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[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 1750 Introduced in Senate (IS)]

112th CONGRESS
  1st Session
                                S. 1750

   To amend the Older Americans Act of 1965 to establish a Home Care 
    Consumer Bill of Rights, to establish State Home Care Ombudsman 
                   Programs, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            October 20, 2011

Mr. Franken (for himself, Mr. Casey, and Mr. Whitehouse) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL

 
   To amend the Older Americans Act of 1965 to establish a Home Care 
    Consumer Bill of Rights, to establish State Home Care Ombudsman 
                   Programs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Home Care Consumer Bill of Rights 
Act''.

                   TITLE I--HOME CARE BILL OF RIGHTS

SEC. 101. ADMINISTRATION ON AGING.

    Section 201(e)(2) of the Older Americans Act of 1965 (42 U.S.C. 
3011(e)(2)) is amended--
            (1) in subparagraph (A), by striking ``and'' at the end;
            (2) in subparagraph (B), by striking the period and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(C) to establish best practices for State-based 
        enforcement of a Home Care Consumer Bill of Rights through a 
        Plan for Enforcement, as such Bill and Plan are outlined in 
        section 705, not later than 6 months after the date of 
        enactment of the Home Care Consumer Bill of Rights Act, and to 
        make those best practices available to States, and to the 
        public through the National Center on Elder Abuse;
            ``(D) to assist States with the development of Home Care 
        Consumer Bills of Rights and Plans for Enforcement, to support 
        the shift from institutional care to home and community-based 
        long-term services and supports and ensure that home care 
        consumers, as defined in section 736, have basic protections as 
        outlined in subsections (b) and (c) of section 705;
            ``(E) to develop a process for review and approval of 
        States' Home Care Consumer Bills of Rights and Plans for 
        Enforcement, not later than 6 months after the date of 
        enactment of the Home Care Consumer Bill of Rights Act; and
            ``(F) to review and approve States' Home Care Consumer 
        Bills of Rights and Plans for Enforcement through that 
        process.''.

SEC. 102. ADDITIONAL STATE PLAN REQUIREMENTS.

    (a) In General.--Section 705 of the Older Americans Act of 1965 (42 
U.S.C. 3058d) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (6), by striking ``and'' at the 
                end;
                    (B) in paragraph (7), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following:
            ``(8) subject to section 102(b) of the Home Care Consumer 
        Bill of Rights Act, an assurance--
                    ``(A) that the State has a Home Care Consumer Bill 
                of Rights and a Plan for Enforcement of such a Bill, 
                developed in accordance with the procedures described 
                under paragraph (2) and as approved by the Assistant 
                Secretary, and include a copy of the Bill and Plan; or
                    ``(B) at the discretion of the Assistant Secretary, 
                in the event the State does not have an approved Home 
                Care Consumer Bill of Rights and Plan for Enforcement, 
                that the State has an alternative such as a proposal 
                for developing and submitting for approval a Home Care 
                Consumer Bill of Rights and Plan for Enforcement.'';
            (2) by redesignating subsection (b) as subsection (d);
            (3) by inserting after subsection (a) the following:
    ``(b) Home Care Consumer Bill of Rights.--The Home Care Consumer 
Bill of Rights referred to in subsection (a)(8) shall, at a minimum--
            ``(1) address a home care consumer's right to basic safety 
        by--
                    ``(A) affirming that home care consumers are 
                protected from physical, sexual, mental, and verbal 
                abuse, neglect, and exploitation, including financial 
                exploitation;
                    ``(B) affirming that home care consumers are served 
                by providers who are properly trained and are providing 
                home care services within their scope of practice and 
                the scope of their certification or licensure (if such 
                a certification or licensure is required by the 
                applicable State);
                    ``(C) affirming that such providers maintain the 
                confidentiality of all personal, financial, and medical 
                information of home care consumers; and
                    ``(D) affirming that providers respect the personal 
                property of home care consumers, and in the event of 
                consumer reports of theft or loss, investigate and 
                report back to the consumer the results of the 
                investigation;
            ``(2) address a home care consumer's right to access 
        information by--
                    ``(A) affirming that home care consumers are 
                informed of their rights under this subsection and 
                subsection (c) within 2 weeks after the start of home 
                care services, and about the entities the consumers may 
                contact if their rights are violated, including the 
                name and contact information for State and local 
                agencies responsible for enforcing the Home Care 
                Consumer Bill of Rights;
                    ``(B) affirming that home care consumers--
                            ``(i) are informed of the cost of home care 
                        services prior to receiving those services, 
                        whether the cost of those services are covered 
