretary may award grants to 

13 eligible entities for the prevention, detection, assessment, 

14 and treatment of, intervention in, investigation of, and 

15 prosecution of elder abuse, neglect, and exploitation in16 cluding—

17 ‘‘(1) physical, psychological, and emotional 

18 abuse and neglect by family and other in-home care19 givers; 

20 ‘‘(2) physical, psychological, and emotional 

21 abuse and neglect of residents in institutional and 

22 other residential care facilities; 

23 ‘‘(3) elder sexual abuse; 

24 ‘‘(4) domestic violence in later life; 

25 ‘‘(5) financial fraud and exploitation; and 
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1 ‘‘(6) self-neglect. 

2 ‘‘(b) CENTERS OF EXCELLENCE.—

3 ‘‘(1) GRANTS AUTHORIZED.—The Secretary, 

4 through the Director of the National Institute on 

5 Aging, and after consultation with the Director of 

6 the Centers for Disease Control and Prevention, the 

7 Director of the Office of Elder Justice in the De8 partment of Health and Human Services, the Direc9 tor of the Office of Elder Justice in the Department 

10 of Justice, and the members of the advisory board 

11 established under section 2214, may award grants to 

12 institutions of higher education and other appro13 priate entities to establish 5 Centers of Excellence 

14 nationwide that shall specialize in research, clinical 

15 practice, and training relating to elder abuse, ne16 glect, and exploitation. 

17 ‘‘(2) AUTHORIZED ACTIVITIES.—The Centers of 

18 Excellence established with funds provided under 

19 paragraph (1) shall conduct the following activities: 

20 ‘‘(A) Examine potential issues relating to 

21 the protection of elders who are the subjects of 

22 research on elder abuse, neglect, and exploi23 tation and provide guidance to other elder 

24 abuse, neglect, or exploitation researchers re25 garding human subjects, protections, and the 
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1 institutional or peer review boards at research 

2 institutions. 

3 ‘‘(B) After consultation with the Director 

4 of the National Institute on Aging, and the Di5 rector of the Office of Human Research Protec6 tions, develop and recommend to the Secretary 

7 guidelines to assist the institutional or peer re8 view boards in the review of research under this 

9 title. 

10 ‘‘(C) Coordinate activities, to the extent 

11 feasible, among the Centers and with other re12 searchers of elder abuse, neglect, and exploi13 tation and related areas, and designate 1 such 

14 Center to lead such coordination. 

15 ‘‘(3) ADDITIONAL ACTIVITIES.—The Centers of 

16 Excellence established under paragraph (1) may con17 duct activities including the following: 

18 ‘‘(A) Carrying out a study to determine 

19 the national incidence and prevalence of elder 

20 abuse, neglect, and exploitation in all settings. 

21 ‘‘(B) Developing uniform, validated screen22 ing tools to assist individuals, families, practi23 tioners, institutions, and communities in detect24 ing ongoing or potential elder abuse, neglect,
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1 and exploitation. The tools that may be devel2 oped include—

3 ‘‘(i) a screening tool to determine 

4 whether a particular elder is at risk for be5 coming, or is, a victim; 

6 ‘‘(ii) a screening tool to measure 

7 whether caregivers are at risk of commit8 ting elder abuse, neglect, or exploitation; 

9 ‘‘(iii) a screening tool to measure 

10 whether families are at risk for elder 

11 abuse, neglect, and exploitation; and 

12 ‘‘(iv) a screening tool to assess com13 munities, evaluating how each individual 

14 agency or system relating to elder abuse, 

15 neglect, or exploitation operates in such a 

16 community and how all of such agencies or 

17 systems communicate and operate in rela18 tionship to each other within such commu19 nity. 

20 ‘‘(C) Carrying out various types of inter21 vention research. 

22 ‘‘(D) Identifying steps that can be taken 

23 (and replicated) to make homes, neighborhoods, 

24 communities, and facilities safer for elders, and 
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1 to enhance their sense of security in all kinds 

2 of environments. 

3 ‘‘(E) Researching successful fiduciary 

4 practices and systems to enhance the well-being 

5 of persons with diminished capacity. 

6 ‘‘(4) COLLABORATION AND ACCESS TO

7 RECORDS.—In awarding a grant under this sub8 section the Secretary shall—

9 ‘‘(A) consider the potential for collabora10 tion among researchers and other relevant enti11 ties, such as State agencies with statutory re12 sponsibility for adult protective services and 

13 State Long-Term Care Ombudsmen, that re14 ceive reports of elder abuse, neglect, and exploi15 tation, but that may be restricted from partici16 pating in research as a result of State law, con17 fidentiality requirements, or other provisions; 

18 and 

19 ‘‘(B) require that each institution of higher 

20 education desiring a grant under this subsection 

21 ensure that the researchers working at such in22 stitution will have access to records necessary 

23 to conduct research in accordance with this sub24 section. 

25 ‘‘(5) EXCELLENCE ADVISORY COMMITTEE.—
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1 ‘‘(A) COMMITTEE ESTABLISHED.—There is 

2 established in the Department of Health and 

3 Human Services an Excellence Advisory Com4 mittee (in this subsection referred to as the 

5 ‘Committee’). 

6 ‘‘(B) MEMBERSHIP.—The Committee shall 

7 be composed of individuals appointed by the 

8 Secretary with a demonstrated interest and ex9 pertise in research, education, and clinical ac10 tivities related to elder abuse, neglect, and ex11 ploitation, or individuals with related experience 

12 in essential fields such as epidemiology or fo13 rensic pathology, including— 

14 ‘‘(i) representatives from private enti15 ties; and 

16 ‘‘(ii) representatives from Federal and 

17 State agencies, including—

18 ‘‘(I) researchers; 

19 ‘‘(II) health care practitioners; 

20 ‘‘(III) policy experts; and 

21 ‘‘(IV) other individuals appro22 priate to promote useful research, 

23 training, and clinical practice. 

24 ‘‘(C) PERIOD OF APPOINTMENT; VACAN25 CIES.—Members shall be appointed for terms of 
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1 3 years. Any vacancy in the Committee shall 

2 not affect its powers, but shall be filled in the 

3 same manner as the original appointment was 

4 made. 

5 ‘‘(D) DUTIES.—The Committee shall co6 ordinate with the Advisory Board established 

7 under section 2214 and shall make rec8 ommendations to the Secretary, the Attorney 

9 General, the Elder Justice Coordinating Council 

10 established under section 2213, and the Centers 

11 of Excellence established under this subsection 

12 concerning—

13 ‘‘(i) facilitating the coordination of the 

14 activities of the Centers of Excellence es15 tablished under this subsection; 

16 ‘‘(ii) developing procedures and mech17 anisms for data sharing between such Cen18 ters of Excellence; and 

19 ‘‘(iii) ensuring that such Centers of 

20 Excellence have similar systems and re21 search and reporting procedures in order 

22 to facilitate the sharing of data. 

23 ‘‘(E) TRAVEL EXPENSES.—The members 

24 of the Committee shall not receive compensa25 tion for the performance of services for the
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1 committee, but shall be allowed travel expenses, 

2 including per diem in lieu of subsistence, at 

3 rates authorized for employees of agencies 

4 under subchapter I of chapter 57 of title 5, 

5 United States Code, while away from their 

6 homes or regular places of business in the per7 formance of services for the Committee. Not8 withstanding section 1342 of title 31, United 

9 States Code, the Secretary may accept the vol10 untary and uncompensated services of members 

11 of the Committee. 

12 ‘‘(F) DETAIL OF GOVERNMENT EMPLOY13 EES.—Any Federal Government employee may 

14 be detailed to the Committee without reim15 bursement, and such detail shall be without 

16 interruption or loss of civil service status or 

17 privilege. 

18 ‘‘(G) TERMINATION.—Section 14 of the 

19 Federal Advisory Committee Act (5 U.S.C. 

20 App.) shall not apply to the Committee. 

21 ‘‘(c) SAFE HAVEN AND LEGAL ADVOCACY

22 GRANTS.—

23 ‘‘(1) SAFE HAVEN GRANTS.—

24 ‘‘(A) GRANTS AUTHORIZED.—The Sec25 retary may award grants to 6 diverse commu-
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1 nities to examine various types of elder shelters 

2 (in this paragraph referred to as ‘safe havens’) 

3 and to test various models for establishing safe 

4 havens at home or elsewhere. 

5 ‘‘(B) AUTHORIZED ACTIVITIES.—Grant 

6 funds awarded pursuant to subparagraph (A) 

7 shall be used to establish safe havens that—

8 ‘‘(i) provide a comprehensive, cul9 turally sensitive, and multidisciplinary 

10 team response to allegations of elder 

11 abuse, neglect, or exploitation; 

12 ‘‘(ii) provide a dedicated, elder-friend13 ly setting; 

14 ‘‘(iii) have the capacity to meet the 

15 needs of elders for care; and 

16 ‘‘(iv) provide various services includ17 ing—

18 ‘‘(I) nursing and forensic evalua19 tion; 

20 ‘‘(II) therapeutic intervention; 

21 ‘‘(III) victim support and advo22 cacy; and 

23 ‘‘(IV) case review and assistance 

24 to make the elder safer at home or to 

25 find appropriate placement in safer 
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1 environments, including shelters, and, 

2 in some circumstances long-term care 

3 facilities, other residential care facili4 ties, and hospitals. 

5 ‘‘(2) LEGAL ADVOCACY GRANTS.—

6 ‘‘(A) GRANTS AUTHORIZED.—The Sec7 retary, after consultation with the Attorney 

8 General, may award grants—

9 ‘‘(i) to study the need for community 

10 resources in order to provide assistance for 

11 legal and related services for victims of 

12 elder abuse, neglect, or exploitation; and 

13 ‘‘(ii) to provide assistance for such 

14 services by awarding grants for demonstra15 tion projects in diverse communities. 

16 ‘‘(B) AUTHORIZED ACTIVITIES.—Grant 

17 funds awarded pursuant to subparagraph (A) 

18 shall be used to provide—

19 ‘‘(i) court-appointed advocates; 

20 ‘‘(ii) authorized fiduciaries, including 

21 public guardians; 

22 ‘‘(iii) monitoring and oversight of fi23 duciaries; 

24 ‘‘(iv) legal services; and 
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1 ‘‘(v) such other services as the Sec2 retary, after consultation with the Attorney 

3 General, determines appropriate. 

4 ‘‘(d) GRANTS TO ENHANCE VOLUNTEER SERV5 ICES.—The Secretary, after consultation with the Attor6 ney General, may award grants to nonprofit organizations 

7 and faith-based organizations to encourage such organiza8 tions to establish or continue volunteer programs that 

9 focus on the issues of elder abuse, neglect, and exploi10 tation, or that provide related services. 

11 ‘‘(e) MULTIDISCIPLINARY EFFORTS.—

12 ‘‘(1) GRANTS.—The Secretary may award 

13 grants to fund various multidisciplinary elder justice 

14 activities, including the following: 

15 ‘‘(A) Supporting and studying team ap16 proaches for bringing a coordinated multidisci17 plinary or interdisciplinary response to elder 

18 abuse, neglect, and exploitation, including a re19 sponse from individuals in social service, health 

20 care, public safety, and legal disciplines. 

21 ‘‘(B) Establishing State coordinating coun22 cils modeled after the national Elder Justice 

23 Coordinating Council established under section 

24 2213. Such State coordinating councils shall 

25 identify the individual States’ needs and provide 
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•HR 2490 IH 

1 the national Elder Justice Coordinating Council 

2 with information and recommendations relating 

3 to State efforts to combat elder abuse, neglect, 

4 and exploitation. 

5 ‘‘(C) Providing training, technical assist6 ance, and other methods of support to groups 

7 carrying out multidisciplinary efforts at the 

8 State level (referred to in some States as ‘State 

9 Working Groups’). 

10 ‘‘(D) Broadening and studying various 

11 models for elder fatality and serious injury re12 view teams, to make recommendations about 

13 their composition, protocols, functions, timing, 

14 roles, and responsibilities, with a goal of pro15 ducing models and information that will allow 

16 for replication based on the needs of other 

17 States and communities. 

18 ‘‘(E) Carrying out other interdisciplinary 

19 or multidisciplinary efforts as determined by 

20 the Secretary to be appropriate. 

21 ‘‘(2) INTRADISCIPLINARY REVIEW.—

22 ‘‘(A) IN GENERAL.—The Director of the 

23 Centers for Disease Control and Prevention, 

24 after consultation with the Director of the Of25 fice of Elder Justice in the Department of
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1 Health and Human Services and the Director 

2 of the Office of Elder Justice in the Depart3 ment of Justice, shall conduct an intensive 

4 intradisciplinary review of entities that conduct 

5 elder justice activities in several different com6 munities, examining how the entities address 

7 elder abuse, neglect, and exploitation issues 

8 (such as an assessment of various types of 

9 health care and social service providers, public 

10 safety agencies, law enforcement agencies, pros11 ecutor offices, and the judiciary). 

12 ‘‘(B) GOAL.—The goals of the study de13 scribed in subparagraph (A) include—

14 ‘‘(i) making an assessment of the 

15 functioning and effectiveness of each entity 

16 in a community that conducts elder justice 

17 activities, and the interdisciplinary commu18 nications and collaborations among such 

19 entities; and 

20 ‘‘(ii) developing a procedure for com21 munities to conduct a self-assessment to 

22 assist them in identifying the manner in 

23 which the entities described in clause (i) in 

24 such communities respond to elder justice 

25 issues, the needs of such communities re-
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•HR 2490 IH 

1 lating to elder justice issues, and ways to 

2 improve the response systems of such com3 munities for elder abuse, neglect, and ex4 ploitation. 

5 ‘‘(f) TRAINING GRANTS.—

6 ‘‘(1) GRANTS AUTHORIZED.—The Secretary 

7 may award grants to groups representing the tar8 geted disciplines described in paragraph (2)(B) to 

9 train individuals with respect to issues of elder 

10 abuse, neglect, and exploitation. 

11 ‘‘(2) AUTHORIZED ACTIVITIES.—

12 ‘‘(A) IN GENERAL.—Grant funds awarded 

13 under paragraph (1) shall be used for training 

14 within a discipline as well as cross-training ac15 tivities that permit individuals in multiple dis16 ciplines to train together, fostering communica17 tion, coordinating efforts, and ensuring collabo18 ration. 

