II 

109TH CONGRESS 

1ST SESSION S. 2010 

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 SENATE OF THE UNITED STATES 

NOVEMBER 15, 2005 

Mr. HATCH (for himself, Mrs. LINCOLN, Mr. SMITH, and Mr. KOHL) introduced the following bill; which was read twice and referred to the Committee on Finance 

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’’. 

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

7 this Act is as follows: 
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Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. Purposes. 

TITLE I—DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Sec. 101. Amendment to the Social Security Act. 

Sec. 102. Supporting the long-term care ombudsman program. 

Sec. 103. Adult protective services functions and grant programs. 

Sec. 104. Assuring safety of residents when nursing facilities close. 

Sec. 105. National nurse aide registry. 

Sec. 106. Background checks on direct access employees of long-term care facilities or providers. 

TITLE II—DEPARTMENT OF JUSTICE 

Sec. 201. Model State laws and practices. 

Sec. 202. Office of Elder Justice of the Department of Justice. 

Sec. 203. Victim advocacy grants. 

Sec. 204. Supporting local prosecutors in elder justice matters. 

Sec. 205. Supporting state prosecutors in elder justice matters. 

Sec. 206. Increased support for federal cases involving elder justice. 

Sec. 207. Supporting law enforcement in elder justice matters. 

Sec. 208. Evaluations. 

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 77,000,000 baby boomers 

6 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. 
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1 (4) Victims of elder abuse, neglect, and exploi2 tation are not only subject to injury from mistreat3 ment and neglect, they are also 3.1 times more likely 

4 to die at an earlier age than expected than elders 

5 who were not victims of elder abuse, neglect, and ex6 ploitation. 

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

8 nature and scope of elder abuse, neglect, and exploi9 tation. 

10 (6) Despite the dearth of data in the field, ex11 perts agree that most cases of elder abuse, neglect, 

12 and exploitation are never reported and that abuse 

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

14 a downward spiral of an otherwise productive, self15 sufficient elder’s life. Programs addressing other dif16 ficult issues such as domestic violence and child 

17 abuse and neglect have demonstrated the need for a 

18 multi-faceted law combining public health, social 

19 service, and law enforcement approaches. 

20 (7) For over 20 years, Congress has been pre21 sented with facts and testimony calling for a coordi22 nated Federal effort to combat elder abuse, neglect, 

23 and exploitation. 

24 (8) The Federal Government has been slow to 

25 respond to the needs of victims of elder abuse, ne-
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1 glect, and exploitation or to undertake prevention ef2 forts. 

3 (9) No Federal law has been enacted that ade4 quately and comprehensively addresses the issues of 

5 elder abuse, neglect, and exploitation and there are 

6 very limited resources available to those in the field 

7 directly dealing with these issues. 

8 (10) Differences in State laws and practices in 

9 the areas of elder abuse, neglect, and exploitation 

10 lead to significant disparities in prevention, protec11 tive and social services, treatment systems, and law 

12 enforcement, and lead to other inequities. 

13 (11) The Federal Government has played an 

14 important role in promoting research, training, pub15 lic safety, data collection, the identification, develop16 ment, and dissemination of promising health care, 

17 social, and protective services, and law enforcement 

18 practices relating to child abuse and neglect, domes19 tic violence, and violence against women. The Fed20 eral Government should promote similar efforts and 

21 protections relating to elder abuse, neglect, and ex22 ploitation. 

23 (12) The Federal Government should provide 

24 leadership and assist States and communities in 
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1 their efforts to protect elders in the United States 

2 by— 

3 (A) promoting coordinated planning among 

4 all levels of government; 

5 (B) generating and sharing knowledge rel6 evant to protecting elders; 

7 (C) providing leadership to combat the 

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

9 elders; and 

10 (D) providing resources to States and com11 munities to promote elder justice. 

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

13 exploitation requires a comprehensive approach 

14 that— 

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

16 and social service agencies and organizations; 

17 (B) emphasizes the need for prevention, re18 porting, investigation, assessment, treatment, 

19 and prosecution of elder abuse, neglect, and ex20 ploitation at all levels of government; 

21 (C) ensures that sufficient numbers of 

22 properly trained personnel with specialized 

23 knowledge are in place to treat, assess, and pro24 vide services relating to elder abuse, neglect, 
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1 and exploitation, and carry out elder and vul2 nerable adult protection duties; 

3 (D) is sensitive to ethnic and cultural di4 versity; 

5 (E) recognizes the role of mental health, 

6 disability, dementia, substance abuse, medica7 tion mismanagement, and family dysfunction 

8 problems in increasing and exacerbating elder 

9 abuse, neglect, and exploitation; and 

10 (F) balances adults’ right to self-deter11 mination with society’s responsibility to protect 

12 elders and vulnerable adults. 

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

14 elder abuse, neglect, and exploitation is high and in15 cludes unnecessary expenditures of medicare and 

16 medicaid funds. 

17 (15) The failure to coordinate activities relating 

18 to, and comprehensively prevent and treat, elder 

19 abuse, neglect, and exploitation threatens the future 

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

21 States. 

22 (16) All elements of society in the United 

23 States have a shared responsibility in responding to 

24 the national problem of elder abuse, neglect, and ex25 ploitation. 
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1 SEC. 3. PURPOSES. 

2 The purposes of this Act are as follows: 

3 (1) To bring a comprehensive approach to pre4 venting and combating elder abuse, neglect, and ex5 ploitation, a long invisible problem that afflicts the 

6 most vulnerable among the aging population of the 

7 United States. 

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

9 and exploitation to national attention, and to create 

10 the infrastructure at the Federal, State, and local 

11 levels to ensure that individuals and organizations 

12 on the front lines who are fighting elder abuse, ne13 glect, and exploitation with scarce resources and 

14 fragmented systems have the resources and informa15 tion needed to carry out their fight. 

16 (3) To bring a comprehensive multi-disciplinary 

17 approach to elder justice. 

18 (4) To set in motion research and data collec19 tion to fill gaps in knowledge about elder abuse, ne20 glect, and exploitation. 

21 (5) To supplement the activities of service pro22 viders and programs, to enhance training, and to le23 verage scarce resources efficiently to ensure that 

24 elder justice receives the attention it deserves as the 

25 Nation’s population ages. 
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1 (6) To examine the many different laws and 

2 practices relating to elder justice in different States 

3 and jurisdictions to ascertain which among those 

4 laws and practices are the most effective. 

5 (7) To promote the development of an effective 

6 adult fiduciary system, including an adult guardian7 ship system, that protects individuals with dimin8 ished capacity, maximizes their autonomy, and devel9 ops effective resources and an elder rights system. 

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

11 health, disability, dementia, substance abuse, medi12 cation mismanagement, and family dysfunction prob13 lems in increasing and exacerbating elder abuse, ne14 glect, and exploitation. 

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

16 plan for the development and coordination of elder 

17 justice research, programs, studies, training, and 

18 other efforts nationwide. 

19 (10) To promote collaborative efforts and di20 minish overlap and gaps in efforts in developing the 

21 important field of elder justice. 
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1 TITLE I—DEPARTMENT OF 

2 HEALTH AND HUMAN SERVICES 

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

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

5 amended by adding at the end the following: 

6 ‘‘TITLE XXII—ELDER JUSTICE 

7 ‘‘SEC. 2201. DEFINITIONS. 

8 ‘‘In this title: 

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

10 knowing infliction of physical or psychological harm 

11 or the knowing deprivation of goods or services that 

12 are necessary to meet essential needs or to avoid 

13 physical or psychological harm. 

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

15 ‘adult protective services’ means such services pro16 vided to adults as the Secretary may specify and in17 cludes services such as— 

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

19 neglect, or exploitation; 

20 ‘‘(B) investigating the reports described in 

21 subparagraph (A); 

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

23 and other case work and services; and 

24 ‘‘(D) providing, arranging for, or facili25 tating the provision of medical, social service, 
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1 economic, legal, housing, law enforcement, or 

2 other protective, emergency, or support services. 

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

4 an individual who has the responsibility for the care 

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

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

7 of law and includes a family member or other indi8 vidual who provides (on behalf of such individual or 

9 of a public or private agency, organization, or insti10 tution) compensated or uncompensated care to an 

11 elder who needs supportive services in any setting. 

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

13 means care by a caregiver who provides assistance or 

14 long-term care services to a recipient. 