                        under health insurance, long-term care 
                        insurance, or other private and public 
                        programs, and any charges the consumer will be 
                        expected to pay; and
                            ``(ii) are given advance notice of any 
                        changes to those costs or services; and
                    ``(C) affirming that home care consumers have 
                access to information about the availability of the 
                home care services provided in the community involved 
                and have the ability to choose among home care services 
                and providers of home care services available in the 
                community;
            ``(3) address a home care consumer's right to choice, 
        participation, and self-determination by--
                    ``(A) affirming that home care consumers can 
                participate in the planning of their home care 
                services, including making choices about aspects of 
                their care and services that are important to them, 
                choosing providers and schedules to the extent 
                practicable, receiving reasonable accommodation of 
                their needs and preferences, and involving anyone they 
                chose to participate with them in that planning;
                    ``(B) affirming that home care consumers are 
                provided with sufficient information to make informed 
                decisions, are fully informed in advance about any 
                proposed changes in care and services, and are involved 
                in the decisionmaking process regarding those changes; 
                and
                    ``(C) affirming that home care consumers can refuse 
                services and receive an explanation of the consequences 
                of doing so;
            ``(4) address a home care consumer's right to receive care 
        and services provided in a way that promotes each consumer's 
        dignity and individuality;
            ``(5) address a home care consumer's right to redress 
        grievances by--
                    ``(A) affirming that home care consumers are able 
                to voice grievances about the quality of their home 
                care services, the number of hours of service, and 
                violations of their rights, receive prompt responses to 
                those concerns, and are informed about the entities the 
                consumers may contact to state those grievances in 
                order to have the grievances addressed in an 
                appropriate and timely manner, and without retaliation; 
                and
                    ``(B) affirming that home care consumers are able 
                to assert their rights under this subsection and 
                subsection (c) without retaliation;
            ``(6) address the role and responsibilities that 
        fiduciaries may have in securing the rights of home care 
        consumers affirmed under the Home Care Consumer Bill of Rights; 
        and
            ``(7) meet any other guidelines determined to be 
        appropriate by the Assistant Secretary.
    ``(c) Plan for Enforcement.--In developing the Plan for Enforcement 
referred to in subsection (a)(8), the State shall take into account the 
best practices established under section 201(e)(2)(C). The Plan shall 
include a description of how State entities with a role in protecting 
older individuals, such as home care services licensing agencies, adult 
protective services agencies, the Office of the State Long-Term Care 
Ombudsman (if the office has jurisdiction over home and community-based 
long-term care), local law enforcement agencies, and other entities 
determined to be appropriate by the Assistant Secretary, will 
coordinate activities to enforce the Home Care Consumer Bill of 
Rights.''; and
            (4) by adding at the end the following:
    ``(e) Definition.--In this section, the term `home care consumer' 
and `home care services' have the meanings given the terms in section 
736.''.
    (b) Application of Requirement To Submit State Home Care Consumer 
Bill of Rights and Plan for Enforcement.--
            (1) In general.--The requirement for a State to provide an 
        assurance, and either a Home Care Consumer Bill of Rights and a 
        Plan for Enforcement of such Bill or an alternative, under 
        paragraph (8) of section 705(a) of the Older Americans Act of 
        1965 (as added by subsection (a)) shall apply to States 
        beginning on the date (referred to in this subsection as the 
        ``application date'') that is 1 year after the date of the 
        establishment of best practices under section 201(e)(2)(C) of 
        such Act (as added by section 101).
            (2) First submission after application date.--A State shall 
        comply with paragraph (8) of section 705(a) of the Older 
        Americans Act of 1965 (as added by subsection (a)) in whichever 
        of the following 2 submissions occurs first with respect to 
        such State after the application date described under paragraph 
        (1):
                    (A) The submission of a new State plan under 
                section 307 of the Older Americans Act of 1965 (42 
                U.S.C. 3027).
                    (B) The submission of an annual revision to a State 
                plan submitted under such section 307.
            (3) Ongoing submissions.--After complying with paragraph 
        (8) of section 705(a) of the Older Americans Act of 1965 (as 
        added by subsection (a)) in a submission in accordance with 
        paragraph (2) of this subsection, a State shall comply with 
        such paragraph (8) in each new State plan submitted under 
        section 307 of the Older Americans Act of 1965 (42 U.S.C. 
        3027).