19 ‘‘(B) TARGETED DISCIPLINES.—Groups 

20 representing disciplines that will be targeted for 

21 training through grants awarded under para22 graph (1) include—

23 ‘‘(i) physicians (geriatricians, family 

24 physicians, internists, emergency physi25 cians, forensic pathologists and medical ex-
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•HR 2490 IH 

1 aminers, psychiatrists, and other special2 ists), and medical residents, interns, and 

3 fellows; 

4 ‘‘(ii) nurses and nurse’s aides, includ5 ing geriatric nurse practitioners, directors 

6 of nursing, and Sexual Abuse Nurse Ex7 aminers (SANE) nurses; 

8 ‘‘(iii) social workers; 

9 ‘‘(iv) public health and safety profes10 sionals including Emergency Medical Serv11 ices professionals; 

12 ‘‘(v) therapists, including creative 

13 arts, occupational, speech, and physical 

14 therapists; 

15 ‘‘(vi) State surveyors (who survey 

16 nursing facilities and other long-term care 

17 facilities); 

18 ‘‘(vii) long-term care facility and hos19 pital staff; 

20 ‘‘(viii) coroners and funeral home op21 erators; 

22 ‘‘(ix) Federal, State, and local offices 

23 with responsibility for elder justice or long24 term care matters; 
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•HR 2490 IH 

1 ‘‘(x) employees or contractors of State 

2 and local agencies with responsibility for 

3 training persons who provide adult protec4 tive services; 

5 ‘‘(xi) State Long-Term Care Ombuds6 men; 

7 ‘‘(xii) victim advocates and advocates 

8 for elders and individuals with disabilities; 

9 ‘‘(xiii) individuals involved in volun10 teer organizations (including faith-based 

11 organizations) who are involved in issues of 

12 elder abuse, neglect, and exploitation; 

13 ‘‘(xiv) police officers, sheriffs, detec14 tives, firefighters, Federal and State inves15 tigators, public safety officers, and correc16 tions personnel; 

17 ‘‘(xv) Federal, State, and local pros18 ecutors, attorneys in private practice in19 volved in elder justice issues, and judges 

20 and court employees; 

21 ‘‘(xvi) TRIADs (federally recognized 

22 partnerships of elders, sheriff departments, 

23 and the American Association of Retired 

24 Persons); 

25 ‘‘(xvii) elder service officers; 
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•HR 2490 IH 

1 ‘‘(xviii) individuals who work with the 

2 public, including bank personnel, postal 

3 workers, utility workers, providers of 

4 home-delivered meals, and others who may 

5 work with elders; 

6 ‘‘(xix) students in professional and 

7 paraprofessional schools, internships, fel8 lowships, and other training programs in a 

9 relevant profession; 

10 ‘‘(xx) fiduciaries, including guardians, 

11 conservators, and agents under powers of 

12 attorney; and 

13 ‘‘(xxi) staff and volunteers of domestic 

14 violence and child abuse and neglect pro15 grams. 

16 ‘‘(g) PILOT PROJECT TO EVALUATE UTILITY OF

17 SERVICES TO ELDERS IN NEED.—The Secretary, acting 

18 through the Director of the Office of Elder Justice in the 

19 Department of Health and Human Services, and after 

20 consultation with the Director of the Office of Elder Jus21 tice in the Department of Justice, is authorized to award 

22 grants to develop and implement pilot projects designed 

23 to ameliorate gaps in basic elder justice-related health, so24 cial, or protective services, with the goal of identifying
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1 what types of services are most useful to elders in need, 

2 and in what contexts the services are useful. 

3 ‘‘(h) INCREASING THE NUMBER OF HEALTH CARE

4 PROFESSIONALS WITH GERIATRIC TRAINING.—The Sec5 retary shall establish programs to increase—

6 ‘‘(1) the number of health care professionals 

7 (including physicians, nurses, nursing personnel, so8 cial workers, and therapists) and students in the 

9 health care professions, who receive education and 

10 training related to geriatrics; and 

11 ‘‘(2) the number of such professionals who pro12 vide health care related to geriatrics. 

13 ‘‘(i) SPECIAL NEEDS GRANTS.—

14 ‘‘(1) GRANTS AUTHORIZED.—The Secretary 

15 may award grants to eligible entities to identify, ad16 dress, and make recommendations on meeting the 

17 special needs of underserved populations of elders. 

18 ‘‘(2) POPULATIONS INCLUDED.—The grant 

19 funds awarded pursuant to paragraph (1) shall be 

20 used to fund programs including the following: 

21 ‘‘(A) RURAL SETTINGS.—Programs de22 signed to meet the needs of elders living in 

23 rural locations, including the needs of their in24 formal caregivers and fiduciaries. The programs 

25 shall include—
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•HR 2490 IH 

1 ‘‘(i) strategies to decrease isolation; 

2 ‘‘(ii) training for informal caregivers 

3 and fiduciaries; 

4 ‘‘(iii) activities involving collaboration 

5 between the entities and local secondary 

6 schools and institutions of higher education 

7 to offer classes for credit, focusing on 

8 training individuals to work with elders 

9 and caregivers; 

10 ‘‘(iv) training for volunteers to serve 

11 in rural communities; and 

12 ‘‘(v) strategies on the use of advance 

13 planning to avoid the need for a guardian 

14 or other fiduciary. 

15 ‘‘(B) MINORITY POPULATIONS.—Programs 

16 designed to meet the needs of elders in minority 

17 populations, including culturally and linguis18 tically appropriate programs. 

19 ‘‘(C) INDIAN TRIBES.—Programs designed 

20 to provide necessary services to elders who are 

21 members of Indian tribes including successful 

22 programs in elder abuse, neglect, and exploi23 tation prevention and treatment that target In24 dian populations. The entities carrying out the 

25 programs shall deliver services and distribute 
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•HR 2490 IH 

1 educational information on elder abuse, neglect, 

2 and exploitation to Indian tribes and other pol3 icymakers, health and social service providers, 

4 law enforcement, and researchers with a par5 ticular interest in elders who are members of 

6 Indian tribes. 

7 ‘‘(j) PUBLIC AWARENESS GRANTS.—

8 ‘‘(1) GRANTS AUTHORIZED.—The Secretary 

9 and the Attorney General, after consultation with 

10 the advisory board established under section 2214 

11 and the coordinating council established under sec12 tion 2213, shall jointly award 1 grant to a national 

13 organization, or 1 or more grants to eligible entities, 

14 to conduct a national multimedia campaign designed 

15 to raise awareness about elder abuse, neglect, and 

16 exploitation. 

17 ‘‘(2) AUTHORIZED ACTIVITIES.—Grant funds 

18 awarded under paragraph (1) shall be used for ac19 tivities including the following: 

20 ‘‘(A) Raising public awareness regarding 

21 financial schemes that target elders. 

22 ‘‘(B) Pilot testing of the effectiveness of 

23 various types of multimedia campaigns in rais24 ing awareness about—
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•HR 2490 IH 

1 ‘‘(i) the types of elder abuse, neglect, 

2 and exploitation; 

3 ‘‘(ii) steps to take if an individual sus4 pects elder abuse, neglect, or exploitation 

5 has occurred; and 

6 ‘‘(iii) ways to prevent elder abuse, ne7 glect, or exploitation. 

8 ‘‘(k) ELDER JUSTICE INNOVATION FUND.—The Sec9 retary and the Attorney General are authorized to jointly 

10 award grants to individuals or entities working in the elder 

11 justice field or related fields for research, a demonstration 

12 project, development or implementation of a promising 

13 program or practice, or another innovative effort, that 

14 might not otherwise be funded or pursued in the absence 

15 of a grant under this subsection. 

16 ‘‘SEC. 2223. STUDIES. 

17 ‘‘(a) ROLES OF ENTITIES RESPONDING TO ELDER

18 ABUSE, NEGLECT, AND EXPLOITATION.—

19 ‘‘(1) IN GENERAL.—The Secretary of Health 

20 and Human Services and the Attorney General shall 

21 jointly sponsor or conduct a study of the roles and 

22 responsibilities of government and government-fund23 ed entities responsible for responding to, inves24 tigating, and taking other actions in response to re-
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•HR 2490 IH 

1 ports of elder abuse, neglect, and exploitation includ2 ing—

3 ‘‘(A) State and local agencies with the re4 sponsibility for adult protective services; 

5 ‘‘(B) the State Long-Term Care Ombuds6 men; 

7 ‘‘(C) law enforcement (including prosecu8 tors); 

9 ‘‘(D) fiduciaries; 

10 ‘‘(E) judges and other court personnel; and 

11 ‘‘(F) such other social and protective serv12 ice, advocacy, and protection organizations as 

13 the Secretary and the Attorney General deter14 mine to be appropriate. 

15 ‘‘(2) GOALS.—The goals of the study author16 ized in paragraph (1) (which may be conducted in 

17 distinct sections, if there is overall coordination) 

18 are—

19 ‘‘(A) to identify gaps in detection of, inves20 tigation of, and intervention in elder abuse, ne21 glect, and exploitation; 

22 ‘‘(B) to improve the response to elder 

23 abuse, neglect, and exploitation; and 

24 ‘‘(C) to reduce elder victimization and its 

25 consequences by assessing and improving the
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•HR 2490 IH 

1 systems created to address reports of the prob2 lems. 

3 ‘‘(3) AUTHORIZED ACTIVITIES.—In conducting 

4 the study authorized in paragraph (1), the Director 

5 shall—

6 ‘‘(A) conduct an evaluation of—

7 ‘‘(i) how the social and protective 

8 service, advocacy, protection, judicial, and 

9 law enforcement entities and systems are 

10 operating; 

11 ‘‘(ii) the interplay and allocation of re12 sponsibilities among those entities; 

13 ‘‘(iii) how that allocation differs from 

14 community to community and State to 

15 State; and 

16 ‘‘(iv) how those differences impact the 

17 population intended to be protected by the 

18 entities and systems; 

19 ‘‘(B) make recommendations on how to 

20 clarify the roles (at the national level) of enti21 ties such as State agencies with responsibility 

22 for adult protective services, the State Long23 Term Care Ombudsmen, and other protection 

24 and advocacy entities to enhance efficiency, 

25 eliminate gaps in service, and identify con-
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•HR 2490 IH 

1 flicting mandates and duplication of efforts; 

2 and 

3 ‘‘(C) evaluate how various communities de4 lineate the roles and responsibilities of the types 

5 of entities described in subparagraph (A) in 

6 order to identify and recommend effective mod7 els and methods to duplicate the delineation ef8 forts (such as duplication through memoranda 

9 of understanding). 

10 ‘‘(b) FAMILY ELDER ABUSE, NEGLECT, AND EX11 PLOITATION STUDY.— 

12 ‘‘(1) IN GENERAL.—The Director of the Cen13 ters for Disease Control and Prevention (in this sub14 section referred to as the ‘Director’), after consulta15 tion with the Director of the Office of Elder Justice 

16 in the Department of Health and Human Services 

17 and the Director of the Office of Elder Justice in 

18 the Department of Justice, shall conduct a study to 

19 determine the best method to address elder abuse, 

20 neglect, and exploitation from a public health per21 spective, including examining methods to reduce 

22 elder abuse, neglect, and exploitation committed by 

23 family members. 

24 ‘‘(2) COLLABORATION.—The Director, in car25 rying out activities under this subsection, shall col-
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•HR 2490 IH 

1 laborate with the Director of the National Institute 

2 on Aging, the Director of the Office of Elder Justice 

3 in the Department of Health and Human Services, 

4 the Director of the Office of Elder Justice in the 

5 Department of Justice, the heads of State agencies 

6 with responsibility for adult protective services, and 

7 the heads of such other entities as the Director de8 termines appropriate. 

9 ‘‘SEC. 2224. FORENSIC MARKERS, METHODOLOGIES, AND 

10 TRAINING. 

11 ‘‘(a) FORENSIC CENTERS.—

12 ‘‘(1) GRANTS.—The Secretary shall make 

13 grants to appropriate entities to establish and oper14 ate stationary and mobile forensic centers, to de15 velop forensic expertise regarding, and provide serv16 ices relating to, elder abuse, neglect, and exploi17 tation. 

18 ‘‘(2) COORDINATION AMONG FORENSIC CEN19 TERS AND CENTERS OF EXCELLENCE.—The entities 

20 establishing and operating the forensic centers shall 

21 coordinate activities on an ongoing basis with the 

22 Centers of Excellence described in section 

23 2222(b)(1) and with the Excellence Advisory Com24 mittee described in section 2222(b)(5). Such coordi25 nation shall include ongoing communication among 
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•HR 2490 IH 

1 the entities, the Centers of Excellence, and the Ex2 cellence Advisory Committee. The entities shall ad3 here to the procedures and mechanisms developed by 

4 the Excellence Advisory Committee including proce5 dures and mechanisms relating to the sharing of 

6 data. 

7 ‘‘(3) STATIONARY FORENSIC CENTERS.—The 

8 Secretary shall make 4 of the grants described in 

9 paragraph (1) to institutions of higher education 

10 with demonstrated expertise in forensics or commit11 ment to preventing or treating elder abuse, neglect, 

12 or exploitation, to establish and operate stationary 

13 forensic centers. The Secretary shall make at least 

14 2 of the 4 grants to an entity operating a Center of 

15 Excellence described in section 2222(b)(1) at an in16 stitution of higher education. 

17 ‘‘(4) MOBILE CENTERS.—The Secretary shall 

18 make 6 of the grants described in paragraph (1) to 

19 appropriate entities to establish and operate mobile 

20 forensic centers. 

21 ‘‘(5) USE OF FUNDS.—

22 ‘‘(A) DEVELOPMENT OF FORENSIC MARK23 ERS AND METHODOLOGIES.—An entity that re24 ceives a grant under this subsection shall use 

25 funds made available through the grant to as-
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1 sist in the determination of whether abuse or 

2 neglect occurred, a crime was committed, to 

3 conduct research to describe and disseminate 

4 information on—

5 ‘‘(i) forensic markers that indicate a 

6 case in which elder abuse, neglect, or ex7 ploitation may have occurred; and 

8 ‘‘(ii) methodologies for determining, in 

9 such a case, when and how health care, 

10 emergency service, social and protective 

11 service, and legal service providers should 

12 intervene and when the providers should 

13 report the case to law enforcement authori14 ties. 

15 ‘‘(B) APPLICATIONS.—An entity that re16 ceives a grant under this subsection shall use 

17 funds made available through the grant to de18 velop forensic expertise regarding elder abuse, 

19 neglect, and exploitation, in order to provide 

20 medical and forensic evaluation, therapeutic 

21 intervention, victim support and advocacy, case 

22 review, and case tracking. 

23 ‘‘(C) COLLECTION OF EVIDENCE.—An en24 tity operating a Center of Excellence described 

25 in section 2222(b)(1) that receives a grant
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1 under this subsection shall use funds made 

2 available through the grant to develop the ca3 pacity to collect forensic evidence, including col4 lecting forensic evidence relating to a potential 

5 determination of elder abuse, neglect, or exploi6 tation. 

7 ‘‘(b) TRAINING TO DEVELOP EXPERTISE IN GERI8 ATRIC FORENSICS.—

9 ‘‘(1) FELLOWSHIP PROGRAMS.—

10 ‘‘(A) IN GENERAL.—The Secretary shall 

11 provide fellowships to eligible individuals, to en12 able the individuals to obtain training through 

13 a standard forensic science training program. 

14 ‘‘(B) ELIGIBLE INDIVIDUALS.—To be eligi15 ble to receive a fellowship under this paragraph, 

16 an individual shall be a physician who—

17 ‘‘(i) is board certified or board eligible 

18 in internal medicine or family practice; 

19 ‘‘(ii) has completed a program in geri20 atrics that meets such criteria as the Sec21 retary may prescribe; and 

22 ‘‘(iii) has entered into an agreement 

23 with the Secretary to provide the team 

24 training described in subparagraph (C), 
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•HR 2490 IH 

1 after receiving the training described in 

2 subparagraph (A). 

