I 

111TH CONGRESS 

1ST SESSION H. R. 2006 

To amend the Social Security Act to enhance the social security of the 

Nation by ensuring adequate public-private infrastructure and to resolve 

to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, 

and exploitation, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 21, 2009 

Mr. KING of New York (for himself, Ms. BALDWIN, Ms. SCHAKOWSKY, and 

Mr. SESTAK) 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 Labor, 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 amend the Social Security Act to enhance the social 

security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, 

treat, intervene in, and prosecute elder abuse, neglect, 

and exploitation, 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, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Elder Justice Act’’. 


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

2 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. Definitions. 

Sec. 102. Elder justice. 

‘‘PART A—BLOCK GRANTS TO STATES FOR SOCIAL SERVICES

‘‘PART B—ELDER JUSTICE

‘‘Sec. 2011. Definitions. 

‘‘Sec. 2012. General provisions. 

‘‘SUBPART 1—NATIONAL COORDINATION OF ELDER JUSTICE ACTIVITIES AND

RESEARCH

‘‘CHAPTER I—ELDER JUSTICE COORDINATING COUNCIL AND ADVISORY

BOARD ON ELDER ABUSE, NEGLECT, AND EXPLOITATION

‘‘Sec. 2021. Elder Justice Coordinating Council. 

‘‘Sec. 2022. Advisory Board on Elder Abuse, Neglect, and Exploitation. 

‘‘Sec. 2023. Research protections. 

‘‘Sec. 2024. Authorization of appropriations. 

‘‘CHAPTER II—ELDER ABUSE, NEGLECT, AND EXPLOITATION FORENSIC

CENTERS

‘‘Sec. 2031. Establishment and support of elder abuse, neglect, and exploitation forensic centers. 

‘‘SUBPART 2—PROGRAMS TO PROMOTE ELDER JUSTICE

‘‘Sec. 2041. Enhancement of long-term care. 

‘‘Sec. 2042. Adult protective services functions and grant programs. 

‘‘Sec. 2043. Long-term care ombudsman program grants and training. 

‘‘Sec. 2044. Provision of information regarding, and evaluations of, elder 

justice programs. 

‘‘Sec. 2045. Report. 

‘‘Sec. 1150A. Reporting to law enforcement of crimes occurring in federally funded long-term care facilities. 

‘‘Sec. 1150B. Ensuring safety of residents when federally funded longterm care facilities close. 

TITLE II—DEPARTMENT OF JUSTICE 

Sec. 201. Analysis, report, and recommendations related to elder justice programs. 

Sec. 202. Victim advocacy grants. 

Sec. 203. Supporting local prosecutors and courts in elder justice matters. 

Sec. 204. Supporting State prosecutors and courts in elder justice matters. 

Sec. 205. Supporting law enforcement in elder justice matters. 


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Sec. 206. Evaluations. 

Sec. 207. Reauthorization of the Missing Alzheimer’s Disease Patient Alert 

Program. 

TITLE III—TAX PROVISIONS 

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

1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) The proportion of the United States popu4 lation age 60 years or older will drastically increase 

5 in the next 30 years as more than 76,000,000 baby 

6 boomers approach retirement and old age. 

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

8 5,000,000 elders in the United States are abused, 

9 neglected, or exploited. 

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

11 no boundaries, and cross all racial, social class, gen12 der, and geographic lines. 

13 (4) Victims of elder abuse, neglect, and exploi14 tation are not only subject to injury from mistreat15 ment and neglect, they are also 3.1 times more likely 

16 than elders who were not victims of elder abuse, ne17 glect, and exploitation to die at an earlier age than 

18 expected. 

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

20 nature and scope of elder abuse, neglect, and exploi21 tation. In recognition of the need to improve data 

22 collection efforts with respect to elder abuse, neglect, 


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1 and exploitation, Congress required the Secretary of 

2 Health and Human Services to conduct a study by 

3 the end of 2008 on establishing a uniform national 

4 database on elder abuse under section 405 of title 

5 IV of division C of the Tax Relief and Health Care 

6 Act of 2006 (Public Law 109–432). 

7 (6) Despite the dearth of data in the field, ex8 perts agree that most cases of elder abuse, neglect, 

9 and exploitation are never reported and that abuse, 

10 neglect, and exploitation shorten a victim’s life, often 

11 triggering a downward spiral of an otherwise pro12 ductive, self-sufficient elder’s life. Programs address13 ing other difficult issues such as domestic violence 

14 and child abuse and neglect have demonstrated the 

15 need for a multifaceted law, combining public health, 

16 social service, and law enforcement approaches. 

17 (7) For over 20 years, Congress has been pre18 sented with facts and testimony calling for a coordi19 nated Federal effort to combat elder abuse, neglect, 

20 and exploitation. 

21 (8) The Federal Government has been slow to 

22 respond to the needs of victims of elder abuse, ne23 glect, and exploitation or to undertake prevention ef24 forts. 


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1 (9) No Federal law has been enacted that ade2 quately and comprehensively addresses the issues of 

3 elder abuse, neglect, and exploitation and there are 

4 very limited resources available to those in the field 

5 that directly deal with the issues. 

6 (10) Differences in State laws and practices in 

7 the areas of elder abuse, neglect, and exploitation 

8 lead to significant disparities in prevention, protec9 tive and social services, treatment systems, and law 

10 enforcement, and lead to other inequities. 

11 (11) The Federal Government has played an 

12 important role in promoting research, training, pub13 lic safety, and data collection, and the identification, 

14 development, and dissemination of promising health 

15 care, social, and protective services, and law enforce16 ment practices, relating to child abuse and neglect, 

17 domestic violence, and violence against women. The 

18 Federal Government should promote similar efforts 

19 and protections relating to elder abuse, neglect, and 

20 exploitation. 

21 (12) The Federal Government should provide 

22 leadership and assist States and communities in 

23 their efforts to protect elders in the United States 

24 by— 


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1 (A) promoting coordinated planning among 

2 all levels of government; 

3 (B) generating and sharing knowledge rel4 evant to protecting elders; 

5 (C) providing leadership to combat the 

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

7 elders; and 

8 (D) providing resources to States and com9 munities to promote elder justice. 

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

11 exploitation requires a comprehensive approach 

12 that— 

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

14 and social service agencies and organizations; 

15 (B) emphasizes the need for prevention, re16 porting, investigation, assessment, treatment, 

17 and prosecution of elder abuse, neglect, and ex18 ploitation at all levels of government; 

19 (C) ensures that sufficient numbers of 

20 properly trained personnel with specialized 

21 knowledge are in place to— 

22 (i) treat, assess, and provide services 

23 relating to elder abuse, neglect, and exploi24 tation; and 

25 (ii) carry out elder protection duties; 


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1 (D) is sensitive to ethnic and cultural di2 versity; 

3 (E) recognizes the role of mental health, 

4 disability, dementia, substance abuse, medica5 tion mismanagement, and family dysfunction 

6 problems in increasing and exacerbating elder 

7 abuse, neglect, and exploitation; and 

8 (F) balances elders’ right to self-deter9 mination with society’s responsibility to protect 

10 elders. 

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

12 elder abuse, neglect, and exploitation is high and in13 cludes unnecessary expenditures of funds from many 

14 public programs. 

15 (15) The failure to coordinate activities relating 

16 to, and comprehensively prevent and treat, elder 

17 abuse, neglect, and exploitation threatens the future 

18 and well-being of millions of elders in the United 

19 States. 

20 (16) All elements of society in the United 

21 States have a shared responsibility in responding to 

22 a national problem of elder abuse, neglect, and ex23 ploitation. 

24 SEC. 3. PURPOSES. 

25 The purposes of this Act are as follows: 


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1 (1) To enhance the social security of the Nation 

2 by ensuring adequate public-private infrastructure 

3 and resolving to prevent, detect, treat, understand, 

4 and intervene in, and where appropriate, aid in the 

5 prosecution of, elder abuse, neglect, and exploitation. 

6 (2) To bring a comprehensive approach to pre7 venting and combating elder abuse, neglect, and ex8 ploitation, a long invisible problem that afflicts the 

9 most vulnerable among the aging population of the 

10 United States. 

11 (3) To raise the issue of elder abuse, neglect, 

12 and exploitation to national attention, and to create 

13 the infrastructure at the Federal, State, and local 

14 levels, to ensure that individuals and organizations 

15 on the front lines, who are fighting elder abuse, ne16 glect, and exploitation with scarce resources and 

17 fragmented systems, have the resources and infor18 mation needed to carry out their fight. 

19 (4) To bring a comprehensive multidisciplinary 

20 approach to elder justice. 

21 (5) To set in motion research and data collec22 tion to fill gaps in knowledge about elder abuse, ne23 glect, and exploitation. 

24 (6) To supplement the activities of service pro25 viders and programs, to enhance training, and to leVerDate Nov 24 2008 22:17 Apr 23, 2009 Jkt 079200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2006.IH H2006

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1 verage scarce resources efficiently, in order to ensure 

2 that elder justice receives the attention it deserves as 

3 the Nation’s population ages. 

4 (7) To recognize and address the role of mental 

5 health, disability, dementia, substance abuse, medi6 cation mismanagement, and family dysfunction prob7 lems in increasing and exacerbating elder abuse, ne8 glect, and exploitation. 

9 (8) To create short- and long-term strategic 

10 plans for the development and coordination of elder 

11 justice research, programs, studies, training, and 

12 other efforts nationwide. 

13 (9) To promote collaborative efforts and dimin14 ish overlap and gaps in efforts in developing the im15 portant field of elder justice. 

16 (10) To honor and respect the right of all indi17 viduals with diminished capacity to decisionmaking 

18 autonomy, self-determination, and dignity of choice. 

19 (11) To respect the wishes of individuals with 

20 diminished capacity and their family members in 

21 providing supportive services and care plans in22 tended to protect elders from abuse, neglect (includ23 ing self-neglect), and exploitation. 


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1 TITLE I—DEPARTMENT OF 

2 HEALTH AND HUMAN SERVICES 

3 SEC. 101. DEFINITIONS. 

4 Except as otherwise specifically provided, any term 

5 that is defined in section 2011 of the Social Security Act 

6 (as added by section 102(a)) and is used in this title has 

7 the meaning given such term by such section. 

8 SEC. 102. ELDER JUSTICE. 

9 (a) ELDER JUSTICE.— 

10 (1) IN GENERAL.—Title XX of the Social Secu11 rity Act (42 U.S.C. 1397 et seq.) is amended— 

12 (A) in the title heading, by inserting 

13 ‘‘AND ELDER JUSTICE’’ after ‘‘SO14 CIAL SERVICES’’; 

15 (B) by inserting before section 2001 the 

16 following: 

17 ‘‘PART A—BLOCK GRANTS TO STATES FOR SOCIAL

18 SERVICES’’; 

19 and 

20 (C) by adding at the end the following: 

21 ‘‘PART B—ELDER JUSTICE

22 ‘‘SEC. 2011. DEFINITIONS. 

23 ‘‘In this part: 

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

25 knowing infliction of physical or psychological harm 


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1 or the knowing deprivation of goods or services that 

2 are necessary to meet essential needs or to avoid 

3 physical or psychological harm. 

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

5 ‘adult protective services’ means such services pro6 vided to adults as the Secretary may specify and in7 cludes services such as— 

8 ‘‘(A) disseminating reports of adult abuse, 

9 neglect, or exploitation; 

10 ‘‘(B) investigating the reports described in 

11 subparagraph (A); 

12 ‘‘(C) case planning, monitoring, evaluation, 

13 and other case work and services; and 

14 ‘‘(D) providing, arranging for, or facili15 tating the provision of medical, social service, 

16 economic, legal, housing, law enforcement, or 

17 other protective, emergency, or support services. 