SEC. 103. PREVENTION OF ELDER ABUSE, NEGLECT, AND EXPLOITATION.

    Section 721(b) of the Older Americans Act of 1965 (42 U.S.C. 
3058i(b)) is amended--
            (1) in paragraph (11), by striking ``and'' at the end;
            (2) in paragraph (12), by striking the period and inserting 
        ``; and''; and
            (3) by adding at the end the following:
            ``(13) developing a State Home Care Consumer Bill of Rights 
        and Plan for Enforcement (as described in section 705) to 
        protect home care consumers (as defined in section 736) from 
        abuse, neglect, and exploitation.''.

SEC. 104. NATIONAL ADULT PROTECTIVE SERVICES RESOURCE CENTER.

    Section 201 of the Older Americans Act of 1965 (42 U.S.C. 3011) is 
amended by adding at the end the following:
    ``(g)(1) The Assistant Secretary shall, by grant or contract with a 
national nonprofit entity, establish a National Adult Protective 
Services Resource Center (referred to in this subsection as the 
`Center'). The purposes of the Center are to improve the capacity of 
State and local adult protective services programs to respond 
effectively to abuse, neglect, and exploitation of vulnerable adults, 
including home care consumers and residents of long-term care 
facilities, and to coordinate with the Home Care Ombudsman Program and 
Long-Term Care Ombudsman Program to protect home care consumers and 
residents most effectively.
    ``(2) The nonprofit entity awarded a grant or contract under this 
subsection shall have expertise in, and representation by, State and 
local adult protective services programs.
    ``(3) The Center shall--
            ``(A) collect and disseminate information regarding, and 
        increase public awareness of, the role of adult protective 
        services programs in investigating the abuse, neglect 
        (including self-neglect), and exploitation of vulnerable 
        adults, including home care consumers and residents of long-
        term care facilities, and in intervening to protect the 
        consumers and residents from abuse;
            ``(B) develop, distribute, and provide training and 
        technical assistance for adult protective services program 
        investigators and supervisors investigating the abuse, neglect 
        (including self-neglect), and exploitation of vulnerable 
        adults, including home care consumers and residents of long-
        term care facilities, and intervening to protect the consumers 
        and residents from further abuse;
            ``(C) develop, distribute, and provide training to home 
        care and long-term care professionals and others on 
        recognizing, reporting (including regarding mandatory reporting 
        requirements), and responding to the abuse, neglect (including 
        self-neglect), and financial exploitation of vulnerable adults, 
        including home care consumers and residents of long-term care 
        facilities;
            ``(D) compile and disseminate reports on research and best 
        practices for adult protective services programs and other 
        programs on effective responses to the abuse, neglect 
        (including self-neglect), and exploitation of vulnerable 
        adults, including home care consumers and residents of long-
        term care facilities;
            ``(E) work with the National Ombudsman Resource Center and 
        State and local home care ombudsman programs and long-term care 
        ombudsman programs to develop and disseminate training, 
        practice standards, and policies regarding--
                    ``(i) the roles and responsibilities of adult 
                protective services and ombudsman programs;
                    ``(ii) confidentiality and abuse reporting issues 
                and protocols; and
                    ``(iii) effective ways to maximize the resources of 
                adult protective services programs for the benefit of 
                home care consumers and residents of long-term care 
                facilities; and
            ``(F) establish a data system to collect information on the 
        abuse, neglect (including self-neglect), and exploitation of 
        home care consumers and residents of long-term care facilities 
        and to measure the effectiveness of the activities carried out 
        by the Center.
    ``(4) In this subsection, the terms `home care consumer' and `home 
care ombudsman program' have the meanings given the terms in section 
736.''.

              TITLE II--STATE HOME CARE OMBUDSMAN PROGRAMS

SEC. 201. PROGRAM.

    Section 701 of the Older Americans Act of 1965 (42 U.S.C. 3058) is 
amended by inserting ``and grants'' after ``allotments''.

SEC. 202. AUTHORIZATION OF APPROPRIATIONS.

    Chapter 1 of subtitle A of title VII of the Older Americans Act of 
1965 is amended by inserting after section 702 (42 U.S.C. 3058a) the 
following:

``SEC. 702A. AUTHORIZATION OF APPROPRIATIONS FOR STATE HOME CARE 
              OMBUDSMAN PROGRAM.

    ``There are authorized to be appropriated to carry out chapter 5 
such sums as may be necessary for fiscal year 2012 and each subsequent 
fiscal year.''.

SEC. 203. GRANTS.

    Section 703 of the Older Americans Act of 1965 (42 U.S.C. 3058b) is 
amended by adding at the end the following:
    ``(d) Grants for State Home Care Ombudsman Programs.--
            ``(1) In general.--The Assistant Secretary shall use funds 
        made available under section 702A to award grants, on a 
        competitive basis, to States for State Home Care Ombudsman 
        Programs.
            ``(2) Considerations.--In selecting States to receive the 
        grants, the Assistant Secretary shall consider--
                    ``(A) a State's current financial support (as of 
                the date of consideration) for home care ombudsman 
                services;
                    ``(B) a State's commitment to preventing conflict 
                of interest between providers of home care services and 
                providers of home care ombudsman services; and
                    ``(C) other criteria determined by the Assistant 
                Secretary.
            ``(3) Priorities.--In selecting States to receive the 
        grants, the Assistant Secretary may give first priority to 
        States that are providing home care ombudsman services to home 
        care consumers on the date of enactment of section 737, and 
        seek to enhance the home care ombudsman programs through which 
        the States provide the services.''.

SEC. 204. ELIGIBILITY.

    (a) Organization.--Section 704 of the Older Americans Act of 1965 
(42 U.S.C. 3058c) is amended, in the matter preceding paragraph (1), by 
inserting ``or grants'' after ``allotments''.
    (b) Additional Requirements.--Section 705(a) of the Older Americans 
Act of 1965 (42 U.S.C. 3058d(a)) is amended--
            (1) in the matter preceding paragraph (1), by inserting 
        ``or grant'' after ``allotment''; and
            (2) in paragraph (4), by striking ``enactment of this 
        subtitle'' and inserting ``enactment of the chapter''.

SEC. 205. STATE HOME CARE OMBUDSMAN PROGRAMS.

    Subtitle A of title VII of the Older Americans Act of 1965 (42 
U.S.C. 3058 et seq.) is amended by adding at the end the following:

            ``CHAPTER 5--STATE HOME CARE OMBUDSMAN PROGRAMS

``SEC. 736. DEFINITIONS.

    ``In this chapter:
            ``(1) Home care consumer.--The term `home care consumer' 
        means a person who receives services in the person's home or 
        community to promote independence and reduce the necessity for 
        residence in a long-term care facility, which may include--
                    ``(A) home care services provided through this Act, 
                the Medicare program under title XVIII of the Social 
                Security Act (42 U.S.C. 1395 et seq.), the Medicaid 
                program under title XIX of the Social Security Act (42 
                U.S.C. 1396 et seq.), or another public or private 
                funding source; or
                    ``(B) home care services determined to be 
                appropriate by a State operating a State Home Care 
                Ombudsman Program.
            ``(2) Home care ombudsman program.--The term `home care 
        ombudsman program' means a State Home Care Ombudsman Program 
        described in section 737(a)(1).
            ``(3) Home care ombudsman representative.--The term `home 
        care ombudsman representative' includes an employee or 
        volunteer who represents an entity designated under section 
        737(a)(5)(A) and who is individually designated by the 
        Ombudsman.
            ``(4) Home care services.--The term `home care services' 
        means home and community-based services to promote independence 
        and reduce the necessity for residence in a long-term care 
        facility, including personal care services designed to assist 
        an individual in the activities of daily living such as 
        bathing, exercising, personal grooming, and getting in and out 
        of bed.
            ``(5) Local home care ombudsman entity.--The term `local 
        home care Ombudsman entity' means an entity designated under 
        section 737(a)(5)(A) to carry out the duties described in 
        section 737(a)(5)(B) with respect to a planning and service 
        area or other substate area.
            ``(6) Office; ombudsman.--The terms `Office' and 
        `Ombudsman', used without further modification, have the 
        meanings given the terms in section 711.