15 ‘‘(5) ELDER.—The term ‘elder’ means an indi16 vidual age 60 or older. 

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

18 means— 

19 ‘‘(A) from a societal perspective, efforts to 

20 prevent, detect, treat, intervene in, and pros21 ecute elder abuse, neglect, and exploitation and 

22 to protect elders with diminished capacity while 

23 maximizing their autonomy; and 

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

25 recognition of an elder’s rights, including the 
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1 right to be free of abuse, neglect, and exploi2 tation. 

3 ‘‘(7) ELIGIBLE ENTITY.—The term ‘eligible en4 tity’ means a State or local government agency, In5 dian tribe, or any other public or private entity that 

6 is engaged in and has expertise in issues relating to 

7 elder justice or in a field necessary to promote elder 

8 justice efforts. 

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

10 means the fraudulent or otherwise illegal, unauthor11 ized, or improper act or process of an individual, in12 cluding a caregiver or fiduciary, that uses the re13 sources of an elder for monetary or personal benefit, 

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

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

16 belongings, or assets. 

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

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

19 legal responsibility— 

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

21 and for the benefit of another person; and 

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

23 fairness; and 

24 ‘‘(B) includes a trustee, a guardian, a con25 servator, an executor, an agent under a finan-
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1 cial power of attorney or health care power of 

2 attorney, or a representative payee. 

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

4 contract, cooperative agreement, or other mechanism 

5 for providing financial assistance. 

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

7 ‘granting authority’ means the Secretary, the Attor8 ney General, or the Secretary and the Attorney Gen9 eral jointly, as appropriate. 

10 ‘‘(12) GUARDIANSHIP.—The term ‘guardian11 ship’ means— 

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

13 determines that an adult individual lacks capac14 ity to make decisions about self-care and prop15 erty, and appoints another individual or entity 

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

17 similar term, as surrogate decision maker; 

18 ‘‘(B) the manner in which the court-ap19 pointed surrogate carries out duties to the indi20 vidual and the court; or 

21 ‘‘(C) the manner in which the court exer22 cises oversight of the surrogate. 

23 ‘‘(13) INDIAN.—The term ‘Indian’ means a per24 son who is a member of an Indian tribe. 
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1 ‘‘(14) INDIAN TRIBE.—The term ‘Indian tribe’ 

2 means any Indian tribe, band, nation, or other orga3 nized group or community, including any Alaska Na4 tive village or regional corporation as defined in or 

5 established pursuant to the Alaska Native Claims 

6 Settlement Act (43 U.S.C. 1601 et seq.), that is rec7 ognized as eligible for the special programs and serv8 ices provided by the United States to Indians be9 cause of their status as Indians. 

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

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

12 title 31, United States Code. 

13 ‘‘(16) LAW ENFORCEMENT.—The term ‘law en14 forcement’ means the full range of potential re15 sponders to elder abuse, neglect, and exploitation in16 cluding— 

17 ‘‘(A) police, sheriffs, detectives, public safe18 ty officers, and corrections personnel; 

19 ‘‘(B) prosecutors; 

20 ‘‘(C) medical examiners; 

21 ‘‘(D) investigators; and 

22 ‘‘(E) coroners. 

23 ‘‘(17) LONG-TERM CARE.— 

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

25 care’ means supportive and health services spec-
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1 ified by the Secretary for individuals who need 

2 assistance because the individuals have a loss of 

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

4 or vulnerability. 

5 ‘‘(B) LOSS OF CAPACITY FOR SELF6 CARE.—For purposes of subparagraph (A), the 

7 term ‘loss of capacity for self-care’ means an in8 ability to engage in activities of daily living, in9 cluding eating, dressing, bathing, and manage10 ment of one’s financial affairs. 

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

12 ‘long-term care facility’ means a residential care pro13 vider that arranges for, or directly provides, long14 term care. 

15 ‘‘(19) NEGLECT.—The term ‘neglect’ means— 

16 ‘‘(A) the failure of a caregiver or fiduciary 

17 to provide the goods or services that are nec18 essary to maintain the health or safety of an 

19 elder; or 

20 ‘‘(B) self-neglect. 

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

22 facility’ has the meaning given such term under sec23 tion 1919(a). 

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

25 means an adult’s inability, due to physical or mental 
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1 impairment or diminished capacity, to perform es2 sential self-care tasks including— 

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

4 shelter, and medical care; 

5 ‘‘(B) obtaining goods and services nec6 essary to maintain physical health, mental 

7 health, or general safety; or 

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

9 ‘‘(22) SERIOUS BODILY INJURY.— 

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

11 bodily injury’ means an injury— 

12 ‘‘(i) involving extreme physical pain; 

13 ‘‘(ii) involving substantial risk of 

14 death; 

15 ‘‘(iii) involving protracted loss or im16 pairment of the function of a bodily mem17 ber, organ, or mental faculty; or 

18 ‘‘(iv) requiring medical intervention 

19 such as surgery, hospitalization, or phys20 ical rehabilitation. 

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

22 bodily injury shall be considered to have oc23 curred if the conduct causing the injury is con24 duct constituting aggravated sexual abuse 

25 under section 2241, or sexual abuse under sec-
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1 tion 2242, of title 18, United States Code, or 

2 any similar offense under State law. 

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

4 with respect to a service, includes adult protective 

5 services. 

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

7 the several States, the District of Columbia, the 

8 Commonwealth of Puerto Rico, the United States, 

9 the Virgin Islands, Guam, American Samoa, and the 

10 Commonwealth of the Mariana Islands. 

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

12 The term ‘State Long-Term Care Ombudsman’ 

13 means the State Long-Term Care Ombudsman de14 scribed in section 712(a)(2) of the Older Americans 

15 Act of 1965. 

16 ‘‘(26) UNDERSERVED POPULATION.—The term 

17 ‘underserved population’ means the population of an 

18 area designated by the Secretary as an area with a 

19 shortage of elder justice programs or a population 

20 group designated by the Secretary as having a short21 age of such programs. Such areas or groups des22 ignated by the Secretary may include— 

23 ‘‘(A) areas or groups that are geographi24 cally isolated (such as isolated in a rural area); 
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1 ‘‘(B) racial and ethnic minority popu2 lations; and 

3 ‘‘(C) populations underserved because of 

4 special needs (such as language barriers, dis5 abilities, alien status, or age). 

6 ‘‘Subtitle A—Federal Elder Justice 

7 System 

8 ‘‘SEC. 2211. OFFICE OF ELDER JUSTICE OF THE DEPART9 MENT OF HEALTH AND HUMAN SERVICES. 

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

11 the Department of Health and Human Services under the 

12 Assistant Secretary for Aging an Office of Elder Justice. 

13 ‘‘(b) DIRECTOR.— 

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

15 advice and consent of the Senate, shall appoint a Di16 rector of the Office of Elder Justice, from among in17 dividuals with experience and expertise in elder jus18 tice issues, to manage the Office of Elder Justice es19 tablished under this section. 

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

21 Elder Justice shall— 

22 ‘‘(A)(i) develop objectives, priorities, poli23 cies, and a long-term plan for elder justice pro24 grams and activities relating to prevention, de25 tection, training, treatment, evaluation, inter-
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1 vention, research, and improvement of the elder 

2 justice system in the United States; 

3 ‘‘(ii) implement the overall policies and a 

4 strategy to carry out the plan described in 

5 clause (i); and 

6 ‘‘(iii) hire personnel to assist the director 

7 in carrying out the policies, programs, and ad8 ministrative activities related to the duties 

9 under clauses (i) and (ii); and 

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

11 elder justice issues. 

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

13 of the Office of Elder Justice shall report to the As14 sistant Secretary for Aging. 

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

16 compensated at a rate that shall not exceed the rate 

17 established for level I of the Executive Schedule 

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

19 ‘‘SEC. 2212. ELDER JUSTICE COORDINATING COUNCIL. 

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

21 the Office of the Secretary an Elder Justice Coordinating 

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

23 ‘‘(b) MEMBERSHIP.— 

24 ‘‘(1) IN GENERAL.—The Council shall be com25 posed of the following members: 
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1 ‘‘(A) The Secretary (or the Secretary’s 

2 designee). 

3 ‘‘(B) The Attorney General (or the Attor4 ney General’s designee). 