3 ‘‘(C) TEAM TRAINING.—An individual who 

4 receives a fellowship under this paragraph shall 

5 provide training in forensic geriatrics to inter6 disciplinary teams of health care professionals. 

7 ‘‘(2) OTHER PROGRAMS.—The Secretary shall 

8 establish programs, and make grants to carry out 

9 the programs, to provide forensic training to experi10 enced geriatricians. 

11 ‘‘Subtitle C—Increasing Security, 

12 Quality, and Consumer Informa13 tion for Long-Term Care 

14 ‘‘CHAPTER 1—INCREASING SECURITY FOR 

15 LONG-TERM CARE

16 ‘‘SEC. 2231. REPORTING TO LAW ENFORCEMENT OF CRIMES 

17 OCCURRING IN FEDERALLY FUNDED LONG18 TERM CARE FACILITIES. 

19 ‘‘(a) DETERMINATION AND NOTIFICATION.—

20 ‘‘(1) DETERMINATION.—Except as provided in 

21 paragraph (2), the owner or operator of each long22 term care facility that receives Federal funds shall 

23 annually determine if the facility received an amount 

24 of Federal funds that was not less than $10,000 

25 during the past year. 
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1 ‘‘(2) SINGLE POSITIVE DETERMINATION.—The 

2 owner or operator shall make the determination for 

3 a year unless the owner or operator determined that 

4 the facility received that amount during any previous 

5 year. 

6 ‘‘(3) NOTIFICATION.—If the owner or operator 

7 determines that the facility received that amount 

8 during any year, the owner or operator shall annu9 ally notify each individual described in subsection (b) 

10 of the obligation to comply with subsection (b). 

11 ‘‘(b) REPORTING REQUIREMENT.—

12 ‘‘(1) IN GENERAL.—Each individual who is an 

13 owner, operator, employee, manager, agent, or con14 tractor of a long-term care facility that is the sub15 ject of a determination described in subsection (a)(3) 

16 shall report to 1 or more law enforcement entities 

17 for the jurisdiction in which the facility is located, 

18 any reasonable suspicion of a crime (as defined by 

19 the law of the applicable political subdivision) 

20 against any person who is a resident of or receiving 

21 care from the facility. 

22 ‘‘(2) TIMING.—If the events that cause the sus23 picion—

24 ‘‘(A) result in serious bodily injury, the in25 dividual shall report the suspicion immediately, 
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•HR 2490 IH 

1 but not later than 2 hours after forming the 

2 suspicion; and 

3 ‘‘(B) do not result in serious bodily injury, 

4 the individual shall report the suspicion not 

5 later than 24 hours after forming the suspicion. 

6 ‘‘(c) PENALTY.—

7 ‘‘(1) IN GENERAL.—If an individual described 

8 in subsection (b) violates subsection (b)—

9 ‘‘(A) the individual shall be fined not more 

10 than $200,000 or subject to a civil money pen11 alty of not more than $200,000; or 

12 ‘‘(B) the Secretary shall classify the indi13 vidual as an excluded individual, for a period of 

14 not more than 3 years. 

15 ‘‘(2) INCREASED HARM.—If an individual de16 scribed in subsection (b) violates subsection (b), and 

17 the violation exacerbates the harm to the victim of 

18 the crime or results in harm to another person—

19 ‘‘(A) the individual shall be fined not more 

20 than $200,000 or subject to a civil money pen21 alty of not more than $200,000; and 

22 ‘‘(B) the Secretary shall classify the indi23 vidual as an excluded individual, for a period of 

24 not more than 3 years. 
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1 ‘‘(3) EXCLUDED INDIVIDUAL.—During any pe2 riod for which an individual is classified as an ex3 cluded individual under this paragraph, an entity 

4 that employs the individual shall be ineligible to re5 ceive funds under the medicare program under title 

6 XVIII or the medicaid program under title XIX. 

7 ‘‘(4) EXTENUATING CIRCUMSTANCES.—The 

8 Secretary may take into account the financial bur9 den on providers with underserved populations in de10 termining the penalty. 

11 ‘‘(d) REGULATIONS.—The Secretary, after consulting 

12 with the Attorney General, shall issue regulations to carry 

13 out this section. 

14 ‘‘CHAPTER 2—IMPROVING THE QUALITY 

15 OF LONG-TERM CARE 

16 ‘‘SEC. 2241. GRANTS AND INCENTIVES TO ENHANCE LONG17 TERM CARE STAFFING. 

18 ‘‘(a) GENERAL AUTHORITY.—The Administrator of 

19 the Centers for Medicare & Medicaid Services (in this sec20 tion referred to as the ‘Administrator’) shall carry out ac21 tivities, including activities described in subsection (b) and 

22 (c), to provide incentives for individuals to train for, seek, 

23 and maintain employment providing direct care in a long24 term care facility.
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1 ‘‘(b) SPECIFIC PROGRAMS TO ENHANCE TRAINING, 

2 RECRUITMENT, AND RETENTION OF STAFF.—

3 ‘‘(1) COORDINATION WITH OTHER PROGRAMS

4 TO RECRUIT AND TRAIN LONG-TERM CARE STAFF.—

5 The Administrator shall coordinate activities with 

6 the Secretary of Labor and the Assistant Secretary 

7 for the Administration for Children and Families, in 

8 order to provide incentives to participants in pro9 grams carried out under section 403(a)(5) and part 

10 A of title IV to train for and seek employment pro11 viding direct care in a long-term care facility. 

12 ‘‘(2) CAREER LADDERS AND WAGE OR BENEFIT

13 INCREASES TO INCREASE STAFFING IN LONG-TERM

14 CARE FACILITIES.—

15 ‘‘(A) IN GENERAL.—The Administrator 

16 shall make grants to eligible entities to carry 

17 out programs through which the entities—

18 ‘‘(i) offer, to employees who provide 

19 direct care in a long-term care facility, 

20 continuing training and varying levels of 

21 certification, based on observed clinical 

22 care practices and the amount of time the 

23 employees spend providing direct care; and 

24 ‘‘(ii) provide, or make arrangements 

25 with employers to provide, bonuses or 
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1 other increased compensation or benefits to 

2 employees who achieve certification under 

3 such a program.

4 ‘‘(B) APPLICATION.—To be eligible to re5 ceive a grant under this paragraph, an entity 

6 shall submit an application to the Adminis7 trator at such time, in such manner, and con8 taining such information as the Administrator 

9 may require. 

10 ‘‘(c) SPECIFIC PROGRAMS TO IMPROVE MANAGE11 MENT PRACTICES.—

12 ‘‘(1) IN GENERAL.—The Administrator shall 

13 make grants to eligible organizations to enable the 

14 organizations to provide training and technical as15 sistance to eligible persons (including administra16 tors, directors of nursing, staff developers, and 

17 charge nurses) who establish or implement manage18 ment practices for long-term care facilities. 

19 ‘‘(2) USE OF FUNDS.—An organization that re20 ceives a grant under paragraph (1) shall use funds 

21 made available through the grant—

22 ‘‘(A) to provide training and technical as23 sistance regarding management practices, that 

24 are for employees that provide direct care in a 

25 long-term care facility, and that are dem-
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1 onstrated to promote retention of those employ2 ees, such as—

3 ‘‘(i) the establishment of basic human 

4 resource policies that reward high perform5 ance, including policies that provide for im6 proved wages and benefits on the basis of 

7 job reviews; 

8 ‘‘(ii) the establishment of motivational 

9 and thoughtful work organization prac10 tices; 

11 ‘‘(iii) the creation of a workplace cul12 ture that respects and values caregivers 

13 and their needs; 

14 ‘‘(iv) the promotion of a workplace 

15 culture that respects the rights of residents 

16 of a long-term care facility and results in 

17 improved care for the residents; and 

18 ‘‘(v) the establishment of other pro19 grams that promote the provision of high 

20 quality care, such as a continuing edu21 cation program that provides additional 

22 hours of training, including on-the-job 

23 training, for employees who are certified 

24 nurse aides; or 
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1 ‘‘(B) to disseminate training materials for 

2 the training described in subparagraph (A), and 

3 to provide the materials to the National Elder 

4 Justice Library established in section 

5 2221(a)(4), so that the materials are available 

6 to other providers of such training. 

7 ‘‘(3) APPLICATION.—To be eligible to receive a 

8 grant under this subsection, an organization shall 

9 submit an application to the Administrator at such 

10 time, in such manner, and containing such informa11 tion as the Administrator may require. 

12 ‘‘(d) EVALUATING PROGRAMS.—After the first pro13 grams developed under this section have been completed, 

14 the Administrator shall evaluate the outcomes of such pro15 grams in determining which future applications to fund. 

16 ‘‘(e) ACCOUNTABILITY MEASURES.—The Adminis17 trator shall develop accountability measures to assure that 

18 funds made available under this section benefit the staff 

19 who are the intended beneficiaries of the programs pro20 vided under this section, to promote increases and stability 

21 in the long-term care workforce. 

22 ‘‘(f) COMPLIANCE WITH APPLICABLE LAWS.—In 

23 order to receive funds under this section, an eligible entity 

24 shall comply with all applicable laws, regulations, and 

25 guidelines.
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1 ‘‘SEC. 2242. COLLABORATIVE EFFORTS TO ENHANCE COM2 MUNICATION ON PROMOTING QUALITY OF 

3 AND PREVENTING ABUSE AND NEGLECT IN 

4 LONG-TERM CARE. 

5 ‘‘(a) IN GENERAL.—The Director of the Agency for 

6 Healthcare Research and Quality (in this section referred 

7 to as the ‘Director’), after consultation with the Attorney 

8 General, may establish pilot projects to improve long-term 

9 care. In carrying out the projects, the Director shall make 

10 grants to eligible partnerships to develop collaborative and 

11 innovative approaches to improve the quality of, including 

12 preventing abuse and neglect in, long-term care. 

13 ‘‘(b) ELIGIBLE PARTNERSHIPS.—To be eligible to re14 ceive a grant under this section, a partnership shall be 

15 a multidisciplinary community partnership, such as a 

16 partnership consisting of representatives in a community 

17 of nursing facility providers, advocates for residents of 

18 long-term care facilities, State Long-Term Care Ombuds19 men, surveyors, the State agency with responsibility for 

20 adult protective services, the State agency with responsi21 bility for licensing long-term care facilities, law enforce22 ment agencies, courts, family councils, residents, certified 

23 nurse aides, registered nurses, physicians, and other ap24 propriate entities and individuals. 

25 ‘‘(c) APPLICATION.—To be eligible to receive a grant 

26 under this section, a partnership shall submit an applica-
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1 tion to the Director at such time, in such manner, and 

2 containing such information as the Director may require. 

3 ‘‘SEC. 2243. COLLABORATIVE EFFORTS TO DEVELOP CON4 SENSUS AROUND THE MANAGEMENT OF CER5 TAIN QUALITY-RELATED FACTORS. 

6 ‘‘(a) IN GENERAL.—The Director of the Agency for 

7 Healthcare Research and Quality (in this section referred 

8 to as the ‘Director’), after consultation with the Attorney 

9 General and the Advisory Board established under section 

10 2214, may make grants to eligible entities to establish 

11 multidisciplinary panels to address, and develop consensus 

12 on, subjects relating to improving the quality of long-term 

13 care. The Director shall make a limited number of such 

14 grants, including at least 1 grant for the establishment 

15 of such a panel to address, and develop consensus on, 

16 methods of managing resident-to-resident abuse in long17 term care. 

18 ‘‘(b) USE OF FUNDS.—An entity that receives a 

19 grant under this section shall—

20 ‘‘(1) establish a multidisciplinary panel to ad21 dress a specific subject; and 

22 ‘‘(2) ensure that the panel uses the funds made 

23 available through the grant to establish a goal with 

24 respect to the subject, examine relevant research and 

25 data, identify best practices with respect to the sub-
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1 ject, determine the best way to carry out those best 

2 practices in a practical and feasible manner, and de3 termine an effective manner of distributing informa4 tion on the subject. 

5 ‘‘(c) APPLICATION.—To be eligible to receive a grant 

6 under this section, an entity shall submit an application 

7 to the Director at such time, in such manner, and con8 taining such information as the Director may require. 

9 ‘‘CHAPTER 3—INCREASING CONSUMER 

10 INFORMATION ABOUT LONG-TERM CARE 

11 ‘‘SEC. 2251. LONG-TERM CARE CONSUMER CLEARING12 HOUSE. 

13 ‘‘(a) IN GENERAL.—The Director of the Office of 

14 Elder Justice in the Department of Health and Human 

15 Services, in coordination with the Director of the Agency 

16 for Healthcare Research and Quality and the Adminis17 trator of the Centers for Medicare & Medicaid Services, 

18 shall establish a long-term care consumer clearinghouse in 

19 the Department of Health and Human Services. 

20 ‘‘(b) INFORMATION.—The clearinghouse shall be es21 tablished as part of the Elder Justice Resource Center (es22 tablished under section 2221) and shall provide com23 prehensive detailed information, in a consumer-friendly 

24 form, to consumers about choices relating to long-term 

25 care providers, such as information (including links to 
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1 websites and other resources that provide information) 

2 about—

3 ‘‘(1) obtaining the services of, and employing, 

4 caregivers who provide long-term care at an individ5 ual’s home; and 

6 ‘‘(2) options for residential long-term care, such 

7 as—

8 ‘‘(A)(i) the type of care provided by nurs9 ing facilities; and 

10 ‘‘(ii) the type of care provided by group 

11 homes and other residential long-term care fa12 cilities that are not nursing facilities; 

13 ‘‘(B) the benefits available through the 

14 programs carried out under titles XVIII and 

15 XIX of the Social Security Act (42 U.S.C. 1395 

16 et seq. and 1396 et seq.); and 

17 ‘‘(C) the care available through specific 

18 long-term care facilities, including data on the 

19 satisfaction level of residents of, and families of 

20 residents of, the facilities. 

21 ‘‘(c) PROVIDERS.—In providing information on long22 term care providers under this section, the clearinghouse 

23 shall provide information (from States and other sources) 

24 on assisted living facilities, board and care facilities, con-
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1 gregate care facilities, home health care providers, and 

2 other long-term care providers. 

3 ‘‘SEC. 2252. CONSUMER INFORMATION ABOUT THE CON4 TINUUM OF RESIDENTIAL LONG-TERM CARE 

5 FACILITIES. 

6 ‘‘(a) STUDY.—

7 ‘‘(1) IN GENERAL.—The Director of the Agency 

8 for Healthcare Research and Quality, after consulta9 tion with the Director of the Office of Elder Justice 

10 in the Department of Health and Human Services 

11 and the Director of the Office of Elder Justice in 

12 the Department of Justice shall, directly or through 

13 a grant, conduct a study on consumer concerns re14 lating to residential long-term care facilities, other 

15 than nursing facilities. 