``SEC. 737. PROGRAM.

    ``(a) Establishment.--
            ``(1) In general.--In order to be eligible to receive a 
        grant under section 703(d) from funds appropriated under 
        section 702A and made available to carry out this chapter, a 
        State agency shall, in accordance with this section, agree to 
        carry out a State Home Care Ombudsman Program within the Office 
        of the State Long-Term Care Ombudsman.
            ``(2) Home care ombudsman program.--The home care ombudsman 
        program shall be carried out by the Ombudsman.
            ``(3) Functions.--In carrying out the home care ombudsman 
        program, the Ombudsman, personally or through representatives 
        of the home care ombudsman program--
                    ``(A) shall identify, investigate, and resolve 
                complaints that--
                            ``(i) are made by, or on behalf of, home 
                        care consumers;
                            ``(ii) relate to action, inaction, or 
                        decisions, that may adversely affect the 
                        health, safety, welfare, or rights of home care 
                        consumers (including the welfare and rights of 
                        home care consumers with respect to the 
                        appointment and activities of guardians and 
                        representative payees), of--
                                    ``(I) entities responsible for 
                                determining eligibility for home care 
                                services, such as State and local 
                                governments; and
                                    ``(II) entities responsible for 
                                determining availability of home care 
                                services, such as managed care 
                                organizations; or
                            ``(iii) relate to action, inaction, or 
                        decisions, regarding informing home care 
                        consumers about their eligibility for, or the 
                        availability of, home care services, of--
                                    ``(I) providers, or representatives 
                                of providers, of home care services;
                                    ``(II) public agencies;
                                    ``(III) health and social service 
                                agencies; and
                                    ``(IV) entities providing consumer-
                                directed services under a consumer-
                                directed program;
                    ``(B) shall provide services to protect the health, 
                safety, welfare, and rights of home care consumers;
                    ``(C) shall inform home care consumers about means 
                of obtaining services provided by providers or agencies 
                described in subparagraph (A)(ii) or services described 
                in subparagraph (B);
                    ``(D) shall, in conjunction with other entities, 
                such as area agencies on aging, conduct public 
                education about the home care ombudsman program and its 
                services, including the rights of home care workers to 
                report concerns to the ombudsman in order to protect 
                the health, safety, welfare, and rights of home care 
                consumers;
                    ``(E) shall ensure that home care consumers and 
                complainants receive timely responses from 
                representatives of the home care ombudsman program to 
                complaints;
                    ``(F) shall represent the interests of home care 
                consumers before governmental agencies and seek 
                administrative, legal, and other remedies to protect 
                the health, safety, welfare, and rights of the home 
                care consumers, including issues related to the 
                sufficiency of the home care workforce and its 
                availability to meet the needs of home care consumers;
                    ``(G) shall provide administrative and technical 
                assistance to entities designated under paragraph (5) 
                to assist the entities in participating in the home 
                care ombudsman program;
                    ``(H) shall provide for training representatives of 
                the home care ombudsman program;
                    ``(I) shall--
                            ``(i) promote the development of citizen 
                        organizations, to participate in the home care 
                        ombudsman program;
                            ``(ii) analyze, comment on, and monitor the 
                        development and implementation of Federal, 
                        State, and local laws, regulations, and other 
                        governmental policies and actions, that pertain 
                        to the health, safety, welfare, and rights of 
                        home care consumers, with respect to the 
                        adequacy of home care services in the State, 
                        including issues related to the sufficiency of 
                        the home care workforce and its availability to 
                        meet the needs of home care consumers;
                            ``(iii) recommend any changes in such laws, 
                        regulations, policies, and actions as the 
                        Ombudsman determines to be appropriate; and
                            ``(iv) facilitate public comment on the 
                        laws, regulations, policies, and actions; and
                    ``(J) shall carry out other activities as the 
                Assistant Secretary determines to be appropriate.
            ``(4) Contracts and arrangements.--
                    ``(A) In general.--
                            ``(i) Agencies and organizations.--Except 
                        as provided in subparagraph (B), the State 
                        agency shall carry out the home care ombudsman 
                        program, directly, or by contract or other 
                        arrangement with any public agency or nonprofit 
                        private organization.
                            ``(ii) Area agencies on aging.--The State 
                        agency shall determine whether to enter into 
                        contracts or arrangements with area agencies on 
                        aging to carry out the home care ombudsman 
                        program, based on the structure of the State's 
                        existing (as of the date of the determination) 
                        long-term care ombudsman program and the 
                        potential for conflicts of interest in the home 
                        and community-based services system in the 
                        State. A State agency may carry out a home care 
                        ombudsman program through area agencies on 
                        aging in the State, if the area agencies on 
                        aging--
                                    ``(I) have existing (as of the date 
                                of the determination) consumer 
                                protection systems in place to prevent 
                                such conflicts of interest; or
                                    ``(II) establish adequate 
                                procedures to prevent conflicts of 
                                interest under the program.
                    ``(B) Licensing and certification organizations; 
                associations.--The State agency may not enter into the 
                contract or other arrangement described in subparagraph 
                (A) with--
                            ``(i) an agency or organization that is 
                        responsible for licensing or certifying home 
                        care services in the State; or
                            ``(ii) an association (or an affiliate of 