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

6 or agency or other governmental entity identi7 fied by the Co-Chairs referred to in subsection 

8 (d) as having responsibilities or administering 

9 programs relating to elder abuse, neglect, and 

10 exploitation. 

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

12 Council shall be an officer or employee of the Fed13 eral Government. 

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

15 not affect its powers, but shall be filled in the same man16 ner as the original appointment was made. 

17 ‘‘(d) CO-CHAIRS.—The members described in sub18 paragraphs (A) and (B) of subsection (b)(1) shall be Co19 Chairs of the Council. 

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

21 times per year, as determined by the Co-Chairs. 

22 ‘‘(f) DUTIES.— 

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

24 recommendations to the Secretary and the Attorney 

25 General for the coordination of activities of the De-
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1 partment of Health and Human Services, the De2 partment of Justice, and other relevant Federal, 

3 State, local, and private agencies and entities, relat4 ing to elder abuse, neglect, and exploitation and 

5 other crimes against elders. 

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

7 2 years after the date of enactment of the Elder 

8 Justice Act and every 2 years thereafter, the Council 

9 shall submit to Congress a report that— 

10 ‘‘(A) describes the activities of, accomplish11 ments of, and challenges faced by— 

12 ‘‘(i) the Council; and 

13 ‘‘(ii) the entities represented on the 

14 Council; and 

15 ‘‘(B) makes such recommendations for leg16 islation, model laws, or other action as the 

17 Council determines to be appropriate. 

18 ‘‘(g) POWERS OF THE COUNCIL.— 

19 ‘‘(1) INFORMATION FROM FEDERAL AGEN20 CIES.— 

21 ‘‘(A) IN GENERAL.—Subject to subpara22 graph (B), the Council may secure directly from 

23 any Federal department or agency such infor24 mation as the Council considers necessary to 

25 carry out this section. Upon request of the Co- 
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1 Chairs of the Council, the head of such depart2 ment or agency shall furnish such information 

3 to the Council. 

4 ‘‘(B) PROTECTION OF PRIVACY.—The Sec5 retary shall oversee the activities of the Council 

6 under this paragraph in order to ensure the 

7 protection of individual health privacy con8 sistent with the regulations promulgated under 

9 section 264(c) of the Health Insurance Port10 ability and Accountability Act of 1996 and 

11 State and local privacy regulations (as applica12 ble). 

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

14 the United States mails in the same manner and 

15 under the same conditions as other departments and 

16 agencies of the Federal Government. 

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

18 Council shall not receive compensation for the perform19 ance of services for the Council. The members shall be 

20 allowed travel expenses, including per diem in lieu of sub21 sistence, at rates authorized for employees of agencies 

22 under subchapter 1 of chapter 57 of title 5, United States 

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

24 business in the performance of services for the Council. 

25 Notwithstanding section 1342 of title 31, United States 
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1 Code, the Secretary may accept the voluntary and uncom2 pensated services of the members of the Council. 

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

4 Federal Government employee may be detailed to the 

5 Council without reimbursement, and such detail shall be 

6 without interruption or loss of civil service status or privi7 lege. 

8 ‘‘SEC. 2213. ADVISORY BOARD ON ELDER ABUSE, NEGLECT, 

9 AND EXPLOITATION. 

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

11 to be known as the ‘Advisory Board on Elder Abuse, Ne12 glect, and Exploitation’ (in this section referred to as the 

13 ‘advisory board’) to create a short- and long-term multi14 disciplinary strategic plan for the development of the field 

15 of elder justice, and to make recommendations to the Sec16 retary, the Attorney General, and the Elder Justice Co17 ordinating Council established under section 2212. 

18 ‘‘(b) SOLICITATION OF NOMINATIONS.—The Sec19 retary shall publish a notice in the Federal Register solic20 iting nominations for the appointment of members of the 

21 advisory board under subsection (c). 

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

23 composed of 27 members appointed by the Secretary from 

24 the general public who are individuals with experience and 
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1 expertise in elder abuse, neglect, and exploitation preven2 tion, intervention, treatment, detection, or prosecution. 

3 ‘‘(d) VACANCIES.— 

4 ‘‘(1) IN GENERAL.—Any vacancy in the Advi5 sory Board shall not affect its powers, but shall be 

6 filled in the same manner as the original appoint7 ment was made. 

8 ‘‘(2) FILLING UNEXPIRED TERM.—An indi9 vidual chosen to fill a vacancy shall be appointed for 

10 the unexpired term of the member replaced. 

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

12 shall elect a chairperson and vice chairperson from among 

13 the members. The advisory board shall elect its initial 

14 chairperson and vice chairperson at its initial meeting. 

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

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

17 and annually thereafter, the advisory board shall prepare 

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

19 the appropriate committees of Congress a report con20 taining— 

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

22 State, and local public and private elder justice ac23 tivities; 

24 ‘‘(2) recommendations (including recommended 

25 priorities) regarding— 
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1 ‘‘(A) elder justice programs, research, 

2 training, services, practice, enforcement, and 

3 coordination; 

4 ‘‘(B) coordination between entities pur5 suing elder justice efforts and those involved in 

6 related areas that may inform or overlap with 

7 elder justice efforts, such as activities to combat 

8 violence against women and child abuse and ne9 glect; and 

10 ‘‘(C) activities relating to adult fiduciary 

11 systems, including guardianship and other fidu12 ciary arrangements, including the development 

13 of State interdisciplinary guardianship commit14 tees; 

15 ‘‘(3) recommendations for specific modifications 

16 to Federal and State laws (including regulations) or 

17 for programs, research, and training to enhance pre18 vention, detection, diagnosis, treatment, intervention 

19 in, investigation, and prosecution of elder abuse, ne20 glect, and exploitation; 

21 ‘‘(4) recommendations for the most effective co22 ordinated national data collection with respect to 

23 elder justice, and elder abuse, neglect, and exploi24 tation; and 
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1 ‘‘(5) recommendations for a multidisciplinary 

2 strategic plan to guide the effective and efficient de3 velopment of the elder justice area. 

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

5 ‘‘(1) INFORMATION FROM FEDERAL AGEN6 CIES.— 

7 ‘‘(A) IN GENERAL.—Subject to subpara8 graph (B), the advisory board may secure di9 rectly from any Federal department or agency 

10 such information as the advisory board con11 siders necessary to carry out this section. Upon 

12 request of the chair, the head of such depart13 ment or agency shall furnish such information 

14 to the advisory board. 

15 ‘‘(B) PROTECTION OF PRIVACY.—The Sec16 retary shall oversee the activities of the advisory 

17 board under this paragraph in order to ensure 

18 the protection of individual health privacy con19 sistent with the regulations promulgated under 

20 section 264(c) of the Health Insurance Port21 ability and Accountability Act of 1996 and 

22 State and local privacy regulations (as applica23 ble). 

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

25 advisory board may secure from any entity pursuing 
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1 elder justice activities under the Elder Justice Act or 

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

3 or recommendations generated in connection with 

4 such activities. 

5 ‘‘(3) POSTAL SERVICES.—The advisory board 

6 may use the United States mails in the same man7 ner and under the same conditions as other depart8 ments and agencies of the Federal Government. 

9 ‘‘(4) GIFTS.—The advisory board may accept, 

10 use, and dispose of gifts or donations of services or 

11 property. 

12 ‘‘(h) TRAVEL EXPENSES.—The members of the advi13 sory board shall not receive compensation for the perform14 ance of services for the advisory board, but shall be al15 lowed travel expenses, including per diem in lieu of sub16 sistence, at rates authorized for employees of agencies 

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

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

19 business in the performance of services for the advisory 

20 board. Notwithstanding section 1342 of title 31, United 

21 States Code, the Secretary and the Attorney General may 

22 accept the voluntary and uncompensated services of the 

23 members of the advisory board. 

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

25 Federal Government employee may be detailed to the advi-
27 

•S 2010 IS

1 sory board without reimbursement, and such detail shall 

2 be without interruption or loss of civil service status or 

3 privilege. 

4 ‘‘(j) STATUS AS PERMANENT ADVISORY COM5 MITTEE.—Section 14 of the Federal Advisory Committee 

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

7 ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 

8 are authorized to be appropriated to carry out this sub9 section— 

10 ‘‘(1) $6,000,000 for fiscal year 2007; and 

11 ‘‘(2) $7,500,000 for each of fiscal years 2008 

12 through 2013. 