16 ‘‘(2) SPECIFIC TOPICS.—The entity conducting 

17 the study shall—

18 ‘‘(A) develop definitions for classes of the 

19 residential long-term care facilities described in 

20 paragraph (1); and 

21 ‘‘(B) collect information on the prices of, 

22 level of services provided by, oversight and en23 forcement provisions of, and admission and dis24 charge criteria of, the facilities.
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1 ‘‘(b) REPORT.—The Director of the Agency for 

2 Healthcare Research and Quality shall prepare a report 

3 containing the results of the study, and submit the report 

4 to the Elder Justice Coordinating Council established 

5 under section 2213, the Committee on Ways and Means 

6 of the House of Representatives, and the Special Com7 mittee on Aging of the Senate. 

8 ‘‘Subtitle D—Administration 

9 ‘‘SEC. 2261. EVALUATIONS. 

10 ‘‘(a) GRANTS.—

11 ‘‘(1) IN GENERAL.—In making a grant under a 

12 provision of this title (other than this section), the 

13 granting authority shall—

14 ‘‘(A) require the recipient of the grant 

15 to—

16 ‘‘(i) reserve a portion of the funds 

17 made available through the grant; and 

18 ‘‘(ii) use the reserved funds to conduct 

19 an evaluation of the other activities carried 

20 out through the grant; or 

21 ‘‘(B)(i) reserve a portion of the funds 

22 available for the grant; and 

23 ‘‘(ii) use the reserved funds to provide as24 sistance to an eligible entity to conduct an eval-
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1 uation of the activities carried out through the 

2 grant. 

3 ‘‘(2) USE OF FUNDS.—A recipient of a grant 

4 described in paragraph (1)(A), or assistance de5 scribed in paragraph (1)(B)(ii), shall use the funds 

6 made available through the grant, or the assistance, 

7 respectively, to conduct a validated evaluation of the 

8 effectiveness of the activities described in subpara9 graph (A) or (B), respectively, of paragraph (1). 

10 ‘‘(3) APPLICATIONS.—

11 ‘‘(A) SUBMISSION.—

12 ‘‘(i) GRANTS FOR PROJECTS CON13 TAINING EVALUATIONS.—To be eligible to 

14 receive a grant for which the granting au15 thority requires the reservation described 

16 in paragraph (1)(A)(i), an entity shall in17 clude a proposal for the evaluation in the 

18 application submitted for the grant. 

19 ‘‘(ii) ASSISTANCE FOR EVALUA20 TIONS.—To be eligible to receive assistance 

21 under paragraph (1)(B)(ii), an entity shall 

22 submit an application to the granting au23 thority at such time, in such manner, and 

24 containing such information as the grant-
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1 ing authority may require, including a pro2 posal for the evaluation. 

3 ‘‘(B) REVIEW AND ASSISTANCE.—An em4 ployee of the National Institute on Aging, and 

5 a private expert, with expertise in evaluation 

6 methodology shall review each proposal de7 scribed in clause (i) or (ii) of subparagraph (A), 

8 and determine whether the methodology de9 scribed in the proposal is adequate to gather 

10 meaningful information. If the employee and 

11 expert determine that the methodology is inad12 equate, the employee and expert shall rec13 ommend that the granting authority deny the 

14 application for the grant described in subpara15 graph (A)(i), or the assistance described in sub16 paragraph (B)(ii), as appropriate, or make rec17 ommendations for how the application should 

18 be amended. If the granting authority denies 

19 the application on the basis of the proposal, the 

20 granting authority shall inform the applicant 

21 why the application was denied, and offer as22 sistance to the applicant in modifying the pro23 posal. 

24 ‘‘(b) OTHER GRANTS.—The granting authority shall 

25 make grants to appropriate entities to conduct validated 
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1 evaluations of activities, to reduce elder abuse, neglect, 

2 and exploitation, that are not funded under this title. 

3 ‘‘(c) CONDITION OF PARTICIPATION.—As a condition 

4 of participation in any grant under this title, individuals, 

5 facilities, and other entities shall agree to be subject to 

6 sections 3729 through 3733 of title 31, United States 

7 Code and other applicable laws. 

8 ‘‘SEC. 2262. HUMAN SUBJECT RESEARCH. 

9 ‘‘(a) IN GENERAL.—For purposes of the application 

10 of subpart A of part 46 of title 45, Code of Federal Regu11 lations to research conducted under this title, the term ‘le12 gally authorized representative’ means, unless otherwise 

13 provided by law, the individual, or judicial or other body 

14 authorized under the applicable law to consent to medical 

15 treatment on behalf of another person. 

16 ‘‘(b) GUIDELINES.—The Secretary of Health and 

17 Human Services, through the Director of the National In18 stitute on Aging, after consultation with the Director of 

19 the Office for Human Research Protections and the Excel20 lence Advisory Committee established under section 

21 2222(b)(5), shall promulgate guidelines to assist research22 ers working in the area of elder abuse, neglect, and exploi23 tation, with issues relating to human subject protections. 
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1 ‘‘SEC. 2263. REGULATIONS. 

2 ‘‘The Secretary may issue such regulations as may 

3 be necessary to carry out this title. 

4 ‘‘SEC. 2264. AUTHORIZATION OF APPROPRIATIONS. 

5 ‘‘There are authorized to be appropriated to carry out 

6 this title such sums as may be necessary for each of fiscal 

7 years 2004 through 2010.’’. 

8 SEC. 102. PATIENT ABUSE PREVENTION. 

9 (a) ESTABLISHMENT OF PROGRAM TO PREVENT

10 ABUSE OF NURSING FACILITY RESIDENTS.—

11 (1) SCREENING OF SKILLED NURSING FACILITY

12 AND NURSING FACILITY EMPLOYEE APPLICANTS.—

13 (A) MEDICARE PROGRAM.—Section 

14 1819(b) of the Social Security Act (42 U.S.C. 

15 1395i–3(b)) is amended by adding at the end 

16 the following: 

17 ‘‘(8) SCREENING OF SKILLED NURSING FACIL18 ITY WORKERS.—

19 ‘‘(A) BACKGROUND CHECKS ON APPLI20 CANTS.—Subject to subparagraph (B)(ii), be21 fore hiring a skilled nursing facility worker, a 

22 skilled nursing facility shall—

23 ‘‘(i) give the worker written notice 

24 that the facility is required to perform

25 background checks with respect to appli26 cants; 
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1 ‘‘(ii) require, as a condition of employ2 ment, that such worker—

3 ‘‘(I) provide a written statement 

4 disclosing any conviction for a rel5 evant crime; 

6 ‘‘(II) provide a statement signed 

7 by the worker authorizing the facility 

8 to request the search and exchange of 

9 criminal records; 

10 ‘‘(III) provide in person to the 

11 facility a copy of the worker’s finger12 prints or thumb print, depending 

13 upon available technology; and 

14 ‘‘(IV) provide any other identi15 fication information the Secretary 

16 may specify in regulation; and 

17 ‘‘(iii) request through the appropriate 

18 State agency that the State initiate a State 

19 and national criminal background check on 

20 such worker in accordance with the provi21 sions of subsection (e)(6) and submit to 

22 such State agency the information de23 scribed in subclauses (II) through (IV) of 

24 clause (ii). 
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1 ‘‘(B) PROHIBITION ON HIRING OF ABUSIVE

2 WORKERS.—

3 ‘‘(i) IN GENERAL.—A skilled nursing 

4 facility may not knowingly employ any 

5 skilled nursing facility worker who has any 

6 conviction for a relevant crime. 

7 ‘‘(ii) PROVISIONAL EMPLOYMENT.—

8 After complying with the requirements of 

9 clauses (i) and (ii) of subparagraph (A), a 

10 skilled nursing facility may provide for a 

11 provisional period of employment for a 

12 skilled nursing facility worker pending 

13 completion of the check against the back14 ground check described under subpara15 graph (A)(iii). Subject to clause (iii), such 

16 facility shall maintain direct supervision of 

17 the covered individual during the worker’s 

18 provisional period of employment. 

19 ‘‘(iii) EXCEPTION FOR SMALL RURAL

20 SKILLED NURSING FACILITIES.—In the 

21 case of a small rural skilled nursing facility 

22 (as defined by the Secretary), the Sec23 retary shall provide, by regulation after 

24 consultation with providers of skilled nurs25 ing facility services and entities rep-
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1 resenting beneficiaries of such services, for 

2 an appropriate level of supervision with re3 spect to any provisional employees em4 ployed by the facility in accordance with 

5 clause (ii). Such regulation should encour6 age the provision of direct supervision of 

7 such employees whenever practicable with 

8 respect to such a facility and if such super9 vision would not impose an unreasonable 

10 cost or other burden on the facility. 

11 ‘‘(C) REPORTING REQUIREMENTS.—A 

12 skilled nursing facility shall report to the State 

13 any instance in which the facility determines 

14 that a skilled nursing facility worker has com15 mitted an act of resident neglect or abuse or 

16 misappropriation of resident property in the 

17 course of employment by the facility. 

18 ‘‘(D) USE OF INFORMATION.—

19 ‘‘(i) IN GENERAL.—A skilled nursing 

20 facility that obtains information about a 

21 skilled nursing facility worker pursuant to 

22 subparagraph (A)(iii) may use such infor23 mation only for the purpose of determining 

24 the suitability of the worker for employ25 ment. 
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1 ‘‘(ii) IMMUNITY FROM LIABILITY.—A 

2 skilled nursing facility that, in denying em3 ployment for an applicant (including dur4 ing the period described in subparagraph 

5 (B)(ii)), reasonably relies upon information 

6 about such applicant provided by the State 

7 pursuant to subsection (e)(6) shall not be 

8 liable in any action brought by such appli9 cant based on the employment determina10 tion resulting from the information. 

11 ‘‘(iii) CRIMINAL PENALTY.—Whoever 

12 knowingly violates the provisions of clause 

13 (i) shall be fined in accordance with title 

14 18, United States Code, imprisoned for not 

15 more than 2 years, or both. 

16 ‘‘(E) CIVIL PENALTY.—

17 ‘‘(i) IN GENERAL.—A skilled nursing 

18 facility that violates the provisions of this 

19 paragraph shall be subject to a civil pen20 alty in an amount not to exceed—

21 ‘‘(I) for the first such violation, 

22 $2,000; and 

23 ‘‘(II) for the second and each 

24 subsequent violation within any 5-year 

25 period, $5,000. 
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1 ‘‘(ii) KNOWING RETENTION OF WORK2 ER.—In addition to any civil penalty under 

3 clause (i), a skilled nursing facility that—

4 ‘‘(I) knowingly continues to em5 ploy a skilled nursing facility worker 

6 in violation of subparagraph (A) or 

7 (B); or 

8 ‘‘(II) knowingly fails to report a 

9 skilled nursing facility worker under 

10 subparagraph (C), 

11 shall be subject to a civil penalty in an 

12 amount not to exceed $5,000 for the first 

13 such violation, and $10,000 for the second 

14 and each subsequent violation within any 

15 5-year period. 

16 ‘‘(F) DEFINITIONS.—In this paragraph: 

17 ‘‘(i) CONVICTION FOR A RELEVANT

18 CRIME.—The term ‘conviction for a rel19 evant crime’ means any Federal or State 

20 criminal conviction for—

21 ‘‘(I) any offense described in 

22 paragraphs (1) through (4) of section 

23 1128(a); and 

24 ‘‘(II) such other types of offenses 

25 as the Secretary may specify in regu-
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•HR 2490 IH 

1 lations, taking into account the sever2 ity and relevance of such offenses, and 

3 after consultation with representatives 

4 of long-term care providers, represent5 atives of long-term care employees, 

6 consumer advocates, and appropriate 

7 Federal and State officials. 

8 ‘‘(ii) DISQUALIFYING INFORMATION.—

9 The term ‘disqualifying information’ means 

10 information about a conviction for a rel11 evant crime. 

12 ‘‘(iii) SKILLED NURSING FACILITY

13 WORKER.—The term ‘skilled nursing facil14 ity worker’ means any individual (other 

15 than a volunteer) that has access to a pa16 tient of a skilled nursing facility under an 

17 employment or other contract, or both, 

18 with such facility. Such term includes indi19 viduals who are licensed or certified by the 

20 State to provide such services, and non21 licensed individuals providing such services, 

22 as defined by the Secretary, including 

23 nurse assistants, nurse aides, home health 

24 aides, and personal care workers and at25 tendants.’’. 
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1 (B) MEDICAID PROGRAM.—Section 

2 1919(b) of the Social Security Act (42 U.S.C. 

3 1396r(b)) is amended by adding at the end the 

4 following new paragraph: 

5 ‘‘(9) SCREENING OF NURSING FACILITY WORK6 ERS.—

7 ‘‘(A) BACKGROUND CHECKS ON APPLI8 CANTS.—Subject to subparagraph (B)(ii), be9 fore hiring a nursing facility worker, a nursing 

10 facility shall—

11 ‘‘(i) give the worker written notice 

12 that the facility is required to perform 

13 background checks with respect to appli14 cants; 

15 ‘‘(ii) require, as a condition of employ16 ment, that such worker—

17 ‘‘(I) provide a written statement 

18 disclosing any conviction for a rel19 evant crime; 

20 ‘‘(II) provide a statement signed 

21 by the worker authorizing the facility 

22 to request the search and exchange of 

23 criminal records; 

24 ‘‘(III) provide in person to the 

25 facility a copy of the worker’s finger-
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•HR 2490 IH 

1 prints or thumb print, depending 

2 upon available technology; and 

3 ‘‘(IV) provide any other identi4 fication information the Secretary 

5 may specify in regulation; and 

6 ‘‘(iii) request through the appropriate 

7 State agency that the State initiate a State 

8 and national criminal background check on 

9 such worker in accordance with the provi10 sions of subsection (e)(8) and submit to 

11 such State agency the information de12 scribed in subclauses (II) through (IV) of 

13 clause (ii). 

14 ‘‘(B) PROHIBITION ON HIRING.—

15 ‘‘(i) IN GENERAL.—A nursing facility 

16 may not knowingly employ any nursing fa17 cility worker who has any conviction for a 

18 relevant crime. 

19 ‘‘(ii) PROVISIONAL EMPLOYMENT.—

20 After complying with the requirements of 

21 clauses (i) and (ii) of subparagraph (A), a 

22 nursing facility may provide for a provi23 sional period of employment for a nursing 

24 facility worker pending completion of the 

25 check against the background check de-
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1 scribed under subparagraph (A)(iii). Sub2 ject to clause (iii), such facility shall main3 tain direct supervision of the worker dur4 ing the worker’s provisional period of em5 ployment. 

6 ‘‘(iii) EXCEPTION FOR SMALL RURAL

7 NURSING FACILITIES.—In the case of a 

8 small rural nursing facility (as defined by 

9 the Secretary), the Secretary shall provide, 

10 by regulation after consultation with pro11 viders of nursing facility services and enti12 ties representing beneficiaries of such serv13 ices, for an appropriate level of supervision 

14 with respect to any provisional employees 

15 employed by the facility in accordance with 

16 clause (ii). Such regulation should encour17 age the provision of direct supervision of 

18 such employees whenever practicable with

19 respect to such a facility and if such super20 vision would not impose an unreasonable 

21 cost or other burden on the facility. 