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

19 an individual who has the responsibility for the care 

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

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

22 of law, and means a family member or other indi23 vidual who provides (on behalf of such individual or 

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1 tution) compensated or uncompensated care to an 

2 elder who needs supportive services in any setting. 

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

4 means care by an employee or contractor who pro5 vides assistance or long-term care services to a re6 cipient. 

7 ‘‘(5) ELDER.—The term ‘elder’ means an indi8 vidual age 60 or older. 

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

10 means— 

11 ‘‘(A) from a societal perspective, efforts 

12 to— 

13 ‘‘(i) prevent, detect, treat, intervene 

14 in, and prosecute elder abuse, neglect, and 

15 exploitation; and 

16 ‘‘(ii) protect elders with diminished 

17 capacity while maximizing their autonomy; 

18 and 

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

20 recognition of an elder’s rights, including the 

21 right to be free of abuse, neglect, and exploi22 tation. 

23 ‘‘(7) ELIGIBLE ENTITY.—The term ‘eligible en24 tity’ means a State or local government agency, In25 dian tribe or tribal organization, or any other public 


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1 or private entity that is engaged in and has expertise 

2 in issues relating to elder justice or in a field nec3 essary to promote elder justice efforts. 

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

5 means the fraudulent or otherwise illegal, unauthor6 ized, or improper act or process of an individual, in7 cluding a caregiver or fiduciary, that uses the re8 sources of an elder for monetary or personal benefit, 

9 profit, or gain, or that results in depriving an elder 

10 of rightful access to, or use of, benefits, resources, 

11 belongings, or assets. 

12 ‘‘(9) FIDUCIARY.—The term ‘fiduciary’— 

13 ‘‘(A) means a person or entity with the 

14 legal responsibility— 

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

16 and for the benefit of another person; and 

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

18 fairness; and 

19 ‘‘(B) includes a trustee, a guardian, a con20 servator, an executor, an agent under a finan21 cial power of attorney or health care power of 

22 attorney, or a representative payee. 

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

24 contract, cooperative agreement, or other mechanism 

25 for providing financial assistance. 


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1 ‘‘(11) GUARDIANSHIP.—The term ‘guardian2 ship’ means— 

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

4 determines that an adult individual lacks capac5 ity to make decisions about self-care and prop6 erty, and appoints another individual or entity 

7 known as a guardian, as a conservator, or by a 

8 similar term, as a surrogate decisionmaker; 

9 ‘‘(B) the manner in which the court-ap10 pointed surrogate decisionmaker carries out du11 ties to the individual and the court; or 

12 ‘‘(C) the manner in which the court exer13 cises oversight of the surrogate decisionmaker. 

14 ‘‘(12) INDIAN TRIBE.— 

15 ‘‘(A) IN GENERAL.—The term ‘Indian 

16 tribe’ has the meaning given such term in sec17 tion 4 of the Indian Self-Determination and 

18 Education Assistance Act (25 U.S.C. 450b). 

19 ‘‘(B) INCLUSION OF PUEBLO AND

20 RANCHERIA.—The term ‘Indian tribe’ includes 

21 any Pueblo or Rancheria. 

22 ‘‘(13) 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 ‘‘(14) LONG-TERM CARE.— 

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

9 care’ means supportive and health services spec10 ified by the Secretary for individuals who need 

11 assistance because the individuals have a loss of 

12 capacity for self-care due to illness, disability, 

13 or vulnerability. 

14 ‘‘(B) LOSS OF CAPACITY FOR SELF15 CARE.—For purposes of subparagraph (A), the 

16 term ‘loss of capacity for self-care’ means an in17 ability to engage in 1 or more activities of daily 

18 living, including eating, dressing, bathing, and 

19 management of one’s financial affairs. 

20 ‘‘(15) 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 ‘‘(16) 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 ‘‘(17) NURSING FACILITY.— 

7 ‘‘(A) IN GENERAL.—The term ‘nursing fa8 cility’ has the meaning given such term under 

9 section 1919(a). 

10 ‘‘(B) INCLUSION OF SKILLED NURSING FA11 CILITY.—The term ‘nursing facility’ includes a 

12 skilled nursing facility (as defined in section 

13 1819(a)). 

14 ‘‘(18) SELF-NEGLECT.—The term ‘self-neglect’ 

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

16 impairment or diminished capacity, to perform es17 sential self-care tasks including— 

18 ‘‘(A) obtaining essential food, clothing, 

19 shelter, and medical care; 

20 ‘‘(B) obtaining goods and services nec21 essary to maintain physical health, mental 

22 health, or general safety; or 

23 ‘‘(C) managing one’s own financial affairs. 

24 ‘‘(19) SERIOUS BODILY INJURY.— 


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

2 bodily injury’ means an injury— 

3 ‘‘(i) involving extreme physical pain; 

4 ‘‘(ii) involving substantial risk of 

5 death; 

6 ‘‘(iii) involving protracted loss or im7 pairment of the function of a bodily mem8 ber, organ, or mental faculty; or 

9 ‘‘(iv) requiring medical intervention 

10 such as surgery, hospitalization, or phys11 ical rehabilitation. 

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

13 bodily injury shall be considered to have oc14 curred if the conduct causing the injury is con15 duct described in section 2241 (relating to ag16 gravated sexual abuse) or 2242 (relating to sex17 ual abuse) of title 18, United States Code, or 

18 any similar offense under State law. 

19 ‘‘(20) SOCIAL.—The term ‘social’, when used 

20 with respect to a service, includes adult protective 

21 services. 

22 ‘‘(21) STATE LEGAL ASSISTANCE DEVEL23 OPER.—The term ‘State legal assistance developer’ 

24 means an individual described in section 731 of the 

25 Older Americans Act of 1965. 


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1 ‘‘(22) STATE LONG-TERM CARE OMBUDSMAN.— 

2 The term ‘State Long-Term Care Ombudsman’ 

3 means the State Long-Term Care Ombudsman de4 scribed in section 712(a)(2) of the Older Americans 

5 Act of 1965. 

6 ‘‘SEC. 2012. GENERAL PROVISIONS. 

7 ‘‘(a) PROTECTION OF PRIVACY.—In pursuing activi8 ties under this part, the Secretary shall ensure the protec9 tion of individual health privacy consistent with the regu10 lations promulgated under section 264(c) of the Health 

11 Insurance Portability and Accountability Act of 1996 and 

12 applicable State and local privacy regulations. 

13 ‘‘(b) RULE OF CONSTRUCTION.—Nothing in this part 

14 shall be construed to interfere with or abridge an elder’s 

15 right to practice his or her religion through reliance on 

16 prayer alone for healing when this choice— 

17 ‘‘(1) is contemporaneously expressed, either 

18 orally or in writing, with respect to a specific illness 

19 or injury which the elder has at the time of the deci20 sion by an elder who is competent at the time of the 

21 decision; 

22 ‘‘(2) is previously set forth in a living will, 

23 health care proxy, or other advance directive docu24 ment that is validly executed and applied under 

25 State law; or 


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1 ‘‘(3) may be unambiguously deduced from the 

2 elder’s life history. 

3 ‘‘SUBPART 1—NATIONAL COORDINATION OF ELDER

4 JUSTICE ACTIVITIES AND RESEARCH

5 ‘‘CHAPTER I—ELDER JUSTICE COORDINATING 

6 COUNCIL AND ADVISORY BOARD ON ELDER 

7 ABUSE, NEGLECT, AND EXPLOITATION 

8 ‘‘SEC. 2021. ELDER JUSTICE COORDINATING COUNCIL. 

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

10 the Office of the Secretary an Elder Justice Coordinating 

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

12 ‘‘(b) MEMBERSHIP.— 

13 ‘‘(1) IN GENERAL.—The Council shall be com14 posed of the following members: 

15 ‘‘(A) The Secretary (or the Secretary’s 

16 designee). 

17 ‘‘(B) The Attorney General (or the Attor18 ney General’s designee). 

19 ‘‘(C) The head of each Federal department 

20 or agency or other governmental entity identi21 fied by the Chair referred to in subsection (d) 

22 as having responsibilities, or administering pro23 grams, relating to elder abuse, neglect, and ex24 ploitation. 


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1 ‘‘(2) REQUIREMENT.—Each member of the 

2 Council shall be an officer or employee of the Fed3 eral Government. 

4 ‘‘(c) VACANCIES.—Any vacancy in the Council shall 

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

7 ‘‘(d) CHAIR.—The member described in subsection 

8 (b)(1)(A) shall be Chair of the Council. 

9 ‘‘(e) MEETINGS.—The Council shall meet at least 2 

10 times per year, as determined by the Chair. 

11 ‘‘(f) DUTIES.— 

12 ‘‘(1) IN GENERAL.—The Council shall make 

13 recommendations to the Secretary for the coordina14 tion of activities of the Department of Health and 

15 Human Services, the Department of Justice, and 

16 other relevant Federal, State, local, and private 

17 agencies and entities, relating to elder abuse, ne18 glect, and exploitation and other crimes against el19 ders. 

20 ‘‘(2) REPORT.—Not later than the date that is 

21 2 years after the date of enactment of the Elder 

22 Justice Act and every 2 years thereafter, the Council 

23 shall submit to the Committee on Finance of the 

24 Senate and the Committee on Ways and Means and 


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1 the Committee on Energy and Commerce of the 

2 House of Representatives a report that— 

3 ‘‘(A) describes the activities and accom4 plishments of, and challenges faced by— 

5 ‘‘(i) the Council; and 

6 ‘‘(ii) the entities represented on the 

7 Council; and 

8 ‘‘(B) makes such recommendations for leg9 islation, model laws, or other action as the 

10 Council determines to be appropriate. 

11 ‘‘(g) POWERS OF THE COUNCIL.— 

12 ‘‘(1) INFORMATION FROM FEDERAL AGEN13 CIES.—Subject to the requirements of section 

14 2012(a), the Council may secure directly from any 

15 Federal department or agency such information as 

16 the Council considers necessary to carry out this sec17 tion. Upon request of the Chair of the Council, the 

18 head of such department or agency shall furnish 

19 such information to the Council. 

20 ‘‘(2) POSTAL SERVICES.—The Council may use 

21 the United States mails in the same manner and 

22 under the same conditions as other departments and 

23 agencies of the Federal Government. 

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

25 Council shall not receive compensation for the performVerDate Nov 24 2008 03:07 Apr 23, 2009 Jkt 079200 PO 00000 Frm 00021 Fmt 6652 Sfmt 6201 E:\BILLS\H2006.IH H2006

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1 ance of services for the Council. The members shall be 

2 allowed travel expenses, including per diem in lieu of sub3 sistence, at rates authorized for employees of agencies 

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

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

6 business in the performance of services for the Council. 

7 Notwithstanding section 1342 of title 31, United States 

8 Code, the Secretary may accept the voluntary and uncom9 pensated services of the members of the Council. 

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

11 Federal Government employee may be detailed to the 

12 Council without reimbursement, and such detail shall be 

13 without interruption or loss of civil service status or privi14 lege. 

15 ‘‘(j) STATUS AS PERMANENT COUNCIL.—Section 14 

16 of the Federal Advisory Committee Act (5 U.S.C. App.) 