13 ‘‘Subtitle B—Activities to Promote 

14 Elder Justice 

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

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

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

18 consultation with the Attorney General, shall estab19 lish within the Office of Elder Justice, an Elder Jus20 tice Resource Center (in this section referred to as 

21 the ‘Center’) to be the central repository for infor22 mation regarding elder abuse, neglect, and exploi23 tation. 

24 ‘‘(2) DUTIES.—The Center shall— 
28 

•S 2010 IS

1 ‘‘(A) develop the capacity and procedures 

2 to collect, maintain, and disseminate informa3 tion relevant to consumers, families, providers, 

4 clinicians, advocates, regulators, law enforce5 ment, policymakers, researchers, fiduciaries in6 cluding guardians, judges, and lawyers, relevant 

7 to the prevention, detection, assessment, identi8 fication, and treatment of, intervention in, and 

9 prosecution of, elder abuse, neglect, and exploi10 tation; 

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

12 information on— 

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

14 face of aging or diminishing capacity and 

15 mobility; 

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

17 of elder abuse, neglect, or exploitation; and 

18 ‘‘(iii) advance planning and how to 

19 avoid the need for a fiduciary; 

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

21 sources of information; 

22 ‘‘(D) compile, analyze, and publish a sum23 mary of research conducted on elder abuse, ne24 glect, and exploitation and information on how 

25 to obtain the original research materials; 
29 

•S 2010 IS

1 ‘‘(E) solicit public comment and comment 

2 from the advisory board established under sec3 tion 2213 on the activities of the Center; 

4 ‘‘(F) establish a toll-free number for infor5 mation and referrals; 

6 ‘‘(G) coordinate activities with resource 

7 centers and clearinghouses on elder justice top8 ics; and 

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

10 agencies and entities to develop or continue the 

11 efforts of specialized elder justice-related clear12 inghouses and information repositories, to be 

13 linked to the Center, that address topics such 

14 as those enumerated in subparagraphs (A) and 

15 (B) and that provide effective services. 

16 ‘‘(3) COORDINATION OF AVAILABLE RE17 SOURCES.—In establishing the Center under this 

18 subsection the Secretary, after consultation with the 

19 Attorney General, shall— 

20 ‘‘(A) consult with other Federal agencies 

21 that operate similar resource centers; 

22 ‘‘(B) consult with private entities that op23 erate resource centers or clearinghouses on 

24 elder justice-related topics; 
30 

•S 2010 IS

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

2 participating in the Elder Justice Coordinating 

3 Council established under section 2212, as well 

4 as other agencies with clearinghouses com5 parable to the Center, such as clearinghouses 

6 relating to child abuse and neglect, to deter7 mine the most efficient and effective manner for 

8 collecting, maintaining, and disseminating in9 formation on elder abuse, neglect, and exploi10 tation; and 

11 ‘‘(D) solicit public comment on the compo12 nents of such Center. 

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

14 ‘‘(A) ESTABLISHMENT.—The Secretary 

15 shall establish within the Center a National 

16 Elder Justice Library (in this paragraph re17 ferred to as the ‘Library’) to serve as a central18 ized repository for all types of appropriate ma19 terials concerning training, technical assistance, 

20 and promising practices relating to elder justice 

21 including— 

22 ‘‘(i) brochures and pamphlets; 

23 ‘‘(ii) video and computer-based re24 sources; 

25 ‘‘(iii) books; and 
31 

•S 2010 IS

1 ‘‘(iv) training materials. 

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

3 and maintain an up-to-date index of the mate4 rials described in subparagraph (A) by title, au5 thor, date, subject, and type of material, and a 

6 brief description of such materials. Such index 

7 shall be available on the Internet as well as in 

8 printed form in order to be easily accessible to 

9 the general public. 

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

11 by the Library shall be available for copying by 

12 individuals and entities nationwide and shall be 

13 disseminated at a nominal or no fee. The mate14 rials shall be copied and disseminated in ac15 cordance with the applicable provisions of title 

16 17, United States Code. 

17 ‘‘(D) DUTIES.— 

18 ‘‘(i) ADDITIONAL MATERIALS.—The 

19 Library shall— 

20 ‘‘(I) collect data on materials 

21 that would be appropriate for such li22 brary; 

23 ‘‘(II) make efforts to identify and 

24 obtain appropriate materials; and 
32 

•S 2010 IS

1 ‘‘(III) identify and obtain mate2 rials relating to effective methods of 

3 conducting training and providing 

4 technical assistance relating to elder 

5 justice, including conducting training 

6 and providing assistance for under7 served populations. 

8 ‘‘(ii) INFORMATION PACKETS.—After 

9 evaluating the materials described in this 

10 paragraph, the Library shall compile and 

11 develop information packets for use by 

12 groups in various settings, including 

13 groups who are underserved or have other 

14 special needs. Such information packets 

15 shall include information and materials on 

16 training, technical assistance, and prom17 ising practices targeted at specific topics, 

18 groups, and settings. 

19 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

20 There are authorized to be appropriated to carry out 

21 this subsection— 

22 ‘‘(A) $4,000,000 for fiscal year 2007; 

23 ‘‘(B) $5,000,000 for fiscal year 2008; and 

24 ‘‘(C) $6,000,000 for each of fiscal years 

25 2009 through 2013. 
33 

•S 2010 IS

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

2 ELDER ABUSE, NEGLECT, AND EXPLOITATION.— 

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

4 is to improve, streamline, and promote uniform col5 lection, maintenance, and dissemination of national 

6 data relating to elder abuse, neglect, and exploi7 tation. 

8 ‘‘(2) PHASE I.— 

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

10 after the date of enactment of the Elder Justice 

11 Act, the Director of the Centers for Disease 

12 Control and Prevention (in this subsection re13 ferred to as the ‘Director’), after consultation 

14 with the Attorney General and working with ex15 perts in relevant disciplines, shall— 

16 ‘‘(i) develop a method for collecting 

17 national data regarding elder abuse, ne18 glect, and exploitation; and 

19 ‘‘(ii) develop uniform national data re20 porting forms adapted to each relevant en21 tity or discipline (such as health, public 

22 safety, social and protective services, and 

23 law) reflecting— 
34 

•S 2010 IS

1 ‘‘(I) the distinct manner in which 

2 each discipline receives and maintains 

3 information; and 

4 ‘‘(II) the sequence and history of 

5 reports to or involvement of different 

6 disciplines, independently, or the se7 quence and history of reports from 

8 one discipline to another over time. 

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

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

11 incorporate the definitions of this title for use 

12 in determining what is considered a reportable 

13 event. 

14 ‘‘(3) PHASE II.— 

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

16 after the completion of the activities described 

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

18 the national data reporting forms and data col19 lection methods developed in accordance with 

20 such paragraph are pilot tested in 6 States de21 termined by the Director. 

22 ‘‘(B) ADJUSTMENTS TO THE FORM AND

23 METHODS.—The Director, after considering the 

24 results of the pilot testing described in subpara25 graph (A), and after consultation with the At-
35 

•S 2010 IS

1 torney General and relevant experts shall adjust 

2 the national data reporting forms and data col3 lection methods as necessary. 

4 ‘‘(4) PHASE III.— 

5 ‘‘(A) DISTRIBUTION OF NATIONAL DATA

6 REPORTING FORMS.—After completion of the 

7 adjustment to the national data reporting forms 

8 under paragraph (3)(B), the Director shall sub9 mit the national data reporting forms along 

10 with instructions to— 

11 ‘‘(i) the heads of the relevant compo12 nents of the Department of Health and 

13 Human Services, the Department of Jus14 tice, and the Department of the Treasury, 

15 and such other Federal entities as may be 

16 appropriate; and 

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

18 State for collection from all relevant State 

19 entities of data, including health care, so20 cial services, and law enforcement data. 

21 ‘‘(B) DATA COLLECTION GRANTS.— 

22 ‘‘(i) AUTHORIZATION.—The Director 

23 is authorized to award grants to States to 

24 improve data collection activities relating 

25 to elder abuse, neglect, and exploitation. 
36 

•S 2010 IS

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

2 receive a grant under this subparagraph, a 

3 State shall submit to the Director an appli4 cation at such time, in such manner, and 

5 containing such information as the Direc6 tor may require. 

7 ‘‘(iii) REQUIREMENTS.—Each State 

8 receiving a grant under this subparagraph 

9 for a fiscal year is required to report data 

10 for the calendar year that begins during 

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

13 (A). 