22 ‘‘(C) REPORTING REQUIREMENTS.—A 

23 nursing facility shall report to the State any in24 stance in which the facility determines that a 

25 nursing facility worker has committed an act of 
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1 resident neglect or abuse or misappropriation of 

2 resident property in the course of employment 

3 by the facility. 

4 ‘‘(D) USE OF INFORMATION.—

5 ‘‘(i) IN GENERAL.—A nursing facility 

6 that obtains information about a nursing 

7 facility worker pursuant to subparagraph 

8 (A)(iii) may use such information only for 

9 the purpose of determining the suitability 

10 of the worker for employment. 

11 ‘‘(ii) IMMUNITY FROM LIABILITY.—A 

12 nursing facility that, in denying employ13 ment for an applicant (including during 

14 the period described in subparagraph 

15 (B)(ii)), reasonably relies upon information 

16 about such applicant provided by the State 

17 pursuant to subsection (e)(8) shall not be 

18 liable in any action brought by such appli19 cant based on the employment determina20 tion resulting from the information. 

21 ‘‘(iii) CRIMINAL PENALTY.—Whoever 

22 knowingly violates the provisions of clause 

23 (i) shall be fined in accordance with title 

24 18, United States Code, imprisoned for not 

25 more than 2 years, or both. 
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1 ‘‘(E) CIVIL PENALTY.—

2 ‘‘(i) IN GENERAL.—A nursing facility 

3 that violates the provisions of this para4 graph shall be subject to a civil penalty in 

5 an amount not to exceed—

6 ‘‘(I) for the first such violation, 

7 $2,000; and 

8 ‘‘(II) for the second and each 

9 subsequent violation within any 5-year 

10 period, $5,000. 

11 ‘‘(ii) KNOWING RETENTION OF WORK12 ER.—In addition to any civil penalty under 

13 clause (i), a nursing facility that—

14 ‘‘(I) knowingly continues to em15 ploy a nursing facility worker in viola16 tion of subparagraph (A) or (B); or

17 ‘‘(II) knowingly fails to report a 

18 nursing facility worker under subpara19 graph (C), 

20 shall be subject to a civil penalty in an 

21 amount not to exceed $5,000 for the first 

22 such violation, and $10,000 for the second 

23 and each subsequent violation within any 

24 5-year period. 

25 ‘‘(F) DEFINITIONS.—In this paragraph: 
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1 ‘‘(i) CONVICTION FOR A RELEVANT

2 CRIME.—The term ‘conviction for a rel3 evant crime’ means any Federal or State 

4 criminal conviction for—

5 ‘‘(I) any offense described in 

6 paragraphs (1) through (4) of section 

7 1128(a); and 

8 ‘‘(II) such other types of offenses 

9 as the Secretary may specify in regu10 lations, taking into account the sever11 ity and relevance of such offenses, and 

12 after consultation with representatives 

13 of long-term care providers, represent14 atives of long-term care employees, 

15 consumer advocates, and appropriate 

16 Federal and State officials. 

17 ‘‘(ii) DISQUALIFYING INFORMATION.—

18 The term ‘disqualifying information’ means 

19 information about a conviction for a rel20 evant crime. 

21 ‘‘(iii) NURSING FACILITY WORKER.—

22 The term ‘nursing facility worker’ means 

23 any individual (other than a volunteer) 

24 that has access to a patient of a nursing 

25 facility under an employment or other con-
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1 tract, or both, with such facility. Such 

2 term includes individuals who are licensed 

3 or certified by the State to provide such 

4 services, and nonlicensed individuals pro5 viding such services, as defined by the Sec6 retary, including nurse assistants, nurse 

7 aides, home health aides, and personal care 

8 workers and attendants.’’. 

9 (C) FEDERAL RESPONSIBILITIES.—

10 (i) DEVELOPMENT OF STANDARD

11 FEDERAL AND STATE BACKGROUND CHECK

12 FORM.—The Secretary of Health and 

13 Human Services, after consultation with 

14 the Attorney General and representatives 

15 of appropriate State agencies, shall develop 

16 a model form that an applicant for employ17 ment at a nursing facility may complete 

18 and Federal and State agencies may use to 

19 conduct the criminal background checks 

20 required under sections 1819(b)(8) and 

21 1919(b)(8) of the Social Security Act (42 

22 U.S.C. 1395i–3(b)(8), 1396r(b)(8)) (as 

23 added by this section). 

24 (ii) PERIODIC EVALUATION.—The 

25 Secretary of Health and Human Services, 
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1 after consultation with the Attorney Gen2 eral, periodically shall evaluate the back3 ground check system imposed under sec4 tions 1819(b)(8) and 1919(b)(8) of the So5 cial Security Act (42 U.S.C. 1395i–

6 3(b)(8), 1396r(b)(8)) (as added by this 

7 section) and shall implement changes, as 

8 necessary, based on available technology, 

9 to make the background check system 

10 more efficient and able to provide a more 

11 immediate response to long-term care pro12 viders using the system. 

13 (D) NO PREEMPTION OF STRICTER STATE

14 LAWS.—Nothing in section 1819(b)(8) or 

15 1919(b)(8) of the Social Security Act (42 

16 U.S.C. 1395i–3(b)(8), 1396r(b)(8)) (as so

17 added) shall be construed to supersede any pro18 vision of State law that—

19 (i) specifies a relevant crime for pur20 poses of prohibiting the employment of an 

21 individual at a long-term care facility that 

22 is not included in the list of such crimes 

23 specified in such sections or in regulations 

24 promulgated by the Secretary of Health 
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1 and Human Services to carry out such sec2 tions; or 

3 (ii) requires a long-term care facility 

4 (as so defined) to conduct a background 

5 check prior to employing an individual in 

6 an employment position that is not in7 cluded in the positions for which a back8 ground check is required under such sec9 tions. 

10 (E) TECHNICAL AMENDMENTS.—Effective 

11 as if included in the enactment of section 941 

12 of the Medicare, Medicaid, and SCHIP Benefits 

13 Improvement and Protection Act of 2000 (114 

14 Stat. 2763A–585), as enacted into law by sec15 tion 1(a)(6) of Public Law 106–554, sections 

16 1819(b) and 1919(b) of the Social Security Act 

17 (42 U.S.C. 1395i–3(b), 1396r(b)), as amended 

18 by such section 941 (as so enacted into law) are 

19 each amended by redesignating the paragraph 

20 (8) added by such section as paragraph (9). 

21 (2) FEDERAL AND STATE REQUIREMENTS CON22 CERNING BACKGROUND CHECKS.—

23 (A) MEDICARE.—Section 1819(e) of the 

24 Social Security Act (42 U.S.C. 1395i–3(e)) is 

25 amended by adding at the end the following: 
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1 ‘‘(6) FEDERAL AND STATE REQUIREMENTS

2 CONCERNING CRIMINAL BACKGROUND CHECKS ON

3 SKILLED NURSING FACILITY EMPLOYEES.—

4 ‘‘(A) IN GENERAL.—Upon receipt of a re5 quest by a skilled nursing facility pursuant to 

6 subsection (b)(8) that is accompanied by the in7 formation described in subclauses (II) through 

8 (IV) of subsection (b)(8)(A)(ii), a State, after 

9 checking appropriate State records and finding 

10 no disqualifying information (as defined in sub11 section (b)(8)(F)(ii)), shall immediately submit 

12 such request and information to the Attorney 

13 General and shall request the Attorney General 

14 to conduct a search and exchange of records 

15 with respect to the individual as described in 

16 subparagraph (B).

17 ‘‘(B) SEARCH AND EXCHANGE OF

18 RECORDS BY ATTORNEY GENERAL.—Upon re19 ceipt of a submission pursuant to subparagraph 

20 (A), the Attorney General shall direct a search 

21 of the records of the Federal Bureau of Inves22 tigation for any criminal history records cor23 responding to the fingerprints and other posi24 tive identification information submitted. The 

25 Attorney General shall provide any cor-
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1 responding information resulting from the 

2 search to the State. 

3 ‘‘(C) STATE REPORTING OF INFORMATION

4 TO SKILLED NURSING FACILITY.—Upon receipt 

5 of the information provided by the Attorney 

6 General pursuant to subparagraph (B), the 

7 State shall—

8 ‘‘(i) review the information to deter9 mine whether the individual has any con10 viction for a relevant crime (as defined in 

11 subsection (b)(8)(F)(i)); and 

12 ‘‘(ii) immediately report to the skilled 

13 nursing facility in writing the results of 

14 such review. 

15 ‘‘(D) FEES FOR PERFORMANCE OF CRIMI16 NAL BACKGROUND CHECKS.—

17 ‘‘(i) AUTHORITY TO CHARGE FEES.—

18 ‘‘(I) ATTORNEY GENERAL.—The 

19 Attorney General may charge a fee to 

20 any State requesting a search and ex21 change of records pursuant to this 

22 paragraph and subsection (b)(8) for 

23 conducting the search and providing 

24 the records. The amount of such fee 

25 shall not exceed the lesser of the ac-
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1 tual cost of such activities or $50. 

2 Such fees shall be available to the At3 torney General, or, in the Attorney 

4 General’s discretion, to the Federal 

5 Bureau of Investigation until ex6 pended. 

7 ‘‘(II) STATE.—A State may 

8 charge a skilled nursing facility a fee 

9 for initiating the criminal background 

10 check under this paragraph and sub11 section (b)(8), including fees charged 

12 by the Attorney General, and for per13 forming the review and report re14 quired by subparagraph (C). The 

15 amount of such fee shall not exceed 

16 the actual cost of such activities. 

17 ‘‘(ii) PROHIBITION ON CHARGING AP18 PLICANTS OR EMPLOYEES.—An entity may 

19 not impose on an applicant for employment 

20 or an employee any charges relating to the 

21 performance of a background check under 

22 this paragraph.

23 ‘‘(E) REGULATIONS.—

24 ‘‘(i) IN GENERAL.—In addition to the 

25 Secretary’s authority to promulgate regula-
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1 tions under this title, the Attorney Gen2 eral, after consultation with the Secretary, 

3 may promulgate such regulations as are 

4 necessary to carry out the Attorney Gen5 eral’s responsibilities under this paragraph 

6 and subsection (b)(8), including regula7 tions regarding the security confidentiality, 

8 accuracy, use, destruction, and dissemina9 tion of information, audits and record10 keeping, and the imposition of fees. 

11 ‘‘(ii) APPEAL PROCEDURES.—The At12 torney General, after consultation with the 

13 Secretary, shall promulgate such regula14 tions as are necessary to establish proce15 dures by which an applicant or employee 

16 may appeal or dispute the accuracy of the

17 information obtained in a background 

18 check conducted under this paragraph. Ap19 peals shall be limited to instances in which 

20 an applicant or employee is incorrectly 

21 identified as the subject of the background 

22 check, or when information about the ap23 plicant or employee has not been updated 

24 to reflect changes in the applicant’s or em25 ployee’s criminal record.
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1 ‘‘(F) REPORT.—Not later than 2 years 

2 after the date of enactment of this paragraph, 

3 the Attorney General shall submit a report to 

4 Congress on—

5 ‘‘(i) the number of requests for 

6 searches and exchanges of records made 

7 under this section;

8 ‘‘(ii) the disposition of such requests; 

9 and 

10 ‘‘(iii) the cost of responding to such 

11 requests.’’. 

12 (B) MEDICAID.—Section 1919(e) of the 

13 Social Security Act (42 U.S.C. 1396r(e)) is 

14 amended by adding at the end the following:

15 ‘‘(8) FEDERAL AND STATE REQUIREMENTS

16 CONCERNING CRIMINAL BACKGROUND CHECKS ON

17 NURSING FACILITY EMPLOYEES.—

18 ‘‘(A) IN GENERAL.—Upon receipt of a re19 quest by a nursing facility pursuant to sub20 section (b)(8) that is accompanied by the infor21 mation described in subclauses (II) through 

22 (IV) of subsection (b)(8)(A)(ii), a State, after 

23 checking appropriate State records and finding 

24 no disqualifying information (as defined in sub25 section (b)(8)(F)(ii)), shall immediately submit 
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1 such request and information to the Attorney 

2 General and shall request the Attorney General 

3 to conduct a search and exchange of records 

4 with respect to the individual as described in 

5 subparagraph (B). 

6 ‘‘(B) SEARCH AND EXCHANGE OF

7 RECORDS BY ATTORNEY GENERAL.—Upon re8 ceipt of a submission pursuant to subparagraph 

9 (A), the Attorney General shall direct a search 

10 of the records of the Federal Bureau of Inves11 tigation for any criminal history records cor12 responding to the fingerprints and other posi13 tive identification information submitted. The 

14 Attorney General shall provide any cor15 responding information resulting from the 

16 search to the State. 

17 ‘‘(C) STATE REPORTING OF INFORMATION

18 TO NURSING FACILITY.—Upon receipt of the in19 formation provided by the Attorney General 

20 pursuant to subparagraph (B), the State 

21 shall—

22 ‘‘(i) review the information to deter23 mine whether the individual has any con24 viction for a relevant crime (as defined in 

25 subsection (b)(8)(F)(i)); and 
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1 ‘‘(ii) immediately report to the nurs2 ing facility in writing the results of such 

3 review. 

4 ‘‘(D) FEES FOR PERFORMANCE OF CRIMI5 NAL BACKGROUND CHECKS.—

6 ‘‘(i) AUTHORITY TO CHARGE FEES.—

7 ‘‘(I) ATTORNEY GENERAL.—The 

8 Attorney General may charge a fee to 

9 any State requesting a search and ex10 change of records pursuant to this 

11 paragraph and subsection (b)(8) for 

12 conducting the search and providing 

13 the records. The amount of such fee 

14 shall not exceed the lesser of the ac15 tual cost of such activities or $50. 

16 Such fees shall be available to the At17 torney General, or, in the Attorney 

18 General’s discretion, to the Federal 

19 Bureau of Investigation, until ex20 pended. 

21 ‘‘(II) STATE.—A State may 

22 charge a nursing facility a fee for ini23 tiating the criminal background check 

24 under this paragraph and subsection 

25 (b)(8), including fees charged by the 
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1 Attorney General, and for performing 

2 the review and report required by sub3 paragraph (C). The amount of such 

4 fee shall not exceed the actual cost of 

5 such activities. 

6 ‘‘(ii) PROHIBITION ON CHARGING AP7 PLICANTS OR EMPLOYEES.—An entity may 

8 not impose on an applicant for employment 

9 or an employee any charges relating to the 

10 performance of a background check under 

11 this paragraph. 

12 ‘‘(E) REGULATIONS.—

13 ‘‘(i) IN GENERAL.—In addition to the 

14 Secretary’s authority to promulgate regula15 tions under this title, the Attorney Gen16 eral, after consultation with the Secretary, 

17 may promulgate such regulations as are 

18 necessary to carry out the Attorney Gen19 eral’s responsibilities under this paragraph 

20 and subsection (b)(8), including regula21 tions regarding the security, confiden22 tiality, accuracy, use, destruction, and dis23 semination of information, audits and rec24 ordkeeping, and the imposition of fees. 
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1 ‘‘(ii) APPEAL PROCEDURES.—The At2 torney General, after consultation with the 

3 Secretary, shall promulgate such regula4 tions as are necessary to establish proce5 dures by which an applicant or employee 

6 may appeal or dispute the accuracy of the 

7 information obtained in a background 

8 check conducted under this paragraph. Ap9 peals shall be limited to instances in which 

10 an applicant or employee is incorrectly 

11 identified as the subject of the background 

12 check, or when information about the ap13 plicant or employee has not been updated 

14 to reflect changes in the applicant’s or em15 ployee’s criminal record. 