17 shall not apply to the Council. 

18 ‘‘SEC. 2022. ADVISORY BOARD ON ELDER ABUSE, NEGLECT, 

19 AND EXPLOITATION. 

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

21 to be known as the ‘Advisory Board on Elder Abuse, Ne22 glect, and Exploitation’ (in this section referred to as the 

23 ‘Advisory Board’) to create short- and long-term multi24 disciplinary strategic plans for the development of the field 

25 of elder justice and to make recommendations to the Elder 


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1 Justice Coordinating Council established under section 

2 2021. 

3 ‘‘(b) COMPOSITION.—The Advisory Board shall be 

4 composed of 27 members appointed by the Secretary from 

5 among members of the general public who are individuals 

6 with experience and expertise in elder abuse, neglect, and 

7 exploitation prevention, detection, treatment, intervention, 

8 or prosecution. 

9 ‘‘(c) SOLICITATION OF NOMINATIONS.—The Sec10 retary shall publish a notice in the Federal Register solic11 iting nominations for the appointment of members of the 

12 Advisory Board under subsection (b). 

13 ‘‘(d) TERMS.— 

14 ‘‘(1) IN GENERAL.—Each member of the Advi15 sory Board shall be appointed for a term of 3 years, 

16 except that, of the members first appointed— 

17 ‘‘(A) 9 shall be appointed for a term of 3 

18 years; 

19 ‘‘(B) 9 shall be appointed for a term of 2 

20 years; and 

21 ‘‘(C) 9 shall be appointed for a term of 1 

22 year. 

23 ‘‘(2) VACANCIES.— 

24 ‘‘(A) IN GENERAL.—Any vacancy on the 

25 Advisory Board shall not affect its powers, but 


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1 shall be filled in the same manner as the origi2 nal appointment was made. 

3 ‘‘(B) FILLING UNEXPIRED TERM.—An in4 dividual chosen to fill a vacancy shall be ap5 pointed for the unexpired term of the member 

6 replaced. 

7 ‘‘(3) EXPIRATION OF TERMS.—The term of any 

8 member shall not expire before the date on which 

9 the member’s successor takes office. 

10 ‘‘(e) ELECTION OF OFFICERS.—The Advisory Board 

11 shall elect a Chair and Vice Chair from among its mem12 bers. The Advisory Board shall elect its initial Chair and 

13 Vice Chair at its initial meeting. 

14 ‘‘(f) DUTIES.— 

15 ‘‘(1) ENHANCE COMMUNICATION ON PRO16 MOTING QUALITY OF, AND PREVENTING ABUSE AND

17 NEGLECT IN, LONG-TERM CARE.—The Advisory 

18 Board shall develop collaborative and innovative ap19 proaches to improve the quality of, including pre20 venting abuse and neglect in, long-term care. 

21 ‘‘(2) COLLABORATIVE EFFORTS TO DEVELOP

22 CONSENSUS AROUND THE MANAGEMENT OF CER23 TAIN QUALITY-RELATED FACTORS.— 

24 ‘‘(A) IN GENERAL.—The Advisory Board 

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1 dress, and develop consensus on, subjects relat2 ing to improving the quality of long-term care. 

3 At least 1 such panel shall address, and develop 

4 consensus on, methods for managing resident5 to-resident abuse in long-term care. 

6 ‘‘(B) ACTIVITIES CONDUCTED.—The multi7 disciplinary panels established under subpara8 graph (A) shall examine relevant research and 

9 data, identify best practices with respect to the 

10 subject of the panel, determine the best way to 

11 carry out those best practices in a practical and 

12 feasible manner, and determine an effective 

13 manner of distributing information on such 

14 subject. 

15 ‘‘(3) REPORT.—Not later than the date that is 

16 18 months after the date of enactment of the Elder 

17 Justice Act, and annually thereafter, the Advisory 

18 Board shall prepare and submit to the Elder Justice 

19 Coordinating Council, the Committee on Finance of 

20 the Senate, and the Committee on Ways and Means 

21 and the Committee on Energy and Commerce of the 

22 House of Representatives a report containing— 

23 ‘‘(A) information on the status of Federal, 

24 State, and local public and private elder justice 

25 activities; 


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1 ‘‘(B) recommendations (including rec2 ommended priorities) regarding— 

3 ‘‘(i) elder justice programs, research, 

4 training, services, practice, enforcement, 

5 and coordination; 

6 ‘‘(ii) coordination between entities 

7 pursuing elder justice efforts and those in8 volved in related areas that may inform or 

9 overlap with elder justice efforts, such as 

10 activities to combat violence against women 

11 and child abuse and neglect; and 

12 ‘‘(iii) activities relating to adult fidu13 ciary systems, including guardianship and 

14 other fiduciary arrangements; 

15 ‘‘(C) recommendations for specific modi16 fications needed in Federal and State laws (in17 cluding regulations) or for programs, research, 

18 and training to enhance prevention, detection, 

19 and treatment (including diagnosis) of, inter20 vention in (including investigation of), and 

21 prosecution of elder abuse, neglect, and exploi22 tation; 

23 ‘‘(D) recommendations on methods for the 

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1 tion with respect to elder justice, and elder 

2 abuse, neglect, and exploitation; and 

3 ‘‘(E) recommendations for a multidisci4 plinary strategic plan to guide the effective and 

5 efficient development of the field of elder jus6 tice. 

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

8 ‘‘(1) INFORMATION FROM FEDERAL AGEN9 CIES.—Subject to the requirements of section 

10 2012(a), the Advisory Board may secure directly 

11 from any Federal department or agency such infor12 mation as the Advisory Board considers necessary to 

13 carry out this section. Upon request of the Chair of 

14 the Advisory Board, the head of such department or 

15 agency shall furnish such information to the Advi16 sory Board. 

17 ‘‘(2) SHARING OF DATA AND REPORTS.—The 

18 Advisory Board may request from any entity pur19 suing elder justice activities under the Elder Justice 

20 Act or an amendment made by that Act, any data, 

21 reports, or recommendations generated in connection 

22 with such activities. 

23 ‘‘(3) POSTAL SERVICES.—The Advisory Board 

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1 ner and under the same conditions as other depart2 ments and agencies of the Federal Government. 

3 ‘‘(h) TRAVEL EXPENSES.—The members of the Advi4 sory Board shall not receive compensation for the perform5 ance of services for the Advisory Board. The members 

6 shall be allowed travel expenses for up to 4 meetings per 

7 year, including per diem in lieu of subsistence, at rates 

8 authorized for employees of agencies under subchapter I 

9 of chapter 57 of title 5, United States Code, while away 

10 from their homes or regular places of business in the per11 formance of services for the Advisory Board. Notwith12 standing section 1342 of title 31, United States Code, the 

13 Secretary may accept the voluntary and uncompensated 

14 services of the members of the Advisory Board. 

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

16 Federal Government employee may be detailed to the Ad17 visory Board without reimbursement, and such detail shall 

18 be without interruption or loss of civil service status or 

19 privilege. 

20 ‘‘(j) STATUS AS PERMANENT ADVISORY COM21 MITTEE.—Section 14 of the Federal Advisory Committee 

22 Act (5 U.S.C. App.) shall not apply to the advisory board. 

23 ‘‘SEC. 2023. RESEARCH PROTECTIONS. 

24 ‘‘(a) GUIDELINES.—The Secretary shall promulgate 

25 guidelines to assist researchers working in the area of 


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1 elder abuse, neglect, and exploitation, with issues relating 

2 to human subject protections. 

3 ‘‘(b) DEFINITION OF LEGALLY AUTHORIZED REP4 RESENTATIVE FOR APPLICATION OF REGULATIONS.—For 

5 purposes of the application of subpart A of part 46 of title 

6 45, Code of Federal Regulations, to research conducted 

7 under this chapter the term ‘legally authorized representa8 tive’ means, unless otherwise provided by law, the indi9 vidual or judicial or other body authorized under the appli10 cable law to consent to medical treatment on behalf of an11 other person. 

12 ‘‘SEC. 2024. AUTHORIZATION OF APPROPRIATIONS. 

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

14 this chapter— 

15 ‘‘(1) for fiscal year 2010, $6,500,000; and 

16 ‘‘(2) for each of fiscal years 2011 through 

17 2012, $7,000,000. 

18 ‘‘CHAPTER II—ELDER ABUSE, NEGLECT, AND 

19 EXPLOITATION FORENSIC CENTERS 

20 ‘‘SEC. 2031. ESTABLISHMENT AND SUPPORT OF ELDER 

21 ABUSE, NEGLECT, AND EXPLOITATION FO22 RENSIC CENTERS. 

23 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

24 with the Attorney General, shall make grants to eligible 

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1 rensic centers, to develop forensic expertise regarding, and 

2 provide services relating to, elder abuse, neglect, and ex3 ploitation. 

4 ‘‘(b) STATIONARY FORENSIC CENTERS.—The Sec5 retary shall make 4 of the grants described in subsection 

6 (a) to institutions of higher education with demonstrated 

7 expertise in forensics or commitment to preventing or 

8 treating elder abuse, neglect, or exploitation, to establish 

9 and operate stationary forensic centers. 

10 ‘‘(c) MOBILE CENTERS.—The Secretary shall make 

11 6 of the grants described in subsection (a) to appropriate 

12 entities to establish and operate mobile forensic centers. 

13 ‘‘(d) AUTHORIZED ACTIVITIES.— 

14 ‘‘(1) DEVELOPMENT OF FORENSIC MARKERS

15 AND METHODOLOGIES.—An eligible entity that re16 ceives a grant under this section shall use funds 

17 made available through the grant to assist in deter18 mining whether abuse, neglect, or exploitation oc19 curred and whether a crime was committed and to 

20 conduct research to describe and disseminate infor21 mation on— 

22 ‘‘(A) forensic markers that indicate a case 

23 in which elder abuse, neglect, or exploitation 

24 may have occurred; and 


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1 ‘‘(B) methodologies for determining, in 

2 such a case, when and how health care, emer3 gency service, social and protective services, and 

4 legal service providers should intervene and 

5 when the providers should report the case to 

6 law enforcement authorities. 

7 ‘‘(2) DEVELOPMENT OF FORENSIC EXPER8 TISE.—An eligible entity that receives a grant under 

9 this section shall use funds made available through 

10 the grant to develop forensic expertise regarding 

11 elder abuse, neglect, and exploitation in order to 

12 provide medical and forensic evaluation, therapeutic 

13 intervention, victim support and advocacy, case re14 view, and case tracking. 

15 ‘‘(3) COLLECTION OF EVIDENCE.—The Sec16 retary, in coordination with the Attorney General, 

17 shall use data made available by grant recipients 

18 under this section to develop the capacity of geriatric 

19 health care professionals and law enforcement to col20 lect forensic evidence, including collecting forensic 

21 evidence relating to a potential determination of 

22 elder abuse, neglect, or exploitation. 

23 ‘‘(e) APPLICATION.—To be eligible to receive a grant 

24 under this section, an entity shall submit an application 


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1 to the Secretary at such time, in such manner, and con2 taining such information as the Secretary may require. 

3 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated to carry out this sec5 tion— 

6 ‘‘(1) for fiscal year 2010, $4,000,000; 

7 ‘‘(2) for fiscal year 2011, $6,000,000; and 

8 ‘‘(3) for each of fiscal years 2012 and 2013, 

9 $8,000,000. 

10 ‘‘SUBPART 2—PROGRAMS TO PROMOTE ELDER JUSTICE

11 ‘‘SEC. 2041. ENHANCEMENT OF LONG-TERM CARE. 