14 ‘‘(iv) FUNDING.— 

15 ‘‘(I) FIRST YEAR.—For the first 

16 fiscal year in which a State receives 

17 grant funds under this subsection, the 

18 Secretary shall initially distribute 50 

19 percent of such funds. The Secretary 

20 shall distribute the remaining funds at 

21 the end of the calendar year that be22 gins during that fiscal year, if the 

23 Secretary determines that the State 

24 has properly reported data required 
37 

•S 2010 IS

1 under this subsection for the calendar 

2 year. 

3 ‘‘(II) SUBSEQUENT YEARS.—Ex4 cept as provided in subclause (I), the 

5 Secretary shall distribute grant funds 

6 to a State under this subsection for a 

7 fiscal year if the Secretary determines 

8 that the State properly reported data 

9 required under this subsection for the 

10 calendar year that ends during that 

11 fiscal year. 

12 ‘‘(C) REQUIRED INFORMATION.—Each re13 port submitted under this paragraph shall— 

14 ‘‘(i) indicate the State and year in 

15 which each event occurred; and 

16 ‘‘(ii) identify— 

17 ‘‘(I) the total number of events 

18 that occurred in each State during the 

19 year; and 

20 ‘‘(II) the type of each event. 

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

22 date of enactment of the Elder Justice Act and an23 nually thereafter, the Secretary shall prepare and 

24 submit to the appropriate committees of Congress, 

25 including to the Special Committee on Aging and 
38 

•S 2010 IS

1 the Finance Committee of the Senate, a report re2 garding activities conducted under this section. 

3 ‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 

4 There are authorized to be appropriated to carry out 

5 this subsection— 

6 ‘‘(A) $10,000,000 for fiscal year 2007; 

7 ‘‘(B) $30,000,000 for fiscal year 2008; and 

8 ‘‘(C) $100,000,000 for each of fiscal years 

9 2009 through 2013. 

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

11 STRENGTHENING SERVICES, SYSTEMS, AND 

12 PREVENTION. 

13 ‘‘(a) GENERAL GRANTS AND CENTERS OF EXCEL14 LENCE.— 

15 ‘‘(1) GENERAL GRANTS.—The Secretary may 

16 award grants to eligible entities for the prevention, 

17 detection, assessment, and treatment of, intervention 

18 in, investigation of, and prosecution of elder abuse, 

19 neglect, and exploitation including— 

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

21 abuse and neglect by family and other in-home 

22 caregivers; 

23 ‘‘(B) physical, psychological, and emotional 

24 abuse and neglect of residents in institutional 

25 and other residential care facilities; 
39 

•S 2010 IS

1 ‘‘(C) elder sexual abuse; 

2 ‘‘(D) domestic violence in later life; 

3 ‘‘(E) financial fraud and exploitation; and 

4 ‘‘(F) self-neglect. 

5 ‘‘(2) CENTERS OF EXCELLENCE.— 

6 ‘‘(A) GRANTS AUTHORIZED.—The Sec7 retary, through the Director of the National In8 stitute on Aging, and after consultation with 

9 the Director of the Centers for Disease Control 

10 and Prevention, the Director of the Office of 

11 Elder Justice in the Department of Health and 

12 Human Services, the Director of the Office of 

13 Elder Justice in the Department of Justice, and 

14 the members of the advisory board established 

15 under section 2213, may award grants to insti16 tutions of higher education and other appro17 priate entities to establish 5 Centers of Excel18 lence nationwide that shall specialize in re19 search, clinical practice, and training relating to 

20 elder abuse, neglect, and exploitation. 

21 ‘‘(B) AUTHORIZED ACTIVITIES.—The Cen22 ters of Excellence established with funds pro23 vided under subparagraph (A) shall conduct the 

24 following activities: 
40 

•S 2010 IS

1 ‘‘(i) Examine potential issues relating 

2 to the protection of elders who are the sub3 jects of research on elder abuse, neglect, 

4 and exploitation and provide guidance to 

5 other elder abuse, neglect, or exploitation 

6 researchers regarding human subjects, pro7 tections, and the institutional or peer re8 view boards at research institutions. 

9 ‘‘(ii) After consultation with the Di10 rector of the National Institute on Aging, 

11 and the Director of the Office of Human 

12 Research Protections, develop and rec13 ommend to the Secretary guidelines to as14 sist the institutional or peer review boards 

15 in the review of research conducted under 

16 this title. 

17 ‘‘(iii) Coordinate activities, to the ex18 tent feasible, among the Centers and with 

19 other researchers of elder abuse, neglect, 

20 and exploitation and related areas, and 

21 designate 1 such Center to lead such co22 ordination. 

23 ‘‘(C) ADDITIONAL ACTIVITIES.—The Cen24 ters of Excellence established under subpara-
41 

•S 2010 IS

1 graph (A) may conduct activities including the 

2 following: 

3 ‘‘(i) Carrying out a study to deter4 mine the national incidence and prevalence 

5 of elder abuse, neglect, and exploitation in 

6 all settings. 

7 ‘‘(ii) Developing uniform, validated 

8 screening tools to assist individuals, fami9 lies, practitioners, institutions, and com10 munities in detecting ongoing or potential 

11 elder abuse, neglect, and exploitation. The 

12 tools that may be developed include— 

13 ‘‘(I) a screening tool to determine 

14 whether a particular elder is at risk 

15 for becoming, or is, a victim of elder 

16 abuse, neglect, or exploitation; 

17 ‘‘(II) a screening tool to measure 

18 whether caregivers are at risk of com19 mitting elder abuse, neglect, or exploi20 tation; 

21 ‘‘(III) a screening tool to meas22 ure whether families are at risk for 

23 elder abuse, neglect, and exploitation; 

24 and 
42 

•S 2010 IS

1 ‘‘(IV) a screening tool to assess 

2 communities, evaluating how each in3 dividual agency or system relating to 

4 elder abuse, neglect, or exploitation 

5 operates in such a community and 

6 how all of such agencies or systems 

7 communicate and operate in relation8 ship to each other within such com9 munity. 

10 ‘‘(iii) Carrying out various types of 

11 intervention research. 

12 ‘‘(iv) Identifying steps that can be 

13 taken (and replicated) to make homes, 

14 neighborhoods, communities, and facilities 

15 safer for elders, and to enhance elders’ 

16 sense of security in all kinds of environ17 ments. 

18 ‘‘(v) Researching successful fiduciary 

19 practices and systems to enhance the well20 being of persons with diminished capacity. 

21 ‘‘(D) COLLABORATION AND ACCESS TO

22 RECORDS.—In awarding a grant under this 

23 paragraph the Secretary shall— 

24 ‘‘(i) consider the potential for collabo25 ration among researchers and other rel-
43 

•S 2010 IS

1 evant entities, such as State agencies with 

2 statutory responsibility for adult protective 

3 services and State Long-Term Care Om4 budsmen, that receive reports of elder 

5 abuse, neglect, and exploitation, but that 

6 may be restricted from participating in re7 search as a result of State law, confiden8 tiality requirements, or other provisions; 

9 and 

10 ‘‘(ii) require that each institution of 

11 higher education desiring a grant under 

12 this subsection ensure that the researchers 

13 working at such institution will have access 

14 to records necessary to conduct research in 

15 accordance with this paragraph. 

16 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

17 There are authorized to be appropriated for the pur18 pose of carrying out paragraphs (1) and (2) of this 

19 subsection— 

20 ‘‘(A) $12,000,000 for fiscal year 2007; 

21 ‘‘(B) $20,000,000 for fiscal year 2008; and 

22 ‘‘(C) $25,000,000 for each of fiscal years 

23 2009 through 2013. 

24 ‘‘(b) SAFE HAVEN AND LEGAL ADVOCACY

25 GRANTS.— 
44 

•S 2010 IS

1 ‘‘(1) SAFE HAVEN GRANTS.— 

2 ‘‘(A) GRANTS AUTHORIZED.—The Sec3 retary may award grants to 6 diverse commu4 nities to examine various types of elder shelters 

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

6 and to test various models for establishing safe 

7 havens at home or elsewhere. 