16 ‘‘(F) REPORT.—Not later than 2 years 

17 after the date of enactment of this paragraph, 

18 the Attorney General shall submit a report to 

19 Congress on—

20 ‘‘(i) the number of requests for 

21 searches and exchanges of records made 

22 under this section; 

23 ‘‘(ii) the disposition of such requests; 

24 and 
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1 ‘‘(iii) the cost of responding to such 

2 requests.’’. 

3 (3) APPLICATION TO OTHER ENTITIES PRO4 VIDING HOME HEALTH OR LONG-TERM CARE SERV5 ICES.—

6 (A) MEDICARE.—Part D of title XVIII of 

7 the Social Security Act (42 U.S.C. 1395x et 

8 seq.) is amended by adding at the end the fol9 lowing: 

10 ‘‘APPLICATION OF SKILLED NURSING FACILITY PREVEN11 TIVE ABUSE PROVISIONS TO ANY PROVIDER OF

12 SERVICES OR OTHER ENTITY PROVIDING HOME

13 HEALTH OR LONG-TERM CARE SERVICES

14 ‘‘SEC. 1897. (a) IN GENERAL.—The requirements of 

15 subsections (b)(8) and (e)(6) of section 1819 shall apply 

16 to any provider of services or any other entity that is eligi17 ble to be paid under this title for providing home health 

18 services, hospice care (including routine home care and 

19 other services included in hospice care under this title), 

20 or long-term care services to an individual entitled to bene21 fits under part A or enrolled under part B, including an 

22 individual provided with a Medicare+Choice plan offered 

23 by a Medicare+Choice organization under part C (in this 

24 section referred to as a ‘medicare beneficiary’). 

25 ‘‘(b) SUPERVISION OF PROVISIONAL EMPLOYEES.—
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1 ‘‘(1) IN GENERAL.—With respect to an entity 

2 that provides home health services, such entity shall 

3 be considered to have satisfied the requirements of 

4 section 1819(b)(8)(B)(ii) or 1919(b)(8)(B)(ii) if the 

5 entity meets such requirements for supervision of 

6 provisional employees of the entity as the Secretary 

7 shall, by regulation, specify in accordance with para8 graph (2). 

9 ‘‘(2) REQUIREMENTS.—The regulations re10 quired under paragraph (1) shall provide the fol11 lowing: 

12 ‘‘(A) Supervision of a provisional employee 

13 shall consist of ongoing, good faith, verifiable 

14 efforts by the supervisor of the provisional em15 ployee to conduct monitoring and oversight ac16 tivities to ensure the safety of a medicare bene17 ficiary. 

18 ‘‘(B) For purposes of subparagraph (A), 

19 monitoring and oversight activities may include 

20 (but are not limited to) the following: 

21 ‘‘(i) Follow-up telephone calls to the 

22 medicare beneficiary. 

23 ‘‘(ii) Unannounced visits to the medi24 care beneficiary’s home while the provi-
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1 sional employee is serving the medicare 

2 beneficiary. 

3 ‘‘(iii) To the extent practicable, lim4 iting the provisional employee’s duties to 

5 serving only those medicare beneficiaries in 

6 a home or setting where another family 

7 member or resident of the home or setting 

8 of the medicare beneficiary is present. 

9 ‘‘(C) In promulgating such regulations, the 

10 Secretary shall take into account the staffing 

11 and geographic issues faced by small rural enti12 ties (as defined by the Secretary) that provide 

13 home health services, hospice care (including 

14 routine home care and other services included 

15 in hospice care under this title), or other long16 term care services. Such regulations should en17 courage the provision of monitoring and over18 sight activities whenever practicable with re19 spect to such an entity, and if such activities 

20 would not impose an unreasonable cost or other 

21 burden on the entity.’’. 

22 (B) MEDICAID.—Section 1902(a) of the 

23 Social Security Act (42 U.S.C. 1396a) is 

24 amended—
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1 (i) in paragraph (64), by striking 

2 ‘‘and’’ at the end; 

3 (ii) in paragraph (65), by striking the 

4 period and inserting ‘‘; and’’; and 

5 (iii) by inserting after paragraph (65) 

6 the following: 

7 ‘‘(66) provide that any entity that is eligible to 

8 be paid under the State plan for providing home 

9 health services, hospice care (including routine home 

10 care and other services included in hospice care 

11 under title XVIII), or long-term care services for 

12 which medical assistance is available under the State 

13 plan to individuals requiring long-term care complies 

14 with the requirements of subsections (b)(8) and 

15 (e)(8) of section 1919 and section 1897(b) (in the 

16 same manner as such section applies to a medicare 

17 beneficiary).’’. 

18 (b) PREVENTION AND TRAINING DEMONSTRATION

19 PROJECT.—

20 (1) ESTABLISHMENT.—The Secretary of Health 

21 and Human Services shall establish a demonstration 

22 program to provide grants to develop information on 

23 best practices in patient abuse prevention training 

24 (including behavior training and interventions) for 
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1 managers and staff of hospital and health care fa2 cilities. 

3 (2) ELIGIBILITY.—To be eligible to receive a 

4 grant under paragraph (1), an entity shall be a pub5 lic or private nonprofit entity and prepare and sub6 mit to the Secretary of Health and Human Services 

7 an application at such time, in such manner, and 

8 containing such information as the Secretary may 

9 require. 

10 (3) USE OF FUNDS.—Amounts received under a 

11 grant under this subsection shall be used to—

12 (A) examine ways to improve collaboration 

13 between State health care survey and provider 

14 certification agencies, long-term care ombuds15 man programs, the long-term care industry, 

16 and local community members; 

17 (B) examine patient care issues relating to 

18 regulatory oversight, community involvement, 

19 and facility staffing and management with a

20 focus on staff training, staff stress manage21 ment, and staff supervision; 

22 (C) examine the use of patient abuse pre23 vention training programs by long-term care en24 tities, including the training program developed 

25 by the National Association of Attorneys Gen-
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1 eral, and the extent to which such programs are 

2 used; and 

3 (D) identify and disseminate best practices 

4 for preventing and reducing patient abuse. 

5 (4) AUTHORIZATION OF APPROPRIATIONS.—

6 There are authorized to be appropriated to carry out 

7 this subsection such sums as may be necessary. 

8 (c) SENSE OF THE SENATE REGARDING THE ESTAB9 LISHMENT OF A NATIONAL BACKGROUND CHECK SYSTEM

10 FOR LONG-TERM CARE EMPLOYEES.—

11 (1) FINDINGS.—The Senate makes the fol12 lowing findings: 

13 (A) Nearly 1,500,000 Americans reside in 

14 17,000 nursing homes throughout the Nation, 

15 and the vast majority of nursing homes partici16 pate in the medicare and medicaid programs. 

17 (B) The Federal Government spent 

18 $82,100,000,000 through the medicare and 

19 medicaid programs in fiscal year 2000 for long20 term care services. 

21 (C) The impending retirement of the baby 

22 boom generation will greatly increase the de23 mand and need for quality long-term care, and 

24 it is incumbent on Congress and the President 

25 to ensure that medicare and medicaid bene-
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1 ficiaries are protected from abuse, neglect, and 

2 mistreatment. 

3 (D) On July 30, 2001, the minority staff 

4 of the special investigations division of the 

5 Committee on Government Reform of the 

6 House of Representatives issued a report which 

7 found that in the past 2 years, over 30 percent 

8 of nursing homes in the United States were 

9 cited for a physical, sexual, or verbal abuse vio10 lation that had the potential to harm residents, 

11 and nearly 10 percent of nursing homes had 

12 violations that caused actual harm to residents. 

13 (E) Although the majority of long-term 

14 care facilities do an excellent job in caring for 

15 elderly and disabled patients, incidents of abuse 

16 and neglect and mistreatment do occur at an 

17 unacceptable rate and are not limited to nurs18 ing homes alone. 

19 (F) Without a national background check 

20 system to screen applicants for employment, all 

21 long-term care providers, including nursing fa22 cilities, home health, home care, and hospice 

23 providers, are at risk for hiring workers with a 

24 history of abuse and violence. 
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1 (G) A March 2002 report by the General 

2 Accounting Office found that few prosecutions 

3 and criminal convictions result from allegations 

4 of abuse in nursing homes. 

5 (H) Federal law requires all States to 

6 maintain a nurse aide registry which includes 

7 any substantiated findings of abuse committed 

8 by nurse aides in nursing homes. 

9 (I) In March 2002, the General Account10 ing Office testified before the Special Com11 mittee on Aging of the Senate that the existing 

12 State registries contained significant gaps be13 cause many nursing home employees are not in14 cluded in the registries and the registries do not 

15 track abuses committed in other States. 

16 (J) A 1998 report from the Office of the 

17 Inspector General of the Department of Health 

18 and Human Services entitled ‘‘Safeguarding 

19 Long-Term Care Residents’’ recommended es20 tablishing a national registry of abusive long21 term care workers to be checked by all long22 term care facilities before hiring an employee. 

23 (2) SENSE OF THE SENATE.—It is the Sense of 

24 the Senate that Congress should pass legislation 

25 that will—
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1 (A) require the Secretary of Health and 

2 Human Services to establish a national registry 

3 of abusive long-term care workers that will in4 corporate abuse information from all existing 

5 State nurse aide registries, and expand infor6 mation included in the State registries and the 

7 national registry to include abuse information 

8 about all employees of all long-term care pro9 viders that receive funding through the medi10 care or medicaid programs (42 U.S.C. 1395 et 

11 seq.; 1396 et seq.); 

12 (B) require all long-term care providers, 

13 before hiring a potential employee, to conduct 

14 checks of both the national registry and crimi15 nal conviction records maintained by the Fed16 eral Bureau of Investigation, and prohibit long17 term care providers from hiring potential em18 ployees with relevant abuse and criminal his19 tories; 

20 (C) require the Secretary of Health and 

21 Human Services and the Attorney General to 

22 develop an efficient system for long-term care 

23 providers to use to check both the national reg24 istry and the criminal conviction records main-
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1 tained by the Federal Bureau of Investigation 

2 before hiring an employee; and 

3 (D) ensure adequate safeguards to protect 

4 the privacy and accuracy of information regard5 ing applicants for employment being checked 

6 through the national registry and the criminal 

7 conviction records maintained by the Federal 

8 Bureau of Investigation. 

9 (d) EFFECTIVE DATE.—

10 (1) IN GENERAL.—Except as provided in para11 graph (2), this section and the amendments made by 

12 this section shall take effect on the date that is 6 

13 months after the effective date of final regulations 

14 promulgated to carry out this section and such 

15 amendments. 

16 (2) SENSE OF THE SENATE.—Subsection (c) 

17 shall take effect on the date of enactment of this 

18 section.

19 SEC. 103. INCREASING THE NUMBER OF HEALTH CARE 

20 PROFESSIONALS WITH GERIATRIC TRAINING. 

21 Section 338C of the Public Health Service Act (42 

22 U.S.C. 254m) is amended by adding at the end the fol23 lowing: 

24 ‘‘(e) For purposes of this section and section 338B, 

25 the term ‘obligated service’, with respect to an individual 
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1 who has entered into a written contract with the Secretary 

2 under section 338B, includes any period in which the indi3 vidual is enrolled and participating in an accredited (as 

4 determined by the Secretary) educational program that 

5 provides geriatric training. Upon the completion of such 

6 training, such individual, after consultation with the Sec7 retary, shall provide geriatric services as appropriate dur8 ing the remainder of such individual’s period of obligated 

9 service.’’. 

10 SEC. 104. SUPPORTING THE LONG-TERM CARE OMBUDS11 MAN PROGRAM. 

12 Section 712(h) of the Older Americans Act of 1965 

13 (42 U.S.C. 3058g(h)) is amended—

14 (1) in paragraph (8), by striking ‘‘; and’’ and 

15 inserting a semicolon; 

16 (2) in paragraph (9), by striking the period and 

17 inserting ‘‘; and’’; and 

18 (3) by adding at the end the following:

19 ‘‘(10) make grants, in consultation with the Di20 rector of the Office of Elder Justice in the Depart21 ment of Health and Human Services and the Direc22 tor of the Office of Elder Justice in the Department 

23 of Justice, to eligible entities with relevant expertise 

24 and experience to conduct evaluations and pilot 

25 studies relating to various programs and methods 
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1 carried out by the Office of the State Long-Term 

2 Care Ombudsman or a local Ombudsman entity 

3 under section 307(a)(9) or this chapter, or to pro4 vide support (such as an ombudsman resource cen5 ter).’’.

6 SEC. 105. ESTABLISHMENT OF OFFICE OF ADULT PROTEC7 TIVE SERVICES. 

8 (a) IN GENERAL.—Part A of title XI of the Social 

9 Security Act (42 U.S.C. 1301 et seq.) is amended by add10 ing at the end the following: 

11 ‘‘OFFICE OF ADULT PROTECTIVE SERVICES

12 ‘‘SEC. 1150A. (a) IN GENERAL.—There is estab13 lished within the Department of Health and Human Serv14 ices, within the Administration on Children and Families, 

15 the Office of Adult Protective Services (in this section re16 ferred to as the ‘Office’). The Office shall be headed by 

17 a Director, who shall be appointed by the Secretary. 

18 ‘‘(b) DUTIES.—The Office shall—

19 ‘‘(1) provide necessary funding and support to 

20 State and local adult protective services offices that 

21 investigate reports of abuse, neglect, and exploi22 tation of elders; 

23 ‘‘(2) annually collect and disseminate data re24 lating to the abuse, exploitation, and neglect of el25 derly individuals in coordination with the Centers for 
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1 Disease Control and Prevention efforts to collect na2 tional data under section 2221(b); 

3 ‘‘(3) develop and disseminate best practices re4 garding, and provide training on, carrying out pro5 tective services for elders; 

6 ‘‘(4) in conjunction with the necessary experts, 

7 conduct research related to the provision of such 

8 protective services; 

9 ‘‘(5) provide technical assistance to States and 

10 other entities that provide or fund the provision of 

11 such protective services, including through grants 

12 made under title XX; 

13 ‘‘(6) participate in the Intra-Agency Elder Jus14 tice Steering Committee established under section 

15 2212; and 

16 ‘‘(7) coordinate activities with the Office of 

17 Elder Justice established under section 2211 and 

18 with other Federal and State agencies that have re19 sponsibility for issues related to elder justice. 

20 ‘‘(c) APPROPRIATIONS.—There are appropriated such 

21 sums as may be necessary to carry out this section.’’. 

22 (b) EFFECTIVE DATE.—The amendments made by 

23 this section take effect 90 days after the date of enactment 

24 of the Elder Justice Act. 
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1 SEC. 106. ASSURING SAFETY OF RESIDENTS WHEN NURS2 ING FACILITIES CLOSE. 