12 ‘‘(a) GRANTS AND INCENTIVES FOR LONG-TERM

13 CARE STAFFING.— 

14 ‘‘(1) IN GENERAL.—The Secretary shall carry 

15 out activities, including activities described in para16 graphs (2) and (3), to provide incentives for individ17 uals to train for, seek, and maintain employment 

18 providing direct care in a long-term care facility. 

19 ‘‘(2) SPECIFIC PROGRAMS TO ENHANCE TRAIN20 ING, RECRUITMENT, AND RETENTION OF STAFF.— 

21 ‘‘(A) COORDINATION WITH SECRETARY OF

22 LABOR TO RECRUIT AND TRAIN LONG-TERM

23 CARE STAFF.—The Secretary shall coordinate 

24 activities under this subsection with the Sec25 retary of Labor in order to provide incentives 


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1 for individuals to train for and seek employ2 ment providing direct care in a long-term care 

3 facility. 

4 ‘‘(B) CAREER LADDERS AND WAGE OR

5 BENEFIT INCREASES TO INCREASE STAFFING IN

6 LONG-TERM CARE FACILITIES.— 

7 ‘‘(i) IN GENERAL.—The Secretary 

8 shall make grants to long-term care facili9 ties to carry out programs through which 

10 the facilities— 

11 ‘‘(I) offer, to employees who pro12 vide direct care to residents of a long13 term care facility, continuing training 

14 and varying levels of certification, 

15 based on observed clinical care prac16 tices and the amount of time the em17 ployees spend providing direct care; 

18 and 

19 ‘‘(II) provide, or make arrange20 ments to provide, bonuses or other in21 creased compensation or benefits to 

22 employees who achieve certification 

23 under such a program. 

24 ‘‘(ii) APPLICATION.—To be eligible to 

25 receive a grant under this subparagraph, a 


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1 long-term care facility shall submit an ap2 plication to the Secretary at such time, in 

3 such manner, and containing such infor4 mation as the Secretary may require 

5 (which may include evidence of consulta6 tion with the State in which the long-term 

7 care facility is located with respect to car8 rying out activities funded under the 

9 grant). 

10 ‘‘(iii) AUTHORITY TO LIMIT NUMBER

11 OF APPLICANTS.—Nothing in this subpara12 graph shall be construed as prohibiting the 

13 Secretary from limiting the number of ap14 plicants for a grant under this subpara15 graph. 

16 ‘‘(3) SPECIFIC PROGRAMS TO IMPROVE MAN17 AGEMENT PRACTICES.— 

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

19 make grants to long-term care facilities to en20 able the facilities to provide training and tech21 nical assistance to eligible employees. 

22 ‘‘(B) AUTHORIZED ACTIVITIES.—A long23 term care facility that receives a grant under 

24 subparagraph (A) shall use funds made avail25 able through the grant to provide training and 


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1 technical assistance to eligible employees re2 garding management practices using methods 

3 that are demonstrated to promote retention of 

4 individuals who provide direct care to residents 

5 of the long-term care facility, such as— 

6 ‘‘(i) the establishment of standard 

7 human resource policies that reward high 

8 performance, including policies that pro9 vide for improved wages and benefits on 

10 the basis of job reviews; 

11 ‘‘(ii) the establishment of motivational 

12 and thoughtful work organization prac13 tices; 

14 ‘‘(iii) the creation of a workplace cul15 ture that respects and values caregivers 

16 and their needs; 

17 ‘‘(iv) the promotion of a workplace 

18 culture that respects the rights of residents 

19 of a long-term care facility and results in 

20 improved care for the residents; and 

21 ‘‘(v) the establishment of other pro22 grams that promote the provision of high 

23 quality care, such as a continuing edu24 cation program that provides additional 

25 hours of training, including on-the-job 


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1 training, for employees who are certified 

2 nurse aides. 

3 ‘‘(C) APPLICATION.—To be eligible to re4 ceive a grant under this paragraph, a long-term 

5 care facility shall submit an application to the 

6 Secretary at such time, in such manner, and 

7 containing such information as the Secretary 

8 may require (which may include evidence of 

9 consultation with the State in which the long10 term care facility is located with respect to car11 rying out activities funded under the grant). 

12 ‘‘(D) AUTHORITY TO LIMIT NUMBER OF

13 APPLICANTS.—Nothing in this paragraph shall 

14 be construed as prohibiting the Secretary from 

15 limiting the number of applicants for a grant 

16 under this paragraph. 

17 ‘‘(E) ELIGIBLE EMPLOYEE DEFINED.—In 

18 this paragraph, the term ‘eligible employee’ 

19 means an individual who establishes or imple20 ments management practices applicable with re21 spect to individuals who provide direct care to 

22 residents of a long-term care facility and in23 cludes administrators, directors of nursing, 

24 staff developers, and charge nurses. 


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1 ‘‘(4) ACCOUNTABILITY MEASURES.—The Sec2 retary shall develop accountability measures to en3 sure that the activities conducted using funds made 

4 available under this subsection benefit eligible em5 ployees and increase the stability of the long-term 

6 care workforce. 

7 ‘‘(b) INFORMATICS SYSTEMS GRANT PROGRAM.— 

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

9 authorized to make grants to long-term care facili10 ties for the purpose of assisting such entities in off11 setting the costs related to purchasing, leasing, de12 veloping, and implementing standardized clinical 

13 health care informatics systems designed to improve 

14 patient safety and reduce adverse events and health 

15 care complications resulting from medication errors. 

16 ‘‘(2) USE OF GRANT FUNDS.—Funds provided 

17 under grants under this subsection may be used for 

18 any of the following: 

19 ‘‘(A) Purchasing, leasing, and installing 

20 computer software and hardware, including 

21 handheld computer technologies. 

22 ‘‘(B) Making improvements to existing 

23 computer software and hardware. 


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1 ‘‘(C) Making upgrades and other improve2 ments to existing computer software and hard3 ware to enable e-prescribing. 

4 ‘‘(D) Providing education and training to 

5 eligible long-term care facility staff on the use 

6 of technology to implement the electronic trans7 mission of prescription and patient information. 

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

9 grant under this subsection, a long-term care facility 

10 shall submit an application to the Secretary at such 

11 time, in such manner, and containing such informa12 tion as the Secretary may require (which may in13 clude evidence of consultation with the State in 

14 which the long-term care facility is located with re15 spect to carrying out activities funded under the 

16 grant). 

17 ‘‘(4) AUTHORITY TO LIMIT NUMBER OF APPLI18 CANTS.—Nothing in this subsection shall be con19 strued as prohibiting the Secretary from limiting the 

20 number of applicants for a grant under this sub21 section. 

22 ‘‘(5) ACCOUNTABILITY MEASURES.—The Sec23 retary shall develop accountability measures to en24 sure that the activities conducted using funds made 

25 available under this subsection help improve patient 


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1 safety and reduce adverse events and health care 

2 complications resulting from medication errors. 

3 ‘‘(c) INCLUSION OF ADJUDICATED CRIMES ON NURS4 ING HOME COMPARE WEBSITE.—Not later than 1 year 

5 after the date of enactment of the Elder Justice Act, the 

6 Secretary shall ensure that the Department of Health and 

7 Human Services includes, as part of the information pro8 vided for comparison of nursing facilities on the official 

9 Internet website of the Federal Government for Medicare 

10 beneficiaries (commonly referred to as the ‘Nursing Home 

11 Compare’ Medicare website), the number of adjudicated 

12 instances of criminal violations by a nursing facility or 

13 crimes committed by an employee of a nursing facility— 

14 ‘‘(1) that were committed inside of the facility; 

15 and 

16 ‘‘(2) with respect to such instances of violations 

17 or crimes committed outside of the facility, that 

18 were the violations or crimes of elder abuse, neglect, 

19 and exploitation, criminal sexual abuse of an elder, 

20 or other violations or crimes that resulted in the se21 rious bodily injury of an elder. 

22 ‘‘(d) DEVELOPMENT OF CONSUMER RIGHTS INFOR23 MATION PAGE ON NURSING HOME COMPARE WEBSITE.— 

24 Not later than 1 year after the date of enactment of the 

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1 partment of Health and Human Services, as part of the 

2 information provided for comparison of nursing facilities 

3 on the Nursing Home Compare Medicare website develops 

4 and includes a consumer rights information page that con5 tains links to descriptions of, and information with respect 

6 to, the following: 

7 ‘‘(1) The documentation on nursing facilities 

8 that is available to the public. 

9 ‘‘(2) General information and tips on choosing 

10 a nursing facility that meets the needs of the indi11 vidual. 

12 ‘‘(3) General information on consumer rights 

13 with respect to nursing facilities. 

14 ‘‘(4) The nursing facility survey process (on a 

15 national and State-specific basis). 

16 ‘‘(5) On a State-specific basis, the services 

17 available through the State long-term care ombuds18 man for such State. 

19 ‘‘(e) DEVELOPMENT AND ADOPTION OF STANDARDS

20 FOR TRANSACTIONS INVOLVING CLINICAL DATA BY

21 LONG-TERM CARE FACILITIES.— 

22 ‘‘(1) STANDARDS.—The Secretary shall develop 

23 and adopt uniform open electronic standards for 

24 transactions involving clinical data by long-term care 


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1 facilities. Such standards shall include messaging 

2 and nomenclature standards. 

3 ‘‘(2) COMPATIBILITY WITH OTHER STAND4 ARDS.—The standards developed and adopted under 

5 paragraph (1) shall be compatible with standards es6 tablished under part C of title XI, standards estab7 lished under subsections (b)(2)(B)(i) and (e)(4) of 

8 section 1860D–4, and with general health informa9 tion technology standards. 

10 ‘‘(3) ELECTRONIC SUBMISSION OF DATA TO

11 THE SECRETARY.— 

12 ‘‘(A) IN GENERAL.—Not later than 10 

13 years after the date of enactment of the Elder 

14 Justice Act, the Secretary shall have procedures 

15 in place to accept the optional electronic sub16 mission of clinical data by long-term care facili17 ties pursuant to the standards developed and 

18 adopted under paragraph (1). 

19 ‘‘(B) RULE OF CONSTRUCTION.—Nothing 

20 in this subsection shall be construed to require 

21 a long-term care facility to submit clinical data 

22 electronically to the Secretary. 

23 ‘‘(f) REGULATIONS.—The Secretary shall promulgate 

24 regulations to carry out subsections (c), (d), and (e) of 

25 this section. Such regulations shall require a State, as a 


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1 condition of the receipt of funds under this part, to con2 duct such data collection and reporting as the Secretary 

3 determines are necessary to satisfy the requirements of 

4 such subsections. 

5 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

6 are authorized to be appropriated to carry out this sec7 tion— 

8 ‘‘(1) for fiscal year 2010, $20,000,000; 

9 ‘‘(2) for fiscal year 2011, $17,500,000; and 

10 ‘‘(3) for each of fiscal years 2012 and 2013, 

11 $15,000,000. 