8 ‘‘(B) AUTHORIZED ACTIVITIES.—Grant 

9 funds awarded pursuant to subparagraph (A) 

10 shall be used to establish safe havens that— 

11 ‘‘(i) provide a comprehensive, cul12 turally sensitive, and multidisciplinary 

13 team response to allegations of elder 

14 abuse, neglect, or exploitation; 

15 ‘‘(ii) provide a dedicated, elder-friend16 ly setting; 

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

18 needs of elders for care; and 

19 ‘‘(iv) provide various services includ20 ing— 

21 ‘‘(I) nursing and forensic evalua22 tion; 

23 ‘‘(II) therapeutic intervention; 

24 ‘‘(III) victim support and advo25 cacy; and 
45 

•S 2010 IS

1 ‘‘(IV) case review and assistance 

2 to make the elder safer at home or to 

3 find appropriate placement in safer 

4 environments, including shelters, and, 

5 in some circumstances, long-term care 

6 facilities, other residential care facili7 ties, and hospitals. 

8 ‘‘(2) LEGAL ADVOCACY GRANTS.— 

9 ‘‘(A) GRANTS AUTHORIZED.—The Sec10 retary, after consultation with the Attorney 

11 General, may award grants— 

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

13 resources in order to provide assistance for 

14 legal and related services for victims of 

15 elder abuse, neglect, or exploitation; and 

16 ‘‘(ii) to provide assistance for such 

17 services by awarding grants for demonstra18 tion projects in diverse communities. 

19 ‘‘(B) AUTHORIZED ACTIVITIES.—Grant 

20 funds awarded pursuant to subparagraph (A) 

21 shall be used to provide— 

22 ‘‘(i) court-appointed advocates; 

23 ‘‘(ii) authorized fiduciaries, including 

24 public guardians; 
46 

•S 2010 IS

1 ‘‘(iii) monitoring and oversight of fi2 duciaries; 

3 ‘‘(iv) legal services; and 

4 ‘‘(v) such other services as the Sec5 retary, after consultation with the Attorney 

6 General, determines appropriate. 

7 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

8 There are authorized to be appropriated to carry out 

9 this subsection— 

10 ‘‘(A) $3,000,000 for fiscal year 2007; 

11 ‘‘(B) $4,000,000 for fiscal year 2008; and 

12 ‘‘(C) $5,000,000 for each of fiscal years 

13 2009 through 2013. 

14 ‘‘(c) GRANTS TO ENHANCE VOLUNTEER SERV15 ICES.— 

16 ‘‘(1) GRANTS.—The Secretary, after consulta17 tion with the Attorney General, may award grants to 

18 nonprofit organizations and faith-based organiza19 tions to encourage such organizations to establish or 

20 continue volunteer programs that focus on the issues 

21 of elder abuse, neglect, and exploitation, or that pro22 vide related services. 

23 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

24 There are authorized to be appropriated to carry out 

25 this subsection— 
47 

•S 2010 IS

1 ‘‘(A) $1,500,000 for fiscal year 2007; 

2 ‘‘(B) $2,000,000 for fiscal year 2008; and 

3 ‘‘(C) $2,500,000 for each of fiscal years 

4 2009 through 2013. 

5 ‘‘(d) MULTIDISCIPLINARY EFFORTS.— 

6 ‘‘(1) GRANTS.— 

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

8 award grants to fund various multidisciplinary 

9 elder justice activities, including the following: 

10 ‘‘(i) Supporting and studying team 

11 approaches for bringing a coordinated mul12 tidisciplinary or interdisciplinary response 

13 to elder abuse, neglect, and exploitation, 

14 including a response from individuals in 

15 social service, health care, public safety, 

16 and legal disciplines. 

17 ‘‘(ii) Establishing State coordinating 

18 councils modeled after the national Elder 

19 Justice Coordinating Council established 

20 under section 2212. Such State coordi21 nating councils shall identify the individual 

22 States’ needs and provide the national 

23 Elder Justice Coordinating Council with 

24 information and recommendations relating 
48 

•S 2010 IS

1 to State efforts to combat elder abuse, ne2 glect, and exploitation. 

3 ‘‘(iii) Providing training, technical as4 sistance, and other methods of support to 

5 groups carrying out multidisciplinary ef6 forts at the State level (referred to in some 

7 States as ‘State Working Groups’). 

8 ‘‘(iv) Broadening and studying various 

9 models for elder fatality and serious injury 

10 review teams, to make recommendations 

11 about their composition, protocols, func12 tions, timing, roles, and responsibilities, 

13 with a goal of producing models and infor14 mation that will allow for replication based 

15 on the needs of other States and commu16 nities. 

17 ‘‘(v) Carrying out such other inter18 disciplinary or multidisciplinary efforts as 

19 the Secretary determines to be appropriate. 

20 ‘‘(B) AUTHORIZATION OF APPROPRIA21 TIONS.—There are authorized to be appro22 priated to carry out this paragraph, $5,000,000 

23 for each of fiscal years 2007 through 2013. 

24 ‘‘(2) INTERDISCIPLINARY STUDY.— 
49 

•S 2010 IS

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

2 Centers for Disease Control and Prevention, 

3 after consultation with the Director of the Of4 fice of Elder Justice in the Department of 

5 Health and Human Services and the Director 

6 of the Office of Elder Justice in the Depart7 ment of Justice, shall conduct an intensive 

8 interdisciplinary study of entities that conduct 

9 elder justice activities in several different com10 munities, examining how the entities address 

11 elder abuse, neglect, and exploitation issues 

12 (such as an assessment of various types of 

13 health care and social service providers, public 

14 safety agencies, law enforcement agencies, pros15 ecutor offices, and the judiciary). 

16 ‘‘(B) GOAL.—The goals of the study de17 scribed in subparagraph (A) include— 

18 ‘‘(i) making an assessment of the 

19 functioning and effectiveness of each entity 

20 in a community that conducts elder justice 

21 activities, and the interdisciplinary commu22 nications and collaborations among such 

23 entities; and 

24 ‘‘(ii) developing a procedure for com25 munities to conduct a self-assessment to 
50 

•S 2010 IS

1 assist them in identifying the manner in 

2 which the entities described in clause (i) in 

3 such communities respond to elder justice 

4 issues, the needs of such communities re5 lating to elder justice issues, and ways to 

6 improve the response systems of such com7 munities for elder abuse, neglect, and ex8 ploitation. 

9 ‘‘(C) AUTHORIZATION OF APPROPRIA10 TIONS.—There are authorized to be appro11 priated to carry out this paragraph— 

12 ‘‘(i) $2,500,000 for fiscal year 2007; 

13 ‘‘(ii) $3,000,000 for fiscal year 2008; 

14 and 

15 ‘‘(iii) $3,500,000 for each of fiscal 

16 years 2009 through 2013. 

17 ‘‘(e) TRAINING GRANTS.— 

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

19 may award grants to groups representing the tar20 geted disciplines described in paragraph (2)(B) to 

21 train individuals with respect to issues of elder 

22 abuse, neglect, and exploitation. 

23 ‘‘(2) AUTHORIZED ACTIVITIES.— 

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

25 under paragraph (1) shall be used for training 
51 

•S 2010 IS

1 within a discipline as well as cross-training ac2 tivities that permit individuals in multiple dis3 ciplines to train together, fostering communica4 tion, coordinating efforts, and ensuring collabo5 ration. 