                        such an association) of providers of home care 
                        services.
            ``(5) Designation of local home care ombudsman entities and 
        home care ombudsman representatives.--
                    ``(A) Designation.--In carrying out the duties of 
                the Office, the Ombudsman may designate an entity as a 
                local home care Ombudsman entity (and, in doing so, the 
                Ombudsman shall, if a local Ombudsman entity has 
                already been designated, designate such local Ombudsman 
                entity as the local home care Ombudsman entity), and 
                may designate an employee or volunteer to represent the 
                entity.
                    ``(B) Duties.--An individual so designated, in 
                accordance with the policies and procedures established 
                by the Ombudsman and the State agency--
                            ``(i) shall provide services to protect the 
                        health, safety, welfare, and rights of home 
                        care consumers;
                            ``(ii) shall ensure that home care 
                        consumers in the service area of the entity 
                        have timely responses to complaints and 
                        requests for assistance;
                            ``(iii) shall identify, investigate, and 
                        resolve complaints made by or on behalf of home 
                        care consumers that relate to action, inaction, 
                        or decisions, that may adversely affect the 
                        health, safety, welfare, or rights of home care 
                        consumers;
                            ``(iv) shall represent the interests of 
                        home care consumers before government agencies 
                        and seek administrative, legal, and other 
                        remedies to protect the health, safety, 
                        welfare, and rights of home care consumers;
                            ``(v) shall--
                                    ``(I) review, and if necessary, 
                                comment on any existing and proposed 
                                laws, regulations, and other government 
                                policies and actions, that pertain to 
                                the rights and well-being of home care 
                                consumers; and
                                    ``(II) facilitate the ability of 
                                the public to comment on the laws, 
                                regulations, policies, and actions; and
                            ``(vi) shall make referrals for services to 
                        protect and provide for the health, safety, 
                        educational needs, welfare, and rights of 
                        family or household members (including 
                        children) of home care consumers; and
                            ``(vii) shall carry out other activities 
                        that the Ombudsman determines to be 
                        appropriate.
                    ``(C) Eligibility for designation.--Entities 
                eligible to be designated as local home care Ombudsman 
                entities, and individuals eligible to be designated as 
                home care ombudsman representatives of such entities, 
                shall--
                            ``(i) have demonstrated capability to carry 
                        out the duties established in section 
                        712(a)(5)(B);
                            ``(ii) be free of conflicts of interest and 
                        not stand to gain financially through an action 
                        or potential action brought on behalf of 
                        individuals the Ombudsman serves; and
                            ``(iii) meet such additional requirements 
                        as the Ombudsman may specify.
                    ``(D) Policies and procedures.--
                            ``(i) In general.--The State agency shall 
                        establish, in accordance with the Ombudsman, 
                        policies and procedures for monitoring local 
                        home care Ombudsman entities designated to 
                        carry out the duties established in section 
                        712(a)(5)(B).
                            ``(ii) Policies.--In a case in which the 
                        entities are grantees or the home care 
                        ombudsman representatives are employees, of 
                        area agencies on aging, the State agency shall 
                        develop the policies in consultation with the 
                        area agencies on aging. The policies shall 
                        provide for participation and comment by the 
                        agencies and for resolution of concerns with 
                        respect to case activity.
                            ``(iii) Confidentiality and disclosure.--
                        The State agency shall develop the policies and 
                        procedures in accordance with all provisions of 
                        this subtitle regarding confidentiality and 
                        conflict of interest for providers of home care 
                        services.
    ``(b) Procedures for Access.--
            ``(1) In general.--The State shall ensure that 
        representatives of the home care ombudsman program shall have--
                    ``(A) access to home care consumers and their homes 
                with permission of the home care consumer involved or a 
                legal representative;
                    ``(B)(i) appropriate access to review all records 
                of a home care consumer, if--
                            ``(I) the representative of the home care 
                        ombudsman program has the permission of the 
                        home care consumer, or the legal representative 
                        of the home care consumer; or
                            ``(II) the home care consumer is unable to 
                        consent to the review and has no legal 
                        representative; or
                    ``(ii) such access to the records as is necessary 
                to investigate a complaint if--
                            ``(I) a legal guardian of the home care 
                        consumer refuses to give the permission;
                            ``(II) a representative of the home care 
                        ombudsman program has reasonable cause to 
                        believe that the guardian is not acting in the 
                        best interests of the home care consumer; and
                            ``(III) the representative obtains the 
                        approval of the Ombudsman;
                    ``(C) access to the administrative records, 
                policies, and documents, to which home care consumers 
                have, or the general public has access, of the provider 
                of home care services; and
                    ``(D) access to and, on request, copies of all 
                licensing and certification records maintained by the 
                State with respect to the provider of home care 
                services.
            ``(2) Procedures.--The State agency shall establish 
        procedures to ensure the access described in paragraph (1).
    ``(c) Reporting System.--The State agency shall ensure that the 
reporting system established in section 712(c) is equipped to--
            ``(1) collect and analyze data relating to complaints and 
        conditions concerning home care services and to home care 
        consumers for the purpose of identifying and resolving 
        significant problems, including complaints concerning--
                    ``(A) quality of services;
                    ``(B) quantity of services;
                    ``(C) availability of services; and
                    ``(D) denial, reduction, and termination of 