3 (a) MEDICARE.—Section 1819(c)(2) of the Social Se4 curity Act (42 U.S.C. 1395i–3(c)(2)) is amended by add5 ing at the end the following: 

6 ‘‘(D) NOTIFICATION OF FACILITY CLO7 SURE.—

8 ‘‘(i) IN GENERAL.—A skilled nursing 

9 facility shall—

10 ‘‘(I) submit to the Secretary and 

11 the appropriate State regulatory agen12 cy written notification of an impend13 ing closure not later than the date 

14 that is 60 days prior to the date of 

15 such closure; 

16 ‘‘(II) include in the notice a plan 

17 for the transfer and adequate reloca18 tion of the residents prior to closure, 

19 including assurances that residents 

20 will not be transferred to facilities 

21 providing substandard care for which 

22 administrative or law enforcement ac23 tion is pending; and 

24 ‘‘(III) not later than 10 days 

25 after the facility closure, submit to the 

26 Secretary and the appropriate State 
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1 agency information identifying where 

2 residents of the closed facility were 

3 transferred and on what date. 

4 ‘‘(ii) SANCTIONS.—Any person owning 

5 a skilled nursing facility that fails to com6 ply with the requirements of clause (i) 

7 shall be subject to—

8 ‘‘(I) a civil monetary penalty of 

9 up to $1,000,000; 

10 ‘‘(II) exclusion from participation 

11 in the programs under this Act (in ac12 cordance with the procedures of sec13 tion 1128); and 

14 ‘‘(III) any other applicable civil 

15 monetary penalties and assessments. 

16 ‘‘(iii) PROCEDURE.—A civil monetary 

17 penalty or assessment authorized under

18 clause (ii) shall be imposed against a per19 son in the same manner as a civil mone20 tary penalty, assessment, or exclusion is 

21 imposed under section 1128A.’’. 

22 (b) MEDICAID.—Section 1919(c)(2) of the Social Se23 curity Act (42 U.S.C. 1396r(c)(2)) is amended by adding 

24 at the end the following: 
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1 ‘‘(G) NOTIFICATION OF FACILITY CLO2 SURE.—

3 ‘‘(i) IN GENERAL.—A nursing facility 

4 shall—

5 ‘‘(I) submit to the Secretary and 

6 the appropriate State regulatory agen7 cy written notification of an impend8 ing closure not later than the date 

9 that is 60 days prior to the date of 

10 such closure; 

11 ‘‘(II) include in the notice a plan 

12 for the transfer and adequate reloca13 tion of the residents prior to closure, 

14 including assurances that residents 

15 will not be transferred to facilities 

16 providing substandard care for which 

17 administrative or law enforcement ac18 tion is pending; and 

19 ‘‘(III) not later than 10 days 

20 after the facility closure submit to the 

21 Secretary and the appropriate State 

22 agency information identifying where 

23 residents of the closed facility were 

24 transferred and on what date. 
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1 ‘‘(ii) SANCTIONS.—Any person owning 

2 a nursing facility that fails to comply with 

3 the requirements of clause (i) shall be sub4 ject to—

5 ‘‘(I) a civil monetary penalty of 

6 up to $1,000,000; 

7 ‘‘(II) exclusion from participation 

8 in the programs under this Act (in ac9 cordance with the procedures of sec10 tion 1128); and 

11 ‘‘(III) any other applicable civil 

12 monetary penalties and assessments. 

13 ‘‘(iii) PROCEDURE.—A civil monetary 

14 penalty or assessment authorized under 

15 clause (ii) shall be imposed against a per16 son in the same manner as a civil mone17 tary penalty, assessment, or exclusion is 

18 imposed under section 1128A.’’.

19 (c) REGULATIONS.—The Secretary, after consulting 

20 with the Attorney General, shall issue regulations to carry 

21 out this section. 
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1 TITLE II—DEPARTMENT OF 

2 JUSTICE 

3 SEC. 201. DEFINITIONS; RULE. 

4 (a) DEFINITIONS.—In this title the terms ‘‘abuse’’, 

5 ‘‘elder’’, ‘‘elder justice’’, ‘‘exploitation’’, ‘‘fiduciary’’, 

6 ‘‘grant’’, ‘‘granting authority’’, ‘‘guardianship’’, ‘‘know7 ingly’’, ‘‘law enforcement’’, ‘‘neglect’’, ‘‘serious bodily in8 jury’’, ‘‘social’’, ‘‘State’’, and ‘‘vulnerable adult’’ have the 

9 meanings given such terms in title XXII of the Social Se10 curity Act. 

11 (b) RULE.—The Attorney General may determine, in 

12 an appropriate case, that a provision of this title that ap13 plies to elders also applies to vulnerable adults. 

14 SEC. 202. MODEL STATE LAWS AND PRACTICES. 

15 (a) IN GENERAL.—The Attorney General, after con16 sultation with the Secretary of Health and Human Serv17 ices, shall—

18 (1) conduct a study and prepare a report of the 

19 findings of that study of State laws and practices re20 lating to elder abuse, neglect, and exploitation and 

21 provide such report or periodic reports to the Elder 

22 Justice Resource Center established under section 

23 2221 of the Social Security Act, to be made avail24 able to the public; and 
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1 (2) not later than 2 years after the date of en2 actment of this Act, submit to the Chairman and 

3 Ranking Member of the Special Committee on Aging 

4 of the Senate, and the Speaker and Minority leader 

5 of the House of Representatives a report that—

6 (A) provides recommendations on a com7 prehensive description and comparative analysis 

8 of the State laws and practices; and 

9 (B) provides recommended models for 

10 State laws and practices based on an analysis 

11 of the most effective State laws and practices, 

12 including recommendations with respect to the 

13 definitions referred to in subsection (b)(1). 

14 (b) STATE LAWS AND PRACTICES.—The Attorney 

15 General shall examine State laws and practices under sub16 section (a) on issues including—

17 (1) definitions of ‘‘elder’’, ‘‘abuse’’, ‘‘neglect’’, 

18 and ‘‘exploitation’’, and related terms; 

19 (2) mandatory reporting laws, with respect to—

20 (A) who is a mandated reporter; 

21 (B) to whom must they report and within 

22 what timeframe; and 

23 (C) any consequences for nonreporting; 

24 (3) evidentiary, procedural, sentencing, choice 

25 of remedies, and data retention issues relating to 
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1 pursuing cases relating to elder abuse, neglect, and 

2 exploitation; 

3 (4) laws requiring immediate reporting of all 

4 nursing home deaths to the county coroner or to 

5 some other individual or entity; 

6 (5) fiduciary laws, including guardianship and 

7 power of attorney laws; 

8 (6) laws that permit or encourage banks and 

9 bank employees to prevent and report suspected 

10 elder abuse, neglect, and exploitation; 

11 (7) laws that may impede research on elder 

12 abuse, neglect, and exploitation; 

13 (8) practices relating to the enforcement of laws 

14 relating to elder abuse, neglect, and exploitation; and 

15 (9) practices relating to other aspects of elder 

16 justice. 

17 SEC. 203. OFFICE OF ELDER JUSTICE OF THE DEPARTMENT 

18 OF JUSTICE. 

19 (a) ESTABLISHMENT.—There is established within 

20 the Department of Justice under the Assistant Attorney 

21 General, Office of Justice Programs, an Office of Elder 

22 Justice. 

23 (b) DIRECTOR.—

24 (1) APPOINTMENT.—The President, with the 

25 advice and consent of the Senate, shall appoint a Di-
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1 rector of the Office of Elder Justice, from among in2 dividuals with experience and expertise in elder jus3 tice issues, to manage the Office of Elder Justice es4 tablished under this section. 

5 (2) DUTIES.—The Director of the Office of 

6 Elder Justice shall—

7 (A)(i) develop objectives, priorities, policy, 

8 and a long-term plan for elder justice programs 

9 and activities relating to prevention, detection, 

10 training, treatment, evaluation, intervention, re11 search, and improvement of the elder justice 

12 system in the United States; 

13 (ii) implement the overall policy and a 

14 strategy to carry out the plan described in 

15 clause (i); and 

16 (iii) hire personnel to assist the director in 

17 carrying out the policy, program, and adminis18 trative activities related to the duties under 

19 clauses (i) and (ii); 

20 (B) provide advice to the Attorney General 

21 on elder justice issues; and 

22 (C) coordinate activities with the Senior 

23 Counsel on Elder Justice. 

24 (3) REPORTING RELATIONSHIP.—The Director 

25 of the Office of Elder Justice shall have the same 
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1 reporting relationship with the Attorney General and 

2 the Assistant Attorney General, Office of Justice 

3 Programs, as the directors of the other offices head4 ed by presidential appointees within the Office of 

5 Justice Programs. 

6 (4) COMPENSATION.—The Director shall be 

7 compensated at a rate that shall not exceed the rate 

8 established for level I of the Executive Schedule 

9 under section 5312 of title 5, United States Code. 

10 (c) SENIOR COUNSEL.—

11 (1) APPOINTMENT.—The Attorney General 

12 shall appoint a Senior Counsel on Elder Justice, 

13 from among individuals with experience and exper14 tise in elder justice issues. 

15 (2) DUTIES.—The Senior Counsel on Elder 

16 Justice shall—

17 (A) coordinate elder justice activities 

18 among—

19 (i) the Office of Elder Justice; 

20 (ii) other offices (including bureaus) 

21 within the Office of Justice Programs that 

22 are involved with elder justice issues;

23 (iii) litigating divisions with cases re24 lating to elder justice matters; 
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1 (iv) the Executive Office of United 

2 States Attorneys and the United States 

3 Attorneys’ offices; and 

4 (v) any other office or division of the 

5 Department of Justice that the Attorney 

6 General considers appropriate for such co7 ordination; and 

8 (B) provide advice to the Attorney General 

9 on elder justice issues. 

10 (3) LOCATION.—The Senior Counsel on Elder 

11 Justice shall be located in—

12 (A) the Office of the Attorney General; 

13 (B) the Office of the Deputy Attorney 

14 General; or 

15 (C) the Office of the Associate Attorney 

16 General. 

17 (4) POSITION.—The position of the Senior 

18 Counsel on Elder Justice shall be a Senior Executive 

19 Service position, as defined in section 3132 of title 

20 5, United States Code. 

21 (5) STAFF.—The Senior Counsel on Elder Jus22 tice may appoint and terminate 1 full-time employee 

23 to enable the Senior Counsel to perform the duties 

24 described in paragraph (2). The Senior Counsel on 

25 Elder Justice may fix the compensation of the em-
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1 ployee in accord with chapter 51 and subchapter III 

2 of chapter 53 of title 5, United States Code, relating 

3 to classification of positions and General Schedule 

4 pay rates. 

5 (6) RELATION TO OTHER LAW.—The positions 

6 described in paragraphs (4) and (5), and the salary 

7 for the positions, shall be in addition to the total 

8 number of positions and the total amount of salary 

9 provided for in Public Law 107–77. 

10 SEC. 204. GRANTS UNDER THE SOCIAL SECURITY ACT. 

11 The Attorney General is authorized to award grants 

12 under subsections (a), (c)(1), (c)(2), (d), (e)(1), (f), (h), 

13 and (i) of section 2222 and under section 2224 of the So14 cial Security Act in accordance with such subsections. 

15 SEC. 205. VICTIM ADVOCACY GRANTS. 

16 (a) GRANTS AUTHORIZED.—The Attorney General, 

17 after consultation with the Secretary of Health and 

18 Human Services, may award grants to eligible entities to 

19 study the special needs of victims of elder abuse, neglect, 

20 and exploitation. 

21 (b) AUTHORIZED ACTIVITIES.—Funds awarded pur22 suant to subsection (a) shall be used for pilot programs 

23 that develop programs, provide training to health care, so24 cial and protective services providers, law enforcement, fi25 duciaries including guardians, judges and court personnel, 
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1 and victim advocates, and examine special approaches de2 signed to meet the needs of victims of elder abuse, neglect, 

3 and exploitation. 

4 SEC. 206. SUPPORTING LOCAL PROSECUTORS IN ELDER 

5 JUSTICE MATTERS. 

6 (a) GRANT AUTHORIZED.—The Attorney General, 

7 after consultation with the Director of Office of Elder Jus8 tice in the Department of Health and Human Services, 

9 shall award grants to provide training, technical assist10 ance, policy development, multidisciplinary coordination, 

11 and other types of support to local prosecutors, handling 

12 elder justice-related cases, including the funding of spe13 cially designated elder justice positions or units, or fund14 ing the creation of a Center for the Prosecution of Elder 

15 Abuse, Neglect, and Exploitation by the American Pros16 ecutor Research Institute of the National District Attor17 neys Association, or other similarly situated entity to ad18 vise and support local prosecutors nationwide in their pur19 suit of cases involving elder abuse, neglect, and exploi20 tation. 

21 (b) DUTIES.—The Center created under subsection 

22 (a) shall, among other things—

23 (1) collaborate with experts in elder abuse, ne24 glect, and exploitation; 
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1 (2) collaborate with the Advisory Board created 

2 by section 2214 of the Social Security Act; and 

3 (3) provide local prosecutors and personnel as4 sisting such prosecutors with training, technical as5 sistance, multidisciplinary teams and input, in the 

6 handling, prevention and prosecution of, and special 

7 circumstances surrounding elder abuse, neglect, and 

8 exploitation. 

9 SEC. 207. SUPPORTING STATE PROSECUTORS IN ELDER 

10 JUSTICE MATTERS. 

11 (a) IN GENERAL.—The Attorney General shall, after 

12 consultation with the Secretary of Health and Human 

13 Services, award grants to provide training, technical as14 sistance, multidisciplinary coordination, policy develop15 ment, and other types of support to State prosecutors, in16 cluding employees of State Attorneys General and Med17 icaid Fraud Control Units, handling elder justice-related 

18 matters. 

19 (b) CREATING SPECIALIZED POSITIONS.—Grants 

20 under this section may be made for—

21 (1) the establishment of specially designated 

22 elder justice positions or units; or 

23 (2) the creation of a position to coordinate elder 

24 justice-related cases, training, technical assistance, 

25 and policy development for State prosecutors, by the 
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1 National Association of Attorneys General (NAAG) 

2 or other similarly situated entity. 

3 SEC. 208. SUPPORTING FEDERAL CASES INVOLVING ELDER 

4 JUSTICE. 

5 (a) SUPPORT AND ASSISTANCE.—

6 (1) IN GENERAL.—The Attorney General shall 

7 support cases relating to elder justice. 

8 (2) ADDITIONAL STAFF.—The Attorney General 

9 shall have additional Federal prosecutors and make 

10 funding available to Federal prosecutors to hire 

11 nurse-investigators or other experts needed to iden12 tify, assist with, or pursue cases relating to elder 

13 justice. 

14 (3) RESOURCE GROUP.—The Attorney General 

15 may fund through the Executive Office of United 

16 States Attorneys for a Resource Group to assist 

17 prosecutors throughout the Nation in pursuing fail18 ure of care and other cases relating to elder justice 

19 matters. 