12 ‘‘SEC. 2042. ADULT PROTECTIVE SERVICES FUNCTIONS AND 

13 GRANT PROGRAMS. 

14 ‘‘(a) SECRETARIAL RESPONSIBILITIES.— 

15 ‘‘(1) IN GENERAL.—The Secretary shall ensure 

16 that the Department of Health and Human Serv17 ices— 

18 ‘‘(A) provides funding authorized by this 

19 subpart to State and local adult protective serv20 ices offices that investigate reports of the abuse, 

21 neglect, and exploitation of elders; 

22 ‘‘(B) collects and disseminates data annu23 ally relating to the abuse, exploitation, and ne24 glect of elders in coordination with the Depart25 ment of Justice; 


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1 ‘‘(C) develops and disseminates informa2 tion on best practices regarding, and provides 

3 training on, carrying out adult protective serv4 ices; 

5 ‘‘(D) conducts research related to the pro6 vision of adult protective services; and 

7 ‘‘(E) provides technical assistance to 

8 States and other entities that provide or fund 

9 the provision of adult protective services, in10 cluding through grants made under subsections 

11 (b) and (c). 

12 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

13 There are authorized to be appropriated to carry out 

14 this subsection, $3,000,000 for fiscal year 2010 and 

15 $4,000,000 for each of fiscal years 2011 through 

16 2013. 

17 ‘‘(b) GRANTS TO ENHANCE THE PROVISION OF

18 ADULT PROTECTIVE SERVICES.— 

19 ‘‘(1) ESTABLISHMENT.—There is established an 

20 adult protective services grant program under which 

21 the Secretary shall annually award grants to States 

22 in the amounts calculated under paragraph (2) for 

23 the purposes of enhancing adult protective services 

24 provided by States and local units of government. 

25 ‘‘(2) AMOUNT OF PAYMENT.— 


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1 ‘‘(A) IN GENERAL.—Subject to the avail2 ability of appropriations and subparagraphs (B) 

3 and (C), the amount paid to a State for a fiscal 

4 year under the program under this subsection 

5 shall equal the amount appropriated for that 

6 year to carry out this subsection multiplied by 

7 the percentage of the total number of elders 

8 who reside in the United States who reside in 

9 that State. 

10 ‘‘(B) GUARANTEED MINIMUM PAYMENT

11 AMOUNT.— 

12 ‘‘(i) 50 STATES.—Subject to clause 

13 (ii), if the amount determined under sub14 paragraph (A) for a State for a fiscal year 

15 is less than 0.75 percent of the amount ap16 propriated for such year, the Secretary 

17 shall increase such determined amount so 

18 that the total amount paid under this sub19 section to the State for the year is equal 

20 to 0.75 percent of the amount so appro21 priated. 

22 ‘‘(ii) TERRITORIES.—In the case of a 

23 State other than 1 of the 50 States, clause 

24 (i) shall be applied as if each reference to 

25 ‘0.75’ were a reference to ‘0.1’. 


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1 ‘‘(C) PRO RATA REDUCTIONS.—The Sec2 retary shall make such pro rata reductions to 

3 the amounts described in subparagraph (A) as 

4 are necessary to comply with the requirements 

5 of subparagraph (B). 

6 ‘‘(3) AUTHORIZED ACTIVITIES.— 

7 ‘‘(A) ADULT PROTECTIVE SERVICES.— 

8 Funds made available pursuant to this sub9 section may only be used by States and local 

10 units of government to provide adult protective 

11 services and may not be used for any other pur12 pose. 

13 ‘‘(B) USE BY AGENCY.—Each State receiv14 ing funds pursuant to this subsection shall pro15 vide such funds to the agency or unit of State 

16 government having legal responsibility for pro17 viding adult protective services within the State. 

18 ‘‘(C) SUPPLEMENT NOT SUPPLANT.—Each 

19 State or local unit of government shall use 

20 funds made available pursuant to this sub21 section to supplement and not supplant other 

22 Federal, State, and local public funds expended 

23 to provide adult protective services in the State. 

24 ‘‘(4) STATE REPORTS.—Each State receiving 

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1 retary, at such time and in such manner as the Sec2 retary may require, a report on the number of elders 

3 served by the grants awarded under this subsection. 

4 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

5 There are authorized to be appropriated to carry out 

6 this subsection, $100,000,000 for each of fiscal 

7 years 2010 through 2013. 

8 ‘‘(c) STATE DEMONSTRATION PROGRAMS.— 

9 ‘‘(1) ESTABLISHMENT.—The Secretary shall 

10 award grants to States for the purposes of con11 ducting demonstration programs in accordance with 

12 paragraph (2). 

13 ‘‘(2) DEMONSTRATION PROGRAMS.—Funds 

14 made available pursuant to this subsection may be 

15 used by States and local units of government to con16 duct demonstration programs that test— 

17 ‘‘(A) training modules developed for the 

18 purpose of detecting or preventing elder abuse; 

19 ‘‘(B) methods to detect or prevent financial 

20 exploitation of elders; 

21 ‘‘(C) methods to detect elder abuse; 

22 ‘‘(D) whether training on elder abuse 

23 forensics enhances the detection of elder abuse 

24 by employees of the State or local unit of gov25 ernment; or 


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1 ‘‘(E) other matters relating to the detec2 tion or prevention of elder abuse. 

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

4 grant under this subsection, a State shall submit an 

5 application to the Secretary at such time, in such 

6 manner, and containing such information as the Sec7 retary may require. 

8 ‘‘(4) STATE REPORTS.—Each State that re9 ceives funds under this subsection shall submit a re10 port to the Secretary at such time, in such manner, 

11 and containing such information as the Secretary 

12 may require on the results of the demonstration pro13 gram conducted by the State using funds made 

14 available under this subsection. 

15 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

16 There are authorized to be appropriated to carry out 

17 this subsection, $25,000,000 for each of fiscal years 

18 2010 through 2013. 

19 ‘‘SEC. 2043. LONG-TERM CARE OMBUDSMAN PROGRAM 

20 GRANTS AND TRAINING. 

21 ‘‘(a) GRANTS TO SUPPORT THE LONG-TERM CARE

22 OMBUDSMAN PROGRAM.— 

23 ‘‘(1) IN GENERAL.—The Secretary shall make 

24 grants to eligible entities with relevant expertise and 

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1 cilities or long-term care ombudsman programs and 

2 responsibilities, for the purpose of— 

3 ‘‘(A) improving the capacity of State long4 term care ombudsman programs to respond to 

5 and resolve complaints about abuse and neglect; 

6 ‘‘(B) conducting pilot programs with State 

7 long-term care ombudsman offices or local om8 budsman entities; and 

9 ‘‘(C) providing support for such State 

10 long-term care ombudsman programs and such 

11 pilot programs (such as through the establish12 ment of a national long-term care ombudsman 

13 resource center). 

14 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

15 There are authorized to be appropriated to carry out 

16 this subsection— 

17 ‘‘(A) for fiscal year 2010, $5,000,000; 

18 ‘‘(B) for fiscal year 2011, $7,500,000; and 

19 ‘‘(C) for each of fiscal years 2012 and 

20 2013, $10,000,000. 

21 ‘‘(b) OMBUDSMAN TRAINING PROGRAMS.— 

22 ‘‘(1) IN GENERAL.—The Secretary shall estab23 lish programs to provide and improve ombudsman 

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1 ploitation for national organizations and State long2 term care ombudsman programs. 

3 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

4 There are authorized to be appropriated to carry out 

5 this subsection, for each of fiscal years 2010 

6 through 2013, $10,000,000. 

7 ‘‘SEC. 2044. PROVISION OF INFORMATION REGARDING, AND 

8 EVALUATIONS OF, ELDER JUSTICE PRO9 GRAMS. 

10 ‘‘(a) PROVISION OF INFORMATION.—To be eligible to 

11 receive a grant under this part, an applicant shall agree— 

12 ‘‘(1) except as provided in paragraph (2), to 

13 provide the eligible entity conducting an evaluation 

14 under subsection (b) of the activities funded through 

15 the grant with such information as the eligible entity 

16 may require in order to conduct such evaluation; or 

17 ‘‘(2) in the case of an applicant for a grant 

18 under section 2041(b), to provide the Secretary with 

19 such information as the Secretary may require to 

20 conduct an evaluation or audit under subsection (c). 

21 ‘‘(b) USE OF ELIGIBLE ENTITIES TO CONDUCT

22 EVALUATIONS.— 

23 ‘‘(1) EVALUATIONS REQUIRED.—Except as pro24 vided in paragraph (2), the Secretary shall— 


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1 ‘‘(A) reserve a portion (not less than 2 per2 cent) of the funds appropriated with respect to 

3 each program carried out under this part; and 

4 ‘‘(B) use the funds reserved under sub5 paragraph (A) to provide assistance to eligible 

6 entities to conduct evaluations of the activities 

7 funded under each program carried out under 

8 this part. 

9 ‘‘(2) INFORMATICS SYSTEMS GRANT PROGRAM

10 NOT INCLUDED.—The provisions of this subsection 

11 shall not apply to the informatics systems grant pro12 gram under section 2041(b). 

13 ‘‘(3) AUTHORIZED ACTIVITIES.—A recipient of 

14 assistance described in paragraph (1)(B) shall use 

15 the funds made available through the assistance to 

16 conduct a validated evaluation of the effectiveness of 

17 the activities funded under a program carried out 

18 under this part. 

19 ‘‘(4) APPLICATIONS.—To be eligible to receive 

20 assistance under paragraph (1)(B), an entity shall 

21 submit an application to the Secretary at such time, 

22 in such manner, and containing such information as 

23 the Secretary may require, including a proposal for 

24 the evaluation. 


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1 ‘‘(5) REPORTS.—Not later than a date specified 

2 by the Secretary, an eligible entity receiving assist3 ance under paragraph (1)(B) shall submit to the 

4 Secretary, the Committee on Ways and Means and 

5 the Committee on Energy and Commerce of the 

6 House of Representatives, and the Committee on Fi7 nance of the Senate a report containing the results 

8 of the evaluation conducted using such assistance to9 gether with such recommendations as the entity de10 termines to be appropriate. 

11 ‘‘(c) EVALUATIONS AND AUDITS OF INFORMATICS

12 SYSTEMS GRANT PROGRAM BY THE SECRETARY.— 

13 ‘‘(1) EVALUATIONS.—The Secretary shall con14 duct an evaluation of the activities funded under the 

15 informatics systems grant program under section 

16 2041(b). Such evaluation shall include an evaluation 

17 of whether the funding provided under the grant is 

18 expended only for the purposes for which it is made. 

19 ‘‘(2) AUDITS.—The Secretary shall conduct ap20 propriate audits of grants made under section 

21 2041(b). 

22 ‘‘SEC. 2045. REPORT. 

23 ‘‘Not later than October 1, 2013, the Secretary shall 

24 submit to the Elder Justice Coordinating Council, the 

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1 ergy and Commerce of the House of Representatives, and 

2 the Committee on Finance of the Senate a report— 

3 ‘‘(1) compiling, summarizing, and analyzing the 

4 information contained in the State reports submitted 

5 under subsections (b)(4) and (c)(4) of section 2042; 

6 and 

7 ‘‘(2) containing such recommendations for legis8 lative or administrative action as the Secretary de9 termines to be appropriate.’’. 

10 (2) OPTION FOR STATE PLAN UNDER PROGRAM

11 FOR TEMPORARY ASSISTANCE FOR NEEDY FAMI12 LIES.— 

13 (A) IN GENERAL.—Section 402(a)(1)(B) of 

14 the Social Security Act (42 U.S.C. 