6 ‘‘(B) TARGETED DISCIPLINES.—Groups 

7 representing disciplines that will be targeted for 

8 training through grants awarded under para9 graph (1) include— 

10 ‘‘(i) physicians, including geriatri11 cians, medical residents, interns, and fel12 lows; 

13 ‘‘(ii) nurses and nurse’s aides, includ14 ing geriatric nurse practitioners, directors 

15 of nursing, and Sexual Abuse Nurse Ex16 aminers (SANE) nurses; 

17 ‘‘(iii) social workers; 

18 ‘‘(iv) public health and safety profes19 sionals, including Emergency Medical Serv20 ices professionals; 

21 ‘‘(v) therapists, including creative 

22 arts, occupational, speech, and physical 

23 therapists; 

24 ‘‘(vi) State surveyors of nursing facili25 ties and other long-term care facilities; 
52 

•S 2010 IS

1 ‘‘(vii) staff of long-term care facilities 

2 or hospitals; 

3 ‘‘(viii) coroners and funeral home op4 erators; 

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

6 with responsibility for elder justice or long7 term care matters; 

8 ‘‘(x) employees or contractors of State 

9 and local agencies with responsibility for 

10 training persons who provide adult protec11 tive services; 

12 ‘‘(xi) State Long-Term Care Ombuds13 men; 

14 ‘‘(xii) victim advocates and advocates 

15 for elders and individuals with disabilities; 

16 ‘‘(xiii) individuals involved in volun17 teer organizations (including faith-based 

18 organizations) who are involved in issues of 

19 elder abuse, neglect, and exploitation; 

20 ‘‘(xiv) police officers, sheriffs, detec21 tives, firefighters, Federal and State inves22 tigators, public safety officers, and correc23 tions personnel; 

24 ‘‘(xv) Federal, State, and local pros25 ecutors, attorneys in private practice in-
53 

•S 2010 IS

1 volved in elder justice issues, judges, and 

2 court employees; 

3 ‘‘(xvi) federally recognized partner4 ships of elders, sheriff departments, and 

5 the American Association of Retired Per6 sons (commonly referred to as TRIADs); 

7 ‘‘(xvii) elder service officers; 

8 ‘‘(xviii) individuals who work with the 

9 public, including bank personnel, postal 

10 workers, utility workers, providers of 

11 home-delivered meals, and others who may 

12 work with elders; 

13 ‘‘(xix) students in professional and 

14 paraprofessional schools, internships, fel15 lowships, and other training programs in a 

16 relevant profession; 

17 ‘‘(xx) fiduciaries, including guardians, 

18 conservators, and agents under powers of 

19 attorney; and 

20 ‘‘(xxi) staff and volunteers of domestic 

21 violence and child abuse and neglect pro22 grams. 

23 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

24 There are authorized to be appropriated to carry out 

25 this subsection— 
54 

•S 2010 IS

1 ‘‘(A) $10,000,000 for fiscal year 2007; 

2 ‘‘(B) $15,000,000 for fiscal year 2008; and 

3 ‘‘(C) $20,000,000 for each of fiscal years 

4 2009 through 2013. 

5 ‘‘(f) INCREASING THE NUMBER OF HEALTH CARE

6 PROFESSIONALS WITH GERIATRIC TRAINING.— 

7 ‘‘(1) INCREASING THE NUMBER OF HEALTH

8 CARE PROFESSIONALS WITH GERIATRIC TRAINING.— 

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

10 establish programs to increase— 

11 ‘‘(i) the number of health care profes12 sionals (including physicians, nurses, nurs13 ing personnel, social workers, and thera14 pists) and students in the health care pro15 fessions, who receive education and train16 ing related to geriatrics; and 

17 ‘‘(ii) the number of such professionals 

18 who provide health care related to geri19 atrics. 

20 ‘‘(B) INCLUSION OF GERIATRIC SERVICES

21 AS PART OF OBLIGATED SERVICE UNDER THE

22 PUBLIC HEALTH SERVICE ACT.—For purposes 

23 of applying sections 338B and 338C of the 

24 Public Health Service Act (42 U.S.C. 254l, 

25 254m), the term ‘obligated service’ shall include 
55 

•S 2010 IS

1 any period during which an individual who has 

2 entered into a written contract with the Sec3 retary under such section 338B (42 U.S.C. 

4 254l) is enrolled and participating in an accred5 ited (as determined by the Secretary) edu6 cational program that provides geriatric train7 ing. Upon the completion of such training, the 

8 individual, after consultation with the Sec9 retary, shall provide geriatric services as appro10 priate during the remainder of the period of ob11 ligated service of such individual. 

12 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

13 There are authorized to be appropriated to carry out 

14 this subsection— 

15 ‘‘(A) $2,500,000 for fiscal year 2007; and 

16 ‘‘(B) $3,500,000 for each of fiscal years 

17 2008 through 2013. 

18 ‘‘(g) DEMENTIA TRAINING GRANTS.— 

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

20 may award grants to eligible entities to provide 

21 training within the health and social science dis22 ciplines, as well as cross-training activities that per23 mit individuals in multiple such disciplines to train 

24 together, to foster communication, coordinate ef-
56 

•S 2010 IS

1 forts, and ensure collaboration on best practices in 

2 caring for individuals with dementia. 

3 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

4 There are authorized to be appropriated to carry out 

5 this subsection $5,000,000 for each of fiscal years 

6 2007 through 2013. 

7 ‘‘(h) SPECIAL NEEDS GRANTS.— 

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

9 may award grants to eligible entities to identify, ad10 dress, and make recommendations on meeting the 

11 special needs of underserved populations of elders. 

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

13 funds awarded pursuant to paragraph (1) shall be 

14 used to fund programs including the following: 

15 ‘‘(A) RURAL SETTINGS.—Programs de16 signed to meet the needs of elders living in 

17 rural locations, including the needs of their in18 formal caregivers and fiduciaries. The programs 

19 shall include— 

20 ‘‘(i) strategies to decrease isolation; 

21 ‘‘(ii) training for informal caregivers 

22 and fiduciaries; 

23 ‘‘(iii) activities involving collaboration 

24 between the entities and local secondary 

25 schools and institutions of higher education 
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•S 2010 IS

1 to offer classes for credit, focusing on 

2 training individuals to work with elders 

3 and caregivers; 

4 ‘‘(iv) training for volunteers to serve 

5 in rural communities; and 

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

7 planning to avoid the need for a guardian 

8 or other fiduciary. 

9 ‘‘(B) MINORITY POPULATIONS.—Programs 

10 designed to meet the needs of elders in minority 

11 populations, including culturally and linguis12 tically appropriate programs. 

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

14 to provide necessary services to elders who are 

15 members of Indian tribes, including successful 

16 programs in elder abuse, neglect, and exploi17 tation prevention and treatment that target In18 dian populations. The entities carrying out the 

19 programs shall deliver services and distribute 

20 educational information on elder abuse, neglect, 

21 and exploitation to Indian tribes and other pol22 icymakers, health and social service providers, 

23 law enforcement, and researchers with a par24 ticular interest in elders who are members of 

25 Indian tribes. 
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•S 2010 IS

1 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

2 There are authorized to be appropriated to carry out 

3 this subsection $7,500,000 for each of fiscal years 

4 2007 through 2013. 

5 ‘‘(i) PUBLIC AWARENESS GRANTS.— 

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

7 and the Attorney General, after consultation with 

8 the advisory board established under section 2213 

9 and the coordinating council established under sec10 tion 2212, shall jointly award 1 grant to a national 

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

12 to conduct a national multimedia campaign designed 

13 to raise awareness about elder abuse, neglect, and 

14 exploitation. 

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

16 awarded under paragraph (1) shall be used for ac17 tivities including the following: 

18 ‘‘(A) Raising public awareness regarding 

19 financial schemes that target elders. 

20 ‘‘(B) Pilot testing the effectiveness of var21 ious types of multimedia campaigns in raising 

22 awareness about— 

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

24 and exploitation; 
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•S 2010 IS

1 ‘‘(ii) steps to take if an individual sus2 pects elder abuse, neglect, or exploitation 

3 has occurred; and 

4 ‘‘(iii) ways to prevent elder abuse, ne5 glect, or exploitation. 

6 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

7 There are authorized to be appropriated to carry out 

8 this subsection $5,000,000 for each of fiscal years 

9 2007 through 2013. 

10 ‘‘(j) ELDER JUSTICE INNOVATION FUND.— 

11 ‘‘(1) IN GENERAL.—The Secretary and the At12 torney General are authorized to jointly award 

13 grants to individuals or entities working in the elder 

14 justice field or related fields for research, a dem15 onstration project, development or implementation of 

16 a promising program or practice, or another innova17 tive effort related to the identification or prevention 

18 of elder abuse, neglect, or exploitation that might 

19 not otherwise be funded or pursued in the absence 

20 of a grant under this subsection. 

21 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

22 There are authorized to be appropriated to carry out 

23 this subsection $5,000,000 for each of fiscal years 

24 2007 through 2013. 
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1 ‘‘SEC. 2223. STUDIES. 