                services; and
            ``(2) submit the data, on a regular basis, to--
                    ``(A) the agency of the State responsible for 
                licensing or certifying providers of home care services 
                in the State;
                    ``(B) other State and Federal entities that the 
                Ombudsman determines to be appropriate;
                    ``(C) the Assistant Secretary; and
                    ``(D) the National Ombudsman Resource Center 
                established in section 202(a)(18)(A).
    ``(d) Disclosure.--
            ``(1) In general.--The State agency shall establish 
        procedures for the disclosure by the Ombudsman or local home 
        care Ombudsman entities of files maintained by the home care 
        ombudsman program, including records described in subsection 
        (b)(1) or (c).
            ``(2) Identity of complainant or home care consumer.--The 
        procedures described in paragraph (1) shall--
                    ``(A) provide that, subject to subparagraph (B), 
                the files and records described in paragraph (1) may be 
                disclosed only at the discretion of the Ombudsman (or 
                the person designated by the Ombudsman to disclose the 
                files and records); and
                    ``(B) prohibit the disclosure of the identity of 
                any complainant or home care consumer with respect to 
                whom the Office maintains such files or records 
                unless--
                            ``(i) the complainant or home care 
                        consumer, or the legal representative of the 
                        complainant or home care consumer, consents to 
                        the disclosure and the consent is given in 
                        writing;
                            ``(ii)(I) the complainant or home care 
                        consumer gives consent orally; and
                            ``(II) the consent is documented 
                        contemporaneously in a writing made by a 
                        representative of the home care ombudsman 
                        program in accordance with such requirements as 
                        the State agency shall establish; or
                            ``(iii) the disclosure is required by court 
                        order.
    ``(e) Consultation.--In planning and carrying out the home care 
ombudsman program, the State agency shall consider the views of area 
agencies on aging, older individuals, and providers of home care 
services and demonstrate how the State agency has taken their views 
into consideration.
    ``(f) Conflict of Interest.--The State agency shall--
            ``(1) ensure that no individual, or member of the immediate 
        family of an individual, involved in the designation of the 
        Ombudsman (whether by appointment or otherwise) or the 
        designation of an entity designated under subsection (a)(5), is 
        subject to a conflict of interest;
            ``(2) ensure that no officer or employee of the Office, 
        home care ombudsman representative of a local home care 
        Ombudsman entity, or member of the immediate family of the 
        officer, employee, or home care ombudsman representative, is 
        subject to a conflict of interest;
            ``(3) ensure that the Ombudsman--
                    ``(A) does not have a direct involvement in the 
                licensing or certification of a provider of home care 
                services;
                    ``(B) does not have an ownership or investment 
                interest (represented by equity, debt, contract, or 
                other financial relationship) in a provider of home 
                care services;
                    ``(C) is not employed by, or participating in the 
                management of, a provider of home care services; and
                    ``(D) does not receive, or have the right to 
                receive, directly or indirectly, remuneration (in cash 
                or in-kind) under a compensation arrangement with an 
                owner or operator of a provider of home care services; 
                and
            ``(4) establish, and specify in writing, mechanisms to 
        identify and remove conflicts of interest referred to in 
        paragraphs (1) and (2), and to identify and eliminate the 
        relationships described in subparagraphs (A) through (D) of 
        paragraph (3), including such mechanisms as--
                    ``(A) the methods by which the State agency will 
                examine individuals, and immediate family members, to 
                identify the conflicts; and
                    ``(B) the actions that the State agency will 
                require the individuals and such family members to take 
                to remove such conflicts.
    ``(g) Legal Counsel.--The State agency shall ensure that--
            ``(1)(A) adequate legal counsel is available, and is able, 
        without conflict of interest, to--
                    ``(i) provide advice and consultation needed to 
                protect the health, safety, welfare, and rights of home 
                care consumers; and
                    ``(ii) assist the Ombudsman and representatives of 
                the home care ombudsman program in the performance of 
                the official duties of the Ombudsman and 
                representatives; and
            ``(B) legal representation is provided to any 
        representative of the home care ombudsman program against whom 
        suit or other legal action is brought or threatened to be 
        brought in connection with the performance of the official 
        duties of the Ombudsman or such a representative; and
            ``(2) the Ombudsman pursues administrative, legal, and 
        other appropriate remedies on behalf of home care consumers.
    ``(h) Administration.--
            ``(1) Requirements.--The State agency shall require the 
        Office to--
                    ``(A) include in its annual report required in 
                section 712(h)(1)--
                            ``(i) a description of the activities 
                        carried out by the Office as they related to 
                        the home care ombudsman program in the year for 
                        which the report is prepared;
                            ``(ii) the data and an analysis of the data 
                        collected under subsection (c);
                            ``(iii) an evaluation of the problems 
                        experienced by, and the complaints made by or 
                        on behalf of, home care consumers;
                            ``(iv) recommendations for--
                                    ``(I) improving quality of the care 
                                and life of the home care consumers; 
                                and
                                    ``(II) protecting the health, 
                                safety, welfare, and rights of the home 
                                care consumers;
                            ``(v)(I) an analysis of the success of the 
                        home care ombudsman program including success 
                        in providing services to home care consumers in 
                        communities with high percentages of racial or 
                        ethnic minorities; and
                            ``(II) identification of barriers that 
                        prevent the optimal operation of the home care 
                        ombudsman program; and
                            ``(vi) policy, regulatory, and legislative 
                        recommendations to solve identified problems, 
                        to resolve the complaints, to improve the 
                        quality of care and life of home care 
                        consumers, to protect the health, safety, 
                        welfare, and rights of home care consumers, and 
                        to remove the barriers;
                    ``(B) not later than 2 years after the date of the 