15 602(a)(1)(B)) is amended by adding at the end 

16 the following new clause: 

17 ‘‘(v) The document shall indicate 

18 whether the State intends to assist individ19 uals to train for, seek, and maintain em20 ployment— 

21 ‘‘(I) providing direct care in a 

22 long-term care facility (as such terms 

23 are defined under section 2011); or 

24 ‘‘(II) in other occupations related 

25 to elder care determined appropriate 


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1 by the State for which the State iden2 tifies an unmet need for service per3 sonnel, 

4 and, if so, shall include an overview of such 

5 assistance.’’. 

6 (B) EFFECTIVE DATE.—The amendment 

7 made by subparagraph (A) shall take effect on 

8 October 1, 2010. 

9 (b) PROTECTING RESIDENTS OF LONG-TERM CARE

10 FACILITIES.— 

11 (1) NATIONAL TRAINING INSTITUTE FOR SUR12 VEYORS.— 

13 (A) IN GENERAL.—The Secretary of 

14 Health and Human Services shall enter into a 

15 contract with an entity for the purpose of estab16 lishing and operating a National Training Insti17 tute for Federal and State surveyors. Such In18 stitute shall provide and improve the training of 

19 surveyors with respect to investigating allega20 tions of abuse, neglect, and misappropriation of 

21 property in programs and long-term care facili22 ties that receive payments under title XVIII or 

23 XIX of the Social Security Act. 

24 (B) ACTIVITIES CARRIED OUT BY THE IN25 STITUTE.—The contract entered into under 


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1 subparagraph (A) shall require the Institute es2 tablished and operated under such contract to 

3 carry out the following activities: 

4 (i) Assess the extent to which State 

5 agencies use specialized surveyors for the 

6 investigation of reported allegations of 

7 abuse, neglect, and misappropriation of 

8 property in such programs and long-term 

9 care facilities. 

10 (ii) Evaluate how the competencies of 

11 surveyors may be improved to more effec12 tively investigate reported allegations of 

13 such abuse, neglect, and misappropriation 

14 of property, and provide feedback to Fed15 eral and State agencies on the evaluations 

16 conducted. 

17 (iii) Provide a national program of 

18 training, tools, and technical assistance to 

19 Federal and State surveyors on inves20 tigating reports of such abuse, neglect, and 

21 misappropriation of property. 

22 (iv) Develop and disseminate informa23 tion on best practices for the investigation 

24 of such abuse, neglect, and misappropria25 tion of property. 


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1 (v) Assess the performance of State 

2 complaint intake systems, in order to en3 sure that the intake of complaints occurs 

4 24 hours per day, 7 days a week (including 

5 holidays). 

6 (vi) To the extent approved by the 

7 Secretary of Health and Human Services, 

8 provide a national 24 hours per day, 7 

9 days a week (including holidays), back-up 

10 system to State complaint intake systems 

11 in order to ensure optimum national re12 sponsiveness to complaints of such abuse, 

13 neglect, and misappropriation of property. 

14 (vii) Analyze and report annually on 

15 the following: 

16 (I) The total number and sources 

17 of complaints of such abuse, neglect, 

18 and misappropriation of property. 

19 (II) The extent to which such 

20 complaints are referred to law en21 forcement agencies. 

22 (III) General results of Federal 

23 and State investigations of such com24 plaints. 


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1 (viii) Conduct a national study of the 

2 cost to State agencies of conducting com3 plaint investigations of skilled nursing fa4 cilities and nursing facilities under sections 

5 1819 and 1919, respectively, of the Social 

6 Security Act (42 U.S.C. 1395i–3, 1396r), 

7 and making recommendations to the Sec8 retary of Health and Human Services with 

9 respect to options to increase the efficiency 

10 and cost-effectiveness of such investiga11 tions. 

12 (C) AUTHORIZATION.—There are author13 ized to be appropriated to carry out this para14 graph, for the period of fiscal years 2010 

15 through 2013, $12,000,000. 

16 (2) GRANTS TO STATE SURVEY AGENCIES.— 

17 (A) IN GENERAL.—The Secretary of 

18 Health and Human Services shall make grants 

19 to State agencies that perform surveys of 

20 skilled nursing facilities or nursing facilities 

21 under sections 1819 or 1919, respectively, of 

22 the Social Security Act (42 U.S.C. 1395i–3, 

23 1395r). 

24 (B) USE OF FUNDS.—A grant awarded 

25 under subparagraph (A) shall be used for the 


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1 purpose of designing and implementing com2 plaint investigations systems that— 

3 (i) promptly prioritize complaints in 

4 order to ensure a rapid response to the 

5 most serious and urgent complaints; 

6 (ii) respond to complaints with opti7 mum effectiveness and timeliness; and 

8 (iii) optimize the collaboration be9 tween local authorities, consumers, and 

10 providers, including— 

11 (I) such State agency; 

12 (II) the State Long-Term Care 

13 Ombudsman; 

14 (III) local law enforcement agen15 cies; 

16 (IV) advocacy and consumer or17 ganizations; 

18 (V) State aging units; 

19 (VI) Area Agencies on Aging; 

20 and 

21 (VII) other appropriate entities. 

22 (C) AUTHORIZATION.—There are author23 ized to be appropriated to carry out this para24 graph, for each of fiscal years 2010 through 

25 2013, $5,000,000. 


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1 (3) REPORTING OF CRIMES AND ENSURING

2 SAFETY OF RESIDENTS WHEN FEDERALLY FUNDED

3 LONG-TERM CARE FACILITIES CLOSE.—Part A of 

4 title XI of the Social Security Act (42 U.S.C. 1301 

5 et seq.) is amended by adding at the end the fol6 lowing new sections: 

7 ‘‘REPORTING TO LAW ENFORCEMENT OF CRIMES OCCUR8 RING IN FEDERALLY FUNDED LONG-TERM CARE FA9 CILITIES

10 ‘‘SEC. 1150A. (a) DETERMINATION AND NOTIFICA11 TION.— 

12 ‘‘(1) DETERMINATION.—The owner or operator 

13 of each long-term care facility that receives Federal 

14 funds under this Act shall annually determine 

15 whether the facility received at least $10,000 in such 

16 Federal funds during the preceding year. 

17 ‘‘(2) NOTIFICATION.—If the owner or operator 

18 determines under paragraph (1) that the facility re19 ceived at least $10,000 in such Federal funds during 

20 the preceding year, such owner or operator shall an21 nually notify each covered individual (as defined in 

22 paragraph (3)) of that individual’s obligation to 

23 comply with the reporting requirements described in 

24 subsection (b). 

25 ‘‘(3) COVERED INDIVIDUAL DEFINED.—In this 

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1 dividual who is an owner, operator, employee, man2 ager, agent, or contractor of a long-term care facility 

3 that is the subject of a determination described in 

4 paragraph (1). 

5 ‘‘(b) REPORTING REQUIREMENTS.— 

6 ‘‘(1) IN GENERAL.—Each covered individual 

7 shall report to the Secretary and 1 or more law en8 forcement entities for the political subdivision in 

9 which the facility is located any reasonable suspicion 

10 of a crime (as defined by the law of the applicable 

11 political subdivision) against any individual who is a 

12 resident of, or is receiving care from, the facility. 

13 ‘‘(2) TIMING.—If the events that cause the sus14 picion— 

15 ‘‘(A) result in serious bodily injury, the in16 dividual shall report the suspicion immediately, 

17 but not later than 2 hours after forming the 

18 suspicion; and 

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

20 the individual shall report the suspicion not 

21 later than 24 hours after forming the suspicion. 

22 ‘‘(c) PENALTIES.— 

23 ‘‘(1) IN GENERAL.—If a covered individual vio24 lates subsection (b)— 


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1 ‘‘(A) the covered individual shall be subject 

2 to a civil money penalty of not more than 

3 $200,000; or 

4 ‘‘(B) the Secretary shall classify the cov5 ered individual as an excluded individual, for a 

6 period of not more than 3 years. 

7 ‘‘(2) INCREASED HARM.—If a covered indi8 vidual violates subsection (b) and the violation exac9 erbates the harm to the victim of the crime or re10 sults in harm to another individual— 

11 ‘‘(A) the covered individual shall be subject 

12 to a civil money penalty of not more than 

13 $300,000; and 

14 ‘‘(B) the Secretary shall classify the cov15 ered individual as an excluded individual, for a 

16 period of not more than 3 years. 

17 ‘‘(3) EXCLUDED INDIVIDUAL.—During any pe18 riod for which a covered individual is classified as an 

19 excluded individual under paragraph (1)(B) or 

20 (2)(B), a long-term care facility that employs such 

21 individual shall be ineligible to receive Federal funds 

22 under this Act. 

23 ‘‘(4) EXTENUATING CIRCUMSTANCES.— 

24 ‘‘(A) IN GENERAL.—The Secretary may 

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1 viders with underserved populations in deter2 mining any penalty to be imposed under this 

3 subsection. 

4 ‘‘(B) UNDERSERVED POPULATION DE5 FINED.—In this paragraph, the term ‘under6 served population’ means the population of an 

7 area designated by the Secretary as an area 

8 with a shortage of elder justice programs or a 

9 population group designated by the Secretary 

10 as having a shortage of such programs. Such 

11 areas or groups designated by the Secretary 

12 may include— 

13 ‘‘(i) areas or groups that are geo14 graphically isolated (such as isolated in a 

15 rural area); 

16 ‘‘(ii) racial and ethnic minority popu17 lations; and 

18 ‘‘(iii) populations underserved because 

19 of special needs (such as language barriers, 

20 disabilities, alien status, or age). 

21 ‘‘(d) ADDITIONAL PENALTIES FOR RETALIATION.— 

22 ‘‘(1) IN GENERAL.—A long-term care facility 

23 may not— 

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1 ment-related benefit to an employee, or in any 

2 other manner discriminate against an employee 

3 in the terms and conditions of employment be4 cause of lawful acts done by the employee; or 

5 ‘‘(B) file a complaint or a report against a 

6 nurse or other employee with the appropriate 

7 State professional disciplinary agency because 

8 of lawful acts done by the nurse or employee, 

9 for making a report, causing a report to be made, 

10 or for taking steps in furtherance of making a report 

11 pursuant to subsection (b)(1). 

12 ‘‘(2) PENALTIES FOR RETALIATION.—If a long13 term care facility violates subparagraph (A) or (B) 

14 of paragraph (1) the facility shall be subject to a 

15 civil money penalty of not more than $200,000 or 

16 the Secretary may classify the entity as an excluded 

17 entity for a period of 2 years pursuant to section 

18 1128(b), or both. 

19 ‘‘(3) REQUIREMENT TO POST NOTICE.—Each 

20 long-term care facility shall post conspicuously in an 

21 appropriate location a sign (in a form specified by 

22 the Secretary) specifying the rights of employees 

23 under this section. Such sign shall include a state24 ment that an employee may file a complaint with the 

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1 lates the provisions of this subsection and informa2 tion with respect to the manner of filing such a com3 plaint. 

4 ‘‘(e) PROCEDURE.—The provisions of section 1128A 

5 (other than subsections (a) and (b) and the second sen6 tence of subsection (f)) shall apply to a civil money penalty 

7 under this section in the same manner as such provisions 

8 apply to a penalty or proceeding under section 1128A(a). 

9 ‘‘(f) DEFINITIONS.—In this section, the terms ‘elder 

10 justice’, ‘long-term care facility’, and ‘law enforcement’ 

11 have the meanings given those terms in section 2011. 