20 (b) OFFICE OF INSPECTOR GENERAL.—The Office of 

21 Inspector General of the Department of Health and 

22 Human Services shall hire nurse investigators and other 

23 experts to investigate and pursue failure of care allega24 tions. 
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1 SEC. 209. COMMUNITY POLICING. 

2 (a) GRANT AUTHORIZED.—The Attorney General, 

3 after consultation with the Secretary of the Department 

4 of Health and Human Services, shall establish a grant 

5 program to develop community policing and other law en6 forcement efforts to make communities safer for elders liv7 ing in all settings. 

8 (b) SPECIAL ELDER UNITS.—The Attorney General, 

9 after consultation with the Secretary of Health and 

10 Human Services, shall establish a grant program to sup11 port—

12 (1) special elder units and officers; 

13 (2) in rural areas with fewer law enforcement 

14 personnel, a specially trained elder officer; 

15 (3) programs, including the Alzheimer Associa16 tion’s ‘‘Safe Return Program’’ or other similar pro17 gram; and 

18 (4) training, technical assistance, policy devel19 opment, multidisciplinary coordination, and other 

20 support and programs relating to elder justice. 

21 SEC. 210. SUPPORTING LAW ENFORCEMENT IN ELDER JUS22 TICE MATTERS. 

23 The Attorney General shall, after consultation with 

24 the Secretary of Health and Human Services, award 

25 grants to provide training, technical assistance, multidisci26 plinary coordination, policy development, and other types 
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1 of support to police, sheriffs, detectives, public safety offi2 cers, corrections personnel, and other front line law en3 forcement responders who handle elder justice-related 

4 matters, to fund specially designated elder justice posi5 tions or units, designed to support front line law enforce6 ment in elder justice matters. 

7 SEC. 211. EVALUATIONS. 

8 (a) GRANTS.—

9 (1) IN GENERAL.—In making a grant under a 

10 provision of this title (other than this section), the 

11 granting authority shall—

12 (A) require the recipient of the grant to—

13 (i) reserve a portion of the funds 

14 made available through the grant; and 

15 (ii) use the reserved funds to conduct 

16 an evaluation of the other activities carried 

17 out through the grant; or 

18 (B)(i) reserve a portion of the funds avail19 able for the grant; and

20 (ii) use the reserved funds to provide as21 sistance to an eligible entity to conduct an eval22 uation of the activities carried out through the 

23 grant. 

24 (2) USE OF FUNDS.—A recipient of a grant de25 scribed in paragraph (1)(A), or assistance described 
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1 in paragraph (1)(B)(ii), shall use the funds made 

2 available through the grant, or the assistance, re3 spectively, to conduct a validated evaluation of the 

4 effectiveness of the activities described in subpara5 graph (A) or (B), respectively, of paragraph (1). 

6 (3) APPLICATIONS.—

7 (A) SUBMISSION.—

8 (i) GRANTS FOR PROJECTS CON9 TAINING EVALUATIONS.—To be eligible to 

10 receive a grant for which the granting au11 thority requires the reservation described 

12 in paragraph (1)(A)(i), an entity shall in13 clude a proposal for the evaluation in the 

14 application submitted for the grant. 

15 (ii) ASSISTANCE FOR EVALUATIONS.—

16 To be eligible to receive assistance under 

17 paragraph (1)(B)(ii), an entity shall sub18 mit an application to the granting author19 ity at such time, in such manner, and con20 taining such information as the granting 

21 authority may require, including a proposal 

22 for the evaluation. 

23 (B) REVIEW AND ASSISTANCE.—An em24 ployee of the Department of Justice, after con25 sultation with an employee of the Department 
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1 of Health and Human Services and a non2 governmental member of the advisory board es3 tablished under section 2214 of the Social Secu4 rity Act, with expertise in evaluation method5 ology shall review each proposal described in 

6 clause (i) or (ii) of subparagraph (A), and de7 termine whether the methodology described in 

8 the proposal is adequate to gather meaningful 

9 information. If the reviewers determine that the 

10 methodology is inadequate, they shall rec11 ommend that the granting authority deny the 

12 application for the grant described in subpara13 graph (A)(i), or the assistance described in sub14 paragraph (B)(ii), as appropriate, or make rec15 ommendations for how the application should 

16 be amended. If the granting authority denies 

17 the application on the basis of the proposal, the 

18 granting authority shall inform the applicant 

19 why the application was denied, and offer as20 sistance to the applicant in modifying the pro21 posal. 

22 (b) OTHER GRANTS.—The granting authority shall 

23 make grants to appropriate entities to conduct validated 

24 evaluations of activities, to reduce elder abuse, neglect, 

25 and exploitation, that are not funded under this title. 
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1 (c) CONDITION OF PARTICIPATION.—As a condition 

2 of participation in any grant under this title, individuals, 

3 facilities, and other entities shall agree to be subject to 

4 the provisions of section 571 of title 18, United States 

5 Code, as added by this Act. 

6 SEC. 212. AUTHORIZATION OF APPROPRIATIONS. 

7 There are authorized to be appropriated such sums 

8 as are necessary for fiscal years 2004 through 2010 to 

9 carry out this title. 

10 SEC. 213. CAUSE OF ACTION FOR ELDER ABUSE AND NE11 GLECT. 

12 (a) IN GENERAL.—Part I of title 18, United States 

13 Code, is amended by adding after chapter 27 the fol14 lowing:

15 ‘‘CHAPTER 28—ELDER ABUSE AND 

16 NEGLECT

‘‘Sec. 

‘‘571. Harm to residents of nursing facilities.

17 ‘‘§ 571. Harm to residents of nursing facilities 

18 ‘‘(a) DEFINITIONS.—In this section:

19 ‘‘(1) ENTITY.—The term ‘entity’ means—

20 ‘‘(A) any nursing facility (including facili21 ties that do not exclusively provide nursing 

22 care); 

23 ‘‘(B) any entity that manages a nursing 

24 facility; or 
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1 ‘‘(C) any entity that owns, directly or indi2 rectly, a controlling interest or a 50 percent or 

3 greater interest in 1 or more nursing facilities. 

4 ‘‘(2) NEGLECT.—The term ‘neglect’ means the 

5 failure of a caregiver (as defined in section 2201 of 

6 the Social Security Act) to provide the goods or 

7 services that are necessary to avoid physical harm, 

8 disability, mental anguish, or mental illness. 

9 ‘‘(3) NURSING FACILITY.—The term ‘nursing 

10 facility’ means both a nursing facility (as defined in 

11 section 1919(a) of the Social Security Act) and a 

12 skilled nursing facility as defined in section 1819(a) 

13 of the Social Security Act (42 U.S.C. 1395i–3(a). 

14 ‘‘(4) PERSON.—The term ‘person’ has the same 

15 meaning as in section 921(a)(1) of this title. 

16 ‘‘(b) OFFENSE.—

17 ‘‘(1) IN GENERAL.—It shall be unlawful for any 

18 person or entity to, with the intent to cause injury 

19 or with reckless disregard for the safety of human

20 life, act or fail to act, if such act or omission results 

21 in—

22 ‘‘(A) serious bodily injury to 1 or more 

23 residents of a nursing facility; and 

24 ‘‘(B) abuse or neglect of an additional 2 or 

25 more residents of the same nursing facility. 
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1 ‘‘(2) PENALTY FOR INDIVIDUAL.—Any indi2 vidual who violates paragraph (1) shall be—

3 ‘‘(A) imprisoned for not more than 20 

4 years and, if death results, shall be imprisoned 

5 for any term of years or for life; and 

6 ‘‘(B) fined in accordance with section 

7 3571. 

8 ‘‘(3) OTHER PENALTY.—Any entity or person, 

9 other than an individual, that violates paragraph (1) 

10 shall be fined not more than $3,000,000 per nursing 

11 facility involved.’’. 

12 (b) HEALTH CARE OFFENSE.—Section 24(a)(1) of 

13 title 18, United States Code, is amended by inserting 

14 ‘‘571,’’ before ‘‘669,’’. 

15 (c) TECHNICAL AND CONFORMING AMENDMENT.—

16 The table of chapters for part I of title 18, United States 

17 Code, is amended by inserting after the item relating to 

18 chapter 27 the following:

‘‘28. Elder Abuse and Neglect ........................................................ 571’’.

19 SEC. 214. CIVIL ACTIONS FOR ELDER ABUSE AND NEGLECT. 

20 (a) DEFINITIONS.—In this section: 

21 (1) ENTITY.—

22 (A) IN GENERAL.—The term ‘‘entity’’ 

23 means—
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1 (i) any nursing facility (including fa2 cilities that do not exclusively provide nurs3 ing care); 

4 (ii) any entity that manages a nursing 

5 facility; or 

6 (iii) any entity that owns, directly or 

7 indirectly, a controlling interest or a 50 

8 percent or greater interest in 1 or more 

9 nursing facilities. 

10 (B) ADDITIONAL ENTITIES.—The term 

11 shall include States, localities, and political sub12 divisions thereof. 

13 (2) NEGLECT.—The term ‘‘neglect’’ means the 

14 failure of a caregiver (as defined in section 2201 of 

15 the Social Security Act, as added by this Act) to 

16 provide the goods or services that are necessary to 

17 avoid physical harm, disability, mental anguish, or 

18 mental illness. 

19 (3) NURSING FACILITY.—The term ‘‘nursing 

20 facility’’ means both a nursing facility (as defined in 

21 section 1919(a) of the Social Security Act (42 

22 U.S.C. 1396r(a))) and a skilled nursing facility as 

23 defined in section 1819(a) of the Social Security 

24 Act. 
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1 (4) PERSON.—The term ‘‘person’’ has the same 

2 meaning as in section 921(a)(1) of title 18, United 

3 States Code. 

4 (5) OTHER TERMS.—The terms ‘‘abuse’’, 

5 ‘‘State’’, and ‘‘serious bodily injury’’ shall have the 

6 meanings given those terms in section 2201 of the 

7 Social Security Act. 

8 (b) CIVIL ACTIONS BROUGHT BY THE ATTORNEY

9 GENERAL.—

10 (1) IN GENERAL.—The Attorney General may 

11 bring an action under this subsection against any 

12 person or entity that knowingly, or in reckless dis13 regard for the safety of human life, acts or fails to 

14 act, if such act or omission results in serious bodily 

15 injury to 1 or more residents of a nursing facility 

16 and in abuse or neglect of an additional 2 or more 

17 residents of the same nursing facility. 

18 (2) CIVIL PENALTY.—A person or entity that 

19 acts or fails to act as described in paragraph (1) 

20 shall be liable to the United States for a civil penalty 

21 of—

22 (A) in the case of an individual (other than 

23 an owner, operator, officer, or manager of such 

24 a nursing facility, such as a nurse or a certified 
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1 nurse’s aide) up to $50,000 for each violation 

2 of this subsection; 

3 (B) in the case of an individual who is an 

4 owner, operator, officer, or manager of such a 

5 nursing facility, up to $500,000 for each viola6 tion of this subsection; 

7 (C) in the case of a violation of this sub8 section involving a single nursing facility, that 

9 facility, or its management company, up to 

10 $3,000,000 for that facility for such violation; 

11 and 

12 (D) in the case of a violation of this sub13 section at 2 or more nursing facilities with com14 mon ownership or under common management, 

15 up to $6,000,000 for each entity that owns 

16 such facilities where there were such violations. 

17 The amount shall be set by the district court, de18 pending on the number of residents who suffered 

19 abuse or neglect, the severity of the injury to resi20 dents relating to abuse or neglect, and the number 

21 of resident deaths relating to abuse or neglect at the 

22 facilities in violation of this subsection.

23 (3) OTHER APPROPRIATE RELIEF.—If the At24 torney General has reason to believe that a person 

25 or entity is engaging in or is about to engage in an 
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1 act or omission that results in or has the potential 

2 for resulting in serious bodily injury to 1 or more 

3 residents of a nursing facility and in abuse or ne4 glect of an additional 2 or more residents of the 

5 same nursing facility, the Attorney General may pe6 tition an appropriate United States district court for 

7 appropriate equitable and declaratory relief to elimi8 nate the circumstances giving rise to the actual or 

9 potential harm. 

10 (4) PROCEDURES.—

11 (A) IN GENERAL.—A subpoena requiring 

12 the attendance of a witness at a trial or hearing 

13 conducted under this subsection may be served 

14 at any place in the United States. 

15 (B) LIMITATION.—An action brought 

16 under paragraph (1) may not be brought more 

17 than 6 years after the date on which the viola18 tion of this subsection occurred, except that the 

19 time for filing is tolled during the period when 

20 the right of action was not known and reason21 ably could not have been known by an official 

22 of the United States charged with responsibility 

23 to act in the circumstances. 

24 (C) STANDARD OF PROOF.—The United 

25 States shall be required to prove all actions 
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1 under this subsection by a preponderance of the 

2 evidence. 

3 (D) CIVIL INVESTIGATIVE DEMAND PROCE4 DURES.—The civil investigative demand proce5 dures set forth in The Antitrust Civil Process 

6 Act (15 U.S.C. 1511 et seq.) may be used in 

7 investigations and actions pursued under this 

8 subsection. 

9 (d) RELATIONSHIP TO OTHER LAWS.—This section 

10 is not intended to supplant or otherwise bar any existing 

11 equitable, common law, or criminal or civil statutory rem12 edies possessed by the United States, including under the 

13 False Claims Act (31 U.S.C. 33729–3733). The Federal 

14 Rules of Civil Procedure shall apply to actions brought 

15 under subsection (b). 

16 (e) NO PRIVATE CAUSE OF ACTION.—Nothing in this 

17 title creates a private cause of action or in any other way 

18 increases the liability of any person under any other law. 

19 TITLE III—TAX PROVISIONS 

20 SEC. 301. LONG-TERM CARE FACILITY WORKER EMPLOY21 MENT TAX CREDIT. 

22 (a) WORK OPPORTUNITY TAX CREDIT.—

23 (1) IN GENERAL.—Section 51(d)(1) of the In24 ternal Revenue code of 1986 (relating to members of 

25 targeted groups) is amended by striking ‘‘or’’ at the 
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1 end of subparagraph (G), by striking the period at 

2 the end of subparagraph (H) and inserting ‘‘, or’’, 

3 and by adding at the end the following: 

4 ‘‘(I) a qualified long-term care facility 

5 worker.’’. 

6 (2) QUALIFIED LONG-TERM CAR FACILITY

7 WORKER.—Section 51(d) of such Code is amended 

8 by redesignating paragraphs (10) through (12) as 

9 paragraphs (11) through (13), respectively, and by 

10 inserting after paragraph (9) the following: 

11 ‘‘(10) QUALIFIED LONG-TERM CARE FACILITY

12 WORKER.—The term ‘qualified long-term care facil13 ity worker’ means any individual who—

14 ‘‘(A) is hired by a long-term care facility 

15 (as defined in section 2201 of the Social Secu16 rity Act; and 

17 ‘‘(B) is certified by the designated local 

18 agency as being qualified to provide long-term 

19 care (as defined in section 2201 of such Act) at 

20 such facility.’’

21 (b) EFFECTIVE DATE.—The amendments made by 

22 this section shall apply to individuals who begin work for 

23 the employer after the date of enactment of this Act.

Æ