                enactment of this chapter, establish procedures for the 
                training of the representatives of the home care 
                ombudsman program, including unpaid volunteers, based 
                on best practices outlined by the Assistant Secretary 
                in the most recent report submitted under subsection 
                (m)(1), in consultation with representatives of citizen 
                groups, providers of home care services, and the home 
                care ombudsman program, that--
                            ``(i) specify a minimum number of hours of 
                        initial training;
                            ``(ii) specify the content of the training, 
                        including training relating to--
                                    ``(I) Federal, State, and local 
                                laws, regulations, and policies, with 
                                respect to providers of home care 
                                services in the State;
                                    ``(II) investigative techniques; 
                                and
                                    ``(III) such other matters as the 
                                State determines to be appropriate; and
                            ``(iii) specify an annual number of hours 
                        of in-service training for all designated 
                        representatives;
                    ``(C) prohibit any representative of the home care 
                ombudsman program (other than the Ombudsman) from 
                carrying out any activity described in subparagraphs 
                (A) through (H) of subsection (a)(3) unless the 
                representative--
                            ``(i) has received the training required 
                        under subparagraph (B); and
                            ``(ii) has been approved by the Ombudsman 
                        as qualified to carry out the activity on 
                        behalf of the Office;
                    ``(D) coordinate home care ombudsman services with 
                the protection and advocacy systems for individuals 
                with developmental disabilities and mental illnesses 
                established under--
                            ``(i) subtitle C of the Developmental 
                        Disabilities Assistance and Bill of Rights Act 
                        of 2000 (42 U.S.C. 15041 et seq.); and
                            ``(ii) the Protection and Advocacy for 
                        Individuals with Mental Illness Act (42 U.S.C. 
                        10801 et seq.);
                    ``(E) coordinate, to the greatest extent possible, 
                home care ombudsman services with legal assistance 
                provided under section 306(a)(2)(C), through adoption 
                of memoranda of understanding and other means;
                    ``(F) coordinate services with State and local law 
                enforcement agencies and courts of competent 
                jurisdiction; and
                    ``(G) permit any local home care Ombudsman entity 
                to carry out the responsibilities described in 
                subparagraph (A), (D), or (E).
            ``(2) Authorities.--The State agency shall require the 
        Office to--
                    ``(A) analyze, comment on, and monitor the 
                development and implementation of Federal, State, and 
                local laws, regulations, and other government policies 
                and actions that pertain to providers of home care 
                services and those services, and to the health, safety, 
                welfare, and rights of home care consumers, in the 
                State, and recommend any changes in such laws, 
                regulations, and policies as the Ombudsman determines 
                to be appropriate;
                    ``(B)(i) provide such information as the Ombudsman 
                determines to be necessary to public and private 
                agencies, legislators, and other persons, regarding--
                            ``(I) the problems and concerns of older 
                        individuals receiving home care services; and
                            ``(II) recommendations related to the 
                        problems and concerns; and
                    ``(ii) make available to the public, and submit to 
                the Assistant Secretary, the chief executive officer of 
                the State, the State legislature, the State agency 
                responsible for licensing or certifying providers of 
                home care services, and other appropriate governmental 
                entities, each report prepared under paragraph (1)(A); 
                and
                    ``(C) permit any local home care Ombudsman entity 
                to carry out the responsibilities described in 
                subparagraph (A) or (B).
    ``(i) Liability.--The State shall ensure that no representative of 
the home care ombudsman program will be liable under State law for the 
good faith performance of official duties.
    ``(j) Noninterference.--The State shall--
            ``(1) ensure that willful interference with representatives 
        of the home care ombudsman program in the performance of the 
        official duties of the representatives (as defined by the 
        Assistant Secretary) shall be unlawful;
            ``(2) prohibit retaliation and reprisals by a provider of 
        home care services or other entity with respect to any 
        recipient of home and community-based services, employee, 
        exclusive representative of an employee, or other person for 
        filing a complaint with, providing information to, or otherwise 
        cooperating with any representative of, the home care ombudsman 
        program; and
            ``(3) provide for appropriate sanctions with respect to the 
        interference, retaliation, and reprisals.
    ``(k) Coordination With Adult Protective Services.--
            ``(1) In general.--The Ombudsman, in carrying out the State 
        Home Care Ombudsman Program, shall coordinate activities with 
        the National Adult Protective Services Resource Center and the 
        head of the State's adult protective services program in a 
        manner that is consistent with the State's existing (as of the 
        date of the coordination) protocols for coordination of 
        activities between the Ombudsman, in carrying out the State 
        Long-Term Care Ombudsman Program.
            ``(2) Establishment of protocols.--If the protocols 
        described in paragraph (1) do not exist in the State, the 
        Ombudsman, in conjunction with the head of the State's adult 
        protective services program, shall establish protocols to 
        coordinate activities with the intent of better serving 
        vulnerable adults, which protocols shall--
                    ``(A) clarify the roles of each program;
                    ``(B) establish procedures for maintaining a 
                working relationship;
                    ``(C) outline mutual expectations; and
                    ``(D) establish procedures for coordinating 
                activities with law enforcement.
    ``(l) Maintenance of Effort.--A State, in using the funds made 
available for a fiscal year through a grant received under section 
703(d), shall maintain the expenditures of the State for home care 
ombudsman services at a level that is not less than the level of such 
expenditures maintained by the State for the preceding fiscal year.
    ``(m) Evaluation.--The Assistant Secretary shall--
            ``(1) in conjunction with the Director of the Office of 
        Long-Term Care Ombudsman Programs and the heads of other 
        entities determined to be necessary by the Assistant Secretary, 
        collect and analyze the data required to be submitted under 
        subsection (c) by the States and within 1 year after receipt of 
        the data, submit a report to Congress outlining best practices 
        for carrying out a home care ombudsman program; and
            ``(2) make the report available to States.''.