12 ‘‘ENSURING SAFETY OF RESIDENTS WHEN FEDERALLY

13 FUNDED LONG-TERM CARE FACILITIES CLOSE

14 ‘‘SEC. 1150B. (a) IN GENERAL.— 

15 ‘‘(1) NOTIFICATION OF FACILITY CLOSURE.— 

16 Subject to paragraph (2), if the owner or operator 

17 determines under section 1150A(a)(1) that a long18 term care facility received at least $10,000 in Fed19 eral funds under this Act during the preceding year, 

20 the owner or operator of the facility shall— 

21 ‘‘(A) submit to the Secretary and the ap22 propriate State regulatory agency written notifi23 cation of an impending closure not later than 

24 the date that is 60 days prior to the date of 

25 such closure; 


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1 ‘‘(B) include in the notice a plan for the 

2 transfer and adequate relocation of the resi3 dents of the facility prior to closure, including 

4 assurances that the residents will be transferred 

5 to the most appropriate facility in terms of 

6 quality, services, and location; and 

7 ‘‘(C) not later than 10 days after the facil8 ity closure, submit to the Secretary and the ap9 propriate State agency information identifying 

10 where residents of the closed facility were trans11 ferred and on what date. 

12 ‘‘(2) EXCEPTION WHERE THE SECRETARY HAS

13 ISSUED A TERMINATION NOTICE.—In the case of a 

14 long-term care facility described in paragraph (1) for 

15 which the Secretary has issued a termination notice 

16 for the facility to close by not later than 15 days 

17 after the issuance of such notice, the Secretary shall 

18 establish requirements for the notification, transfer, 

19 and adequate relocation of residents within an ap20 propriate timeframe. 

21 ‘‘(b) SANCTIONS.—Any person owning or operating 

22 a long-term care facility that fails to comply with the re23 quirements of subsection (a) shall be subject to— 

24 ‘‘(1) a civil monetary penalty of up to 

25 $1,000,000; 


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1 ‘‘(2) exclusion from participation in the pro2 grams under this Act (in accordance with the proce3 dures of section 1128); and 

4 ‘‘(3) any other applicable civil monetary pen5 alties and assessments. 

6 ‘‘(c) PROCEDURE.—The provisions of section 1128A 

7 (other than subsections (a) and (b) and the second sen8 tence of subsection (f)) shall apply to a civil money penalty 

9 or assessment under this section in the same manner as 

10 such provisions apply to a penalty or proceeding under 

11 section 1128A(a). 

12 ‘‘(d) DEFINITION.—In this section, the term ‘long13 term care facility’ has the meaning given that term in sec14 tion 2011.’’. 

15 (c) NATIONAL NURSE AIDE REGISTRY.— 

16 (1) DEFINITION OF NURSE AIDE.—In this sub17 section, the term ‘‘nurse aide’’ has the meaning 

18 given that term in sections 1819(b)(5)(F) and 

19 1919(b)(5)(F) of the Social Security Act (42 U.S.C. 

20 1395i–3(b)(5)(F), 1396r(b)(5)(F)). 

21 (2) STUDY AND REPORT.— 

22 (A) IN GENERAL.—The Secretary, in con23 sultation with appropriate government agencies 

24 and private sector organizations, shall conduct 


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1 a study on establishing a national nurse aide 

2 registry. 

3 (B) AREAS EVALUATED.—The study con4 ducted under this subsection shall include an 

5 evaluation of— 

6 (i) who should be included in the reg7 istry; 

8 (ii) how such a registry would comply 

9 with Federal and State privacy laws and 

10 regulations; 

11 (iii) how data would be collected for 

12 the registry; 

13 (iv) what entities and individuals 

14 would have access to the data collected; 

15 (v) how the registry would provide ap16 propriate information regarding violations 

17 of Federal and State law by individuals in18 cluded in the registry; 

19 (vi) how the functions of a national 

20 nurse aide registry would be coordinated 

21 with the pilot program for national and 

22 State background checks on direct patient 

23 access employees of long-term care facili24 ties or providers established under section 

25 307 of the Medicare Prescription Drug, 


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1 Improvement, and Modernization Act of 

2 2003 (Public Law 108–173); and 

3 (vii) how the information included in 

4 State nurse aide registries developed and 

5 maintained under sections 1819(e)(2) and 

6 1919(e)(2) of the Social Security Act (42 

7 U.S.C. 1395i–3(e)(2), 1396r(e)(2)(2)) 

8 would be provided as part of a national 

9 nurse aide registry. 

10 (C) CONSIDERATIONS.—In conducting the 

11 study and preparing the report required under 

12 this subsection, the Secretary shall take into 

13 consideration the findings and conclusions of 

14 relevant reports and other relevant resources, 

15 including the following: 

16 (i) The Department of Health and 

17 Human Services Office of Inspector Gen18 eral Report, Nurse Aide Registries: State 

19 Compliance and Practices (February 

20 2005). 

21 (ii) The General Accounting Office 

22 (now known as the Government Account23 ability Office) Report, Nursing Homes: 

24 More Can Be Done to Protect Residents 

25 from Abuse (March 2002). 


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1 (iii) The Department of Health and 

2 Human Services Office of the Inspector 

3 General Report, Nurse Aide Registries: 

4 Long-Term Care Facility Compliance and 

5 Practices (July 2005). 

6 (iv) The Department of Health and 

7 Human Services Health Resources and 

8 Services Administration Report, Nursing 

9 Aides, Home Health Aides, and Related 

10 Health Care Occupations—National and 

11 Local Workforce Shortages and Associated 

12 Data Needs (2004) (in particular with re13 spect to chapter 7 and appendix F). 

14 (v) The 2001 Report to CMS from 

15 the School of Rural Public Health, Texas 

16 A&M University, Preventing Abuse and 

17 Neglect in Nursing Homes: The Role of 

18 Nurse Aide Registries. 

19 (vi) Information included in State 

20 nurse aide registries developed and main21 tained under sections 1819(e)(2) and 

22 1919(e)(2) of the Social Security Act (42 

23 U.S.C. 1395i–3(e)(2), 1396r(e)(2)(2)). 

24 (D) REPORT.—Not later than 18 months 

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1 retary shall submit a report to the Elder Jus2 tice Coordinating Council, the Committee on 

3 Finance of the Senate, and the Committee on 

4 Ways and Means and the Committee on Energy 

5 and Commerce of the House of Representatives 

6 containing the findings and recommendations of 

7 the study conducted under this paragraph. 

8 (E) FUNDING LIMITATION.—Funding for 

9 the study conducted under this subsection shall 

10 not exceed $500,000. 

11 (3) CONGRESSIONAL ACTION.—After receiving 

12 the report submitted by the Secretary under para13 graph (2)(D), the Committee on Finance of the Sen14 ate and the Committee on Ways and Means and the 

15 Committee on Energy and Commerce of the House 

16 of Representatives shall, as they deem appropriate, 

17 take action based on the recommendations contained 

18 in the report. 

19 (4) AUTHORIZATION OF APPROPRIATIONS.— 

20 There are authorized to be appropriated such sums 

21 as are necessary for the purpose of carrying out this 

22 subsection. 

23 (d) CONFORMING AMENDMENTS.— 


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1 (1) TITLE XX.—Title XX of the Social Security 

2 Act (42 U.S.C. 1397 et seq.), as amended by section 

3 102(a), is amended— 

4 (A) in the heading of section 2001, by 

5 striking ‘‘TITLE’’ and inserting ‘‘PART’’; and 

6 (B) in part A, by striking ‘‘this title’’ each 

7 place it appears and inserting ‘‘this part’’. 

8 (2) TITLE IV.—Title IV of the Social Security 

9 Act (42 U.S.C. 601 et seq.) is amended— 

10 (A) in section 404(d)— 

11 (i) in paragraph (1)(A), by striking 

12 ‘‘Title’’ and inserting ‘‘Part A of title’’; 

13 (ii) in paragraphs (2)(A) and (3)(B), 

14 by inserting ‘‘part A of’’ before ‘‘title XX’’ 

15 each place it appears; 

16 (iii) in the heading of paragraph (2), 

17 by inserting ‘‘PART A OF’’ before ‘‘TITLE

18 XX’’; and 

19 (iv) in the heading of paragraph 

20 (3)(B), by inserting ‘‘PART A OF’’ before 

21 ‘‘TITLE XX’’; and 

22 (B) in sections 422(b), 471(a)(4), 

23 472(h)(1), and 473(b)(2), by inserting ‘‘part A 

24 of’’ before ‘‘title XX’’ each place it appears. 


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1 (3) TITLE XI.—Title XI of the Social Security 

2 Act (42 U.S.C. 1301 et seq.) is amended— 

3 (A) in section 1128(h)(3)— 

4 (i) by inserting ‘‘part A of’’ before 

5 ‘‘title XX’’; and 

6 (ii) by striking ‘‘such title’’ and in7 serting ‘‘such part’’; and 

8 (B) in section 1128A(i)(1), by inserting 

9 ‘‘part A of’’ before ‘‘title XX’’. 

10 TITLE II—DEPARTMENT OF 

11 JUSTICE 

12 SEC. 201. ANALYSIS, REPORT, AND RECOMMENDATIONS RE13 LATED TO ELDER JUSTICE PROGRAMS. 

14 (a) IN GENERAL.—The Attorney General, in con15 sultation with the Secretary of Health and Human Serv16 ices, shall carry out the following: 

17 (1) STUDY.—Conduct a study of laws and prac18 tices relating to elder abuse, neglect, and exploi19 tation, which shall include— 

20 (A) a comprehensive description of State 

21 laws and practices relating to elder abuse, ne22 glect, and exploitation; 

23 (B) a comprehensive analysis of the effec24 tiveness of such State laws and practices; and 


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1 (C) an examination of State laws and prac2 tices relating to specific elder abuse, neglect, 

3 and exploitation issues, including— 

4 (i) the definition of— 

5 (I) ‘‘elder’’; 

6 (II) ‘‘abuse’’; 

7 (III) ‘‘neglect’’; 

8 (IV) ‘‘exploitation’’; and 

9 (V) such related terms the Attor10 ney General determines to be appro11 priate; 

12 (ii) mandatory reporting laws, with re13 spect to— 

14 (I) who is a mandated reporter; 

15 (II) to whom must they report 

16 and within what time frame; and 

17 (III) any consequences for not 

18 reporting; 

19 (iii) evidentiary, procedural, sen20 tencing, choice of remedies, and data re21 tention issues relating to pursuing cases 

22 relating to elder abuse, neglect, and exploi23 tation; 


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1 (iv) laws requiring reporting of all 

2 nursing home deaths to the county coroner 

3 or to some other individual or entity; 

4 (v) fiduciary laws, including guardian5 ship and power of attorney laws; 

6 (vi) laws that permit or encourage 

7 banks and bank employees to prevent and 

8 report suspected elder abuse, neglect, and 

9 exploitation; 

10 (vii) laws relating to fraud and related 

11 activities in connection with mail, tele12 marketing, or the Internet; 

13 (viii) laws that may impede research 

14 on elder abuse, neglect, and exploitation; 

15 (ix) practices relating to the enforce16 ment of laws relating to elder abuse, ne17 glect, and exploitation; and 

18 (x) practices relating to other aspects 

19 of elder justice. 

20 (2) DEVELOPMENT OF PLAN.—Develop objec21 tives, priorities, policies, and a long-term plan for 

22 elder justice programs and activities relating to— 

23 (A) prevention and detection of elder 

24 abuse, neglect, and exploitation; 


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1 (B) intervention and treatment for victims 

2 of elder abuse, neglect, and exploitation; 

3 (C) training, evaluation, and research re4 lated to elder justice programs and activities; 

5 and 

6 (D) improvement of the elder justice sys7 tem in the United States. 