   TITLE III--QUALITY ASSURANCE FOR HOME AND COMMUNITY-BASED SERVICES

SEC. 301. FUNCTIONS OF ASSISTANT SECRETARY.

    Section 202(b) of the Older Americans Act of 1965 (42 U.S.C. 
3012(b)) is amended--
            (1) in paragraph (8)--
                    (A) in subparagraph (D), by striking ``and'' at the 
                end;
                    (B) in subparagraph (E) by adding ``and'' at the 
                end; and
                    (C) by adding at the end the following:
                    ``(F) to provide quality assurance information, 
                relating to the standards identified under paragraph 
                (11)(A), using the methods described in paragraph 
                (11)(B), about home and community-based long-term care 
                programs, service providers, and resources, when 
                referring consumers to those programs, providers, or 
                resources;'';
            (2) in paragraph (9)--
                    (A) in the matter preceding subparagraph (A), by 
                striking ``and community-based service providers'' and 
                inserting ``community-based service providers, and, for 
                purposes of subparagraph (C), Aging and Disability 
                Resource Centers,'';
                    (B) in subparagraph (A), by striking ``and'' at the 
                end;
                    (C) subparagraph (B), by adding ``and'' at the end; 
                and
                    (D) by adding at the end the following:
                    ``(C) methods, consistent with the methods 
                described in paragraph (11)(B), to communicate to 
                consumers quality assurance information, relating to 
                the standards identified under paragraph (11)(A), about 
                home and community-based long-term care programs, 
                service providers, and resources;'';
            (3) in paragraph (10), by striking ``and'' at the end;
            (4) by redesignating paragraph (11) as paragraph (12); and
            (5) by inserting after paragraph (10) the following:
            ``(11)(A) identify, in consultation with States (either 
        directly or by entering into a contract under this subparagraph 
        and considering the recommendation of the contract recipient) 
        quality assurance standards for home and community-based long-
        term care programs, service providers, and resources that--
                    ``(i) shall be designed to ensure the health, 
                safety, and welfare of consumers who are referred to 
                such programs, service providers, and resources by area 
                agencies on aging, Aging and Disability Resource 
                Centers, and such other entities as the Assistant 
                Secretary determines to be appropriate; and
                    ``(ii) shall be identified after the Assistant 
                Secretary takes into account, at a minimum, standards 
                for--
                            ``(I) background checks of service 
                        providers;
                            ``(II) licensure of agencies and 
                        certification and training of service 
                        providers;
                            ``(III) consumer satisfaction regarding 
                        programs, service providers, and resources, in 
                        cases in which consumer satisfaction 
                        information is available; and
                            ``(IV) such additional matters as the 
                        Assistant Secretary determines to be 
                        appropriate; and
            ``(B) taking into account the variation in communication 
        infrastructure development among Aging and Disability Resource 
        Centers, establish consumer-friendly methods for communicating 
        to consumers, consistently throughout a State--
                    ``(i) quality assurance information relating to the 
                standards identified under subparagraph (A) about home 
                and community-based long-term care programs, service 
                providers, and resources to which such consumers are 
                referred to by area agencies on aging, Aging and 
                Disability Resource Centers, and such other entities as 
                the Assistant Secretary determines to be appropriate; 
                and
                    ``(ii)(I) the content of the State certification or 
                licensure requirements applicable to such home and 
                community-based long-term care programs, service 
                providers, or resources; or
                    ``(II) an explanation that the State does not have 
                certification or licensure requirements applicable to 
                such home and community-based long-term care programs, 
                service providers, or resources; and''.

SEC. 302. ORGANIZATION.

    Section 305(a)(3)(E) of the Older Americans Act of 1965 (42 U.S.C. 
3025(a)(3)(E)) is amended--
            (1) in the matter before clause (i), by striking 
        ``information relating to'';
            (2) in clause (i)--
                    (A) by inserting ``information relating to'' after 
                ``(i)''; and
                    (B) by striking ``and'' at the end;
            (3) in clause (ii)--
                    (A) by inserting ``information relating to'' after 
                ``(ii)''; and
                    (B) by striking the period and inserting ``; and''; 
                and
            (4) by adding at the end the following:
                            ``(iii) quality assurance information, 
                        relating to the standards identified under 
                        section 202(b)(11)(A), about home and 
                        community-based long-term care programs, 
                        service providers, and resources, provided 
                        through methods described in section 
                        202(b)(11)(B), when the Aging and Disability 
                        Resource Centers, area agencies on aging, and 
                        such other entities as the Assistant Secretary 
                        determines to be appropriate, refer consumers 
                        to those programs, providers, and resources in 
                        the State.''.
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