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

9 date of enactment of this Act, submit to the Chair10 man and Ranking Member of the Special Committee 

11 on Aging of the Senate, the Speaker and minority 

12 leader of the House of Representatives, and the Sec13 retary of Health and Human Services, and make 

14 available to the States, a report that contains— 

15 (A) the findings of the study conducted 

16 under paragraph (1); 

17 (B) a description of the objectives, prior18 ities, policies, and a long-term plan developed 

19 under paragraph (2); and 

20 (C) a list, description, and analysis of the 

21 best practices used by States to develop, imple22 ment, maintain, and improve elder justice sys23 tems, based on such findings. 

24 (b) GAO RECOMMENDATIONS.—Not later than 18 

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1 troller General shall review existing Federal programs and 

2 initiatives in the Federal criminal justice system relevant 

3 to elder justice and shall submit to Congress— 

4 (1) a report on such programs and initiatives; 

5 and 

6 (2) any recommendations the Comptroller Gen7 eral determines are appropriate to improve elder jus8 tice in the United States. 

9 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

10 are authorized to be appropriated to carry out this section 

11 $6,000,000 for each of the fiscal years 2010 through 

12 2016. 

13 SEC. 202. VICTIM ADVOCACY GRANTS. 

14 (a) GRANTS AUTHORIZED.—The Attorney General, 

15 after consultation with the Secretary of Health and 

16 Human Services, may award grants to eligible entities to 

17 study the special needs of victims of elder abuse, neglect, 

18 and exploitation. 

19 (b) AUTHORIZED ACTIVITIES.—Funds awarded pur20 suant to subsection (a) shall be used for pilot programs 

21 that— 

22 (1) develop programs for and provide training 

23 to health care, social, and protective services pro24 viders, law enforcement, fiduciaries (including 


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1 guardians), judges and court personnel, and victim 

2 advocates; and 

3 (2) examine special approaches designed to 

4 meet the needs of victims of elder abuse, neglect, 

5 and exploitation. 

6 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

7 are authorized to be appropriated to carry out this section 

8 $3,000,000 for each of the fiscal years 2010 through 

9 2016. 

10 SEC. 203. SUPPORTING LOCAL PROSECUTORS AND COURTS 

11 IN ELDER JUSTICE MATTERS. 

12 (a) GRANTS AUTHORIZED.—The Attorney General, 

13 after consultation with the Secretary of Health and 

14 Human Services, shall award grants to provide training, 

15 technical assistance, policy development, multidisciplinary 

16 coordination, and other types of support to local prosecu17 tors and courts handling elder justice-related cases, in18 cluding— 

19 (1) funding specially designated elder justice 

20 positions or units; and 

21 (2) funding the creation of a Center for the 

22 Prosecution of Elder Abuse, Neglect, and Exploi23 tation by the American Prosecutor Research Insti24 tute of the National District Attorneys Association, 

25 or any other similarly situated entity, to advise and 


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1 support local prosecutors and courts nationwide in 

2 their pursuit of cases involving elder abuse, neglect, 

3 and exploitation. 

4 (b) AUTHORIZATION OF APPROPRIATIONS.—There 

5 are authorized to be appropriated to carry out this section 

6 $6,000,000 for each of the fiscal years 2010 through 

7 2016. 

8 SEC. 204. SUPPORTING STATE PROSECUTORS AND COURTS 

9 IN ELDER JUSTICE MATTERS. 

10 (a) IN GENERAL.—The Attorney General shall, after 

11 consultation with the Secretary of Health and Human 

12 Services, award grants to provide training, technical as13 sistance, multidisciplinary coordination, policy develop14 ment, and other types of support to State prosecutors and 

15 courts, employees of State Attorneys General, and Med16 icaid Fraud Control Units handling elder justice-related 

17 matters. 

18 (b) CREATING SPECIALIZED POSITIONS.—Grants 

19 under this section may be made for— 

20 (1) the establishment of specially designated 

21 elder justice positions or units; and 

22 (2) the creation of a position to coordinate elder 

23 justice-related cases, training, technical assistance, 

24 and policy development for State prosecutors and 


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1 courts, by the National Association of Attorneys 

2 General or any other similarly situated entity. 

3 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

4 are authorized to be appropriated to carry out this section 

5 $6,000,000 for each of the fiscal years 2010 through 

6 2016. 

7 SEC. 205. SUPPORTING LAW ENFORCEMENT IN ELDER JUS8 TICE MATTERS. 

9 (a) IN GENERAL.—The Attorney General shall, after 

10 consultation with the Secretary of Health and Human 

11 Services, the Postmaster General, and the Chief Postal In12 spector for the United States Postal Inspection Service, 

13 award grants to provide training, technical assistance, 

14 multidisciplinary coordination, policy development, and 

15 other types of support to police, sheriffs, detectives, public 

16 safety officers, corrections personnel, and other front line 

17 law enforcement responders who handle elder justice-re18 lated matters, to fund specially designated elder justice po19 sitions or units designed to support front line law enforce20 ment in elder justice matters. 

21 (b) AUTHORIZATION OF APPROPRIATIONS.—There 

22 are authorized to be appropriated to carry out this section 

23 $8,000,000 for each of the fiscal years 2010 through 

24 2016. 


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1 SEC. 206. EVALUATIONS. 

2 (a) GRANTS UNDER THIS TITLE.— 

3 (1) IN GENERAL.—In carrying out the grant 

4 programs under this title, the Attorney General 

5 shall— 

6 (A) require each recipient of a grant to use 

7 a portion of the funds made available through 

8 the grant to conduct a validated evaluation of 

9 the effectiveness of the activities carried out 

10 through the grant by such recipient; or 

11 (B) as the Attorney General considers ap12 propriate, use a portion of the funds available 

13 under this title for a grant program under this 

14 title to provide assistance to an eligible entity to 

15 conduct a validated evaluation of the effective16 ness of the activities carried out through such 

17 grant program by each of the grant recipients. 

18 (2) APPLICATIONS.— 

19 (A) SUBMISSION.—To be eligible to receive 

20 a grant under this title, an entity shall submit 

21 an application to the Attorney General at such 

22 time, in such manner, and containing such in23 formation as the Attorney General may require, 

24 which shall include— 


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1 (i) a proposal for the evaluation re2 quired in accordance with paragraph 

3 (1)(A); and 

4 (ii) the amount of assistance under 

5 paragraph (1)(B) the entity is requesting, 

6 if any. 

7 (B) REVIEW AND ASSISTANCE.— 

8 (i) IN GENERAL.—An employee of the 

9 Department of Justice, after consultation 

10 with an employee of the Department of 

11 Health and Human Services and a non12 governmental member of the Advisory 

13 Board of Elder Abuse, Neglect, and Ex14 ploitation (established under title XX of 

15 the Social Security Act (42 U.S.C. 1397 et 

16 seq.), as amended by this Act) with exper17 tise in evaluation methodology, shall review 

18 each application described in subparagraph 

19 (A) and determine whether the method20 ology described in the proposal under sub21 paragraph (A)(i) is adequate to gather 

22 meaningful information. 

23 (ii) DENIAL.—If the reviewing em24 ployee determines the methodology de25 scribed in such proposal is inadequate, the 


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1 reviewing employee shall recommend that 

2 the Attorney General deny the application 

3 for the grant, or make recommendations 

4 for how the application should be amended. 

5 (iii) NOTICE TO APPLICANT.—If the 

6 Attorney General denies the application on 

7 the basis of such proposal, the Attorney 

8 General shall inform the applicant of the 

9 reasons the application was denied, and 

10 offer assistance to the applicant in modi11 fying the proposal. 

12 (b) OTHER GRANTS.—The Attorney General shall 

13 make grants to appropriate entities to conduct validated 

14 evaluations of grant activities to reduce elder abuse, ne15 glect, and exploitation that are funded by Federal funds 

16 not provided under this title. 

17 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

18 are authorized to be appropriated to carry out this section 

19 $7,000,000 for each of the fiscal years 2010 through 

20 2016. 


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1 SEC. 207. REAUTHORIZATION OF THE MISSING ALZ2 HEIMER’S DISEASE PATIENT ALERT PRO3 GRAM. 

4 Section 240001 of the Violent Crime Control and 

5 Law Enforcement Act of 1994 (42 U.S.C. 14181) is 

6 amended— 

7 (1) by amending subsection (a) to read as fol8 lows: 

9 ‘‘(a) GRANT.—Subject to the availability of appro10 priations to carry out this section, the Attorney General, 

11 through the Bureau of Justice Assistance and in consulta12 tion with the Secretary of Health and Human Services, 

13 shall award competitive grants to States, units of local 

14 government, and nonprofit organizations to assist such 

15 States, units, and organizations, respectively, in paying for 

16 the costs of planning, designing, establishing, and oper17 ating locally based, proactive programs to protect and lo18 cate missing patients with Alzheimer’s disease and related 

19 dementias and other missing elderly individuals.’’; 

20 (2) in subsection (b)— 

21 (A) by inserting ‘‘competitive’’ after ‘‘to re22 ceive a’’; and 

23 (B) by adding at the end the following new 

24 sentence: ‘‘The Attorney General shall periodi25 cally solicit applications for grants under this 

26 section by publishing a request for applications 


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1 in the Federal Register and by posting such a 

2 request on the website of the Department of 

3 Justice.’’; 

4 (3) by amending subsection (c) to read as fol5 lows: 

6 ‘‘(c) PREFERENCE.—In awarding grants under sub7 section (a), the Attorney General shall give preference to 

8 nonprofit organizations that have a direct link to patients, 

9 and families of patients, with Alzheimer’s disease and re10 lated dementias.’’; and 

11 (4) by amending subsection (d) to read as fol12 lows: 

13 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated to carry out this section 

15 $5,000,000 for each of the fiscal years 2010 through 

16 2016.’’. 

17 TITLE III—TAX PROVISIONS 

18 SEC. 301. LONG-TERM CARE FACILITY WORKER EMPLOY19 MENT TAX CREDIT. 

20 (a) WORK OPPORTUNITY TAX CREDIT.— 

21 (1) IN GENERAL.—Section 51(d)(1) of the In22 ternal Revenue Code of 1986 (relating to members 

23 of targeted groups) is amended by striking ‘‘or’’ at 

24 the end of subparagraph (H), by striking the period 


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1 at the end of subparagraph (I) and inserting ‘‘or’’, 

2 and by adding at the end the following: 

3 ‘‘(J) a qualified long-term care facility 

4 worker.’’. 

5 (2) QUALIFIED LONG-TERM CARE FACILITY

6 WORKER.—Section 51(d) of such Code is amended 

7 by redesignating paragraphs (11) through (14) as 

8 paragraphs (12) through (15), respectively, and by 

9 inserting after paragraph (10) the following: 

10 ‘‘(11) QUALIFIED LONG-TERM CARE FACILITY

11 WORKER.—The term ‘qualified long-term care facil12 ity worker’ means any individual who— 

13 ‘‘(A) is hired by a long-term care facility 

14 (as defined in paragraph (18) of section 2201 

15 of the Social Security Act); and 

16 ‘‘(B) is certified by the designated local 

17 agency as being qualified to provide long-term 

18 care (as defined in paragraph (17) of such sec19 tion 2201).’’. 

20 (b) EFFECTIVE DATE.—The amendments made by 

21 subsection (a) shall apply to individuals who begin work 

22 for an employer after the date of the enactment of this 

23 Act. 

Æ 


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