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

3 ABUSE, NEGLECT, AND EXPLOITATION.— 

4 ‘‘(1) IN GENERAL.—The Secretary and the At5 torney General shall jointly sponsor or conduct a 

6 study of the roles and responsibilities of Government 

7 and Government-funded entities responsible for re8 sponding to, investigating, and taking other actions 

9 in response to reports of elder abuse, neglect, and 

10 exploitation including— 

11 ‘‘(A) State and local agencies with the re12 sponsibility for adult protective services; 

13 ‘‘(B) the State Long-Term Care Ombuds14 men; 

15 ‘‘(C) law enforcement (including prosecu16 tors); 

17 ‘‘(D) fiduciaries; 

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

19 ‘‘(F) such other social and protective serv20 ice, advocacy, and protection organizations as 

21 the Secretary and the Attorney General deter22 mine to be appropriate. 

23 ‘‘(2) GOALS.—The goals of the study author24 ized in paragraph (1) (which may be conducted in 

25 distinct sections, if there is overall coordination) 

26 are— 
61 

•S 2010 IS

1 ‘‘(A) to identify gaps in the detection of, 

2 investigation of, and intervention in elder abuse, 

3 neglect, and exploitation; 

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

5 abuse, neglect, and exploitation; and 

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

7 consequences by assessing and improving the 

8 systems created to address reports of elder 

9 abuse, neglect, and exploitation. 

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

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

12 shall— 

13 ‘‘(A) conduct an evaluation of— 

14 ‘‘(i) how the social and protective 

15 service, advocacy, protection, judicial, and 

16 law enforcement entities and systems are 

17 operating; 

18 ‘‘(ii) the interplay and allocation of re19 sponsibilities among those entities; 

20 ‘‘(iii) how that allocation differs from 

21 community to community and State to 

22 State; and 

23 ‘‘(iv) how those differences impact the 

24 population intended to be protected by the 

25 entities and systems; 
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•S 2010 IS

1 ‘‘(B) make recommendations on how to 

2 clarify the roles (at the Federal level) of entities 

3 such as State agencies with responsibility for 

4 adult protective services, the State Long-Term 

5 Care Ombudsmen, and other protection and ad6 vocacy entities to enhance efficiency, eliminate 

7 gaps in service, and identify conflicting man8 dates and duplication of efforts; and 

9 ‘‘(C) evaluate how various communities de10 lineate the roles and responsibilities of the types 

11 of entities described in subparagraph (A) in 

12 order to identify and recommend effective mod13 els and methods to duplicate the delineation ef14 forts (such as duplication through memoranda 

15 of understanding). 

16 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

17 There are authorized to be appropriated to carry out 

18 this subsection $2,000,000 for each of fiscal years 

19 2007 through 2013. 

20 ‘‘(b) FAMILY ELDER ABUSE, NEGLECT, AND EX21 PLOITATION STUDY.— 

22 ‘‘(1) IN GENERAL.—The Director of the Cen23 ters for Disease Control and Prevention (in this sub24 section referred to as the ‘Director’), after consulta25 tion with the Director of the Office of Elder Justice 
63 

•S 2010 IS

1 in the Department of Health and Human Services 

2 and the Director of the Office of Elder Justice in 

3 the Department of Justice, shall conduct a study to 

4 determine the best method to address elder abuse, 

5 neglect, and exploitation from a public health per6 spective, including examining methods to reduce 

7 elder abuse, neglect, and exploitation committed by 

8 family members. 

9 ‘‘(2) COLLABORATION.—The Director, in car10 rying out activities under this subsection, shall col11 laborate with the Director of the National Institute 

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

13 in the Department of Health and Human Services, 

14 the Director of the Office of Elder Justice in the 

15 Department of Justice, the heads of State agencies 

16 with responsibility for adult protective services, and 

17 the heads of such other entities as the Director de18 termines appropriate. 

19 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

20 There are authorized to be appropriated to carry out 

21 this subsection— 

22 ‘‘(A) $1,500,000 for fiscal year 2007; and 

23 ‘‘(B) $2,000,000 for each of fiscal years 

24 2008 through 2013. 
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1 ‘‘SEC. 2224. FORENSIC MARKERS, METHODOLOGIES, AND 

2 TRAINING. 

3 ‘‘(a) FORENSIC CENTERS.— 

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

5 grants to appropriate entities to establish and oper6 ate stationary and mobile forensic centers, to de7 velop forensic expertise regarding, and provide serv8 ices relating to, elder abuse, neglect, and exploi9 tation. 

10 ‘‘(2) COORDINATION AMONG FORENSIC CEN11 TERS AND CENTERS OF EXCELLENCE.—The entities 

12 establishing and operating the forensic centers shall 

13 coordinate activities on an ongoing basis with the 

14 Centers of Excellence described in section 

15 2222(b)(1). Such coordination shall include ongoing 

16 communication among the entities and the Centers 

17 of Excellence. The entities shall adhere to proce18 dures and mechanisms developed by the Secretary, 

19 including procedures and mechanisms relating to the 

20 sharing of data. 

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

22 Secretary shall make 4 of the grants described in 

23 paragraph (1) to institutions of higher education 

24 with demonstrated expertise in forensics or commit25 ment to preventing or treating elder abuse, neglect, 

26 or exploitation, to establish and operate stationary 
65 

•S 2010 IS

1 forensic centers. The Secretary shall make at least 

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

3 Excellence described in section 2222(b)(1) at an in4 stitution of higher education. 

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

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

7 appropriate entities to establish and operate mobile 

8 forensic centers. 

9 ‘‘(5) USE OF FUNDS.— 

10 ‘‘(A) DEVELOPMENT OF FORENSIC MARK11 ERS AND METHODOLOGIES.—An entity that re12 ceives a grant under this subsection shall use 

13 funds made available through the grant to as14 sist in the determination of whether abuse or 

15 neglect occurred, or a crime was committed, 

16 and to conduct research to describe and dis17 seminate information on— 

18 ‘‘(i) forensic markers that indicate a 

19 case in which elder abuse, neglect, or ex20 ploitation may have occurred; and 

21 ‘‘(ii) methodologies for determining, in 

22 such a case, when and how health care, 

23 emergency service, social and protective 

24 service, and legal service providers should 

25 intervene and when the providers should 
66 

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1 report the case to law enforcement authori2 ties. 

3 ‘‘(B) APPLICATIONS.—An entity that re4 ceives a grant under this subsection shall use 

5 funds made available through the grant to de6 velop forensic expertise regarding elder abuse, 

7 neglect, and exploitation, in order to provide 

8 medical and forensic evaluation, therapeutic 

9 intervention, victim support and advocacy, case 

10 review, and case tracking. 

11 ‘‘(C) COLLECTION OF EVIDENCE.—An en12 tity operating a Center of Excellence described 

13 in section 2222(b)(1) that receives a grant 

14 under this subsection shall use funds made 

15 available through the grant to develop the ca16 pacity to collect forensic evidence, including col17 lecting forensic evidence relating to a potential 

18 determination of elder abuse, neglect, or exploi19 tation. 

20 ‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 

21 There are authorized to be appropriated to carry out 

22 this subsection— 

23 ‘‘(A) $4,000,000 for fiscal year 2007; 

24 ‘‘(B) $6,000,000 for fiscal year 2008; and 
67 

•S 2010 IS

1 ‘‘(C) $8,000,000 for each of fiscal years 

2 2009 through 2013. 

3 ‘‘(b) TRAINING TO DEVELOP EXPERTISE IN GERI4 ATRIC FORENSICS.— 

5 ‘‘(1) FELLOWSHIP PROGRAMS.— 

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

7 award fellowships to eligible individuals, to en8 able the individuals to obtain training through 

9 a standard forensic science training program. 

10 ‘‘(B) ELIGIBLE INDIVIDUALS.—To be eligi11 ble to receive a fellowship under this paragraph, 

12 an individual shall be a physician who— 

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

14 in internal medicine or family practice; 

15 ‘‘(ii) has completed a program in geri16 atrics that meets such criteria as the Sec17 retary may prescribe; and 

18 ‘‘(iii) has entered into an agreement 

19 with the Secretary to provide the team 

20 training described in subparagraph (C), 

21 after receiving the training described in 

22 subparagraph (A). 

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

24 receives a fellowship under this paragraph shall 
68 

•S 2010 IS

1 provide training in forensic geriatrics to inter2 disciplinary teams of health care professionals. 

3 ‘‘(2) ADDITIONAL PROGRAMS.—In addition to 

4 the fellowships awarded under paragraph (1), the 

5 Secretary shall establish programs, and make grants 

6 to carry out such programs, that are designed to 

7 provide forensic training to experienced geriatricians. 

8 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

9 There are authorized to be appropriated to carry out 

10 this subsection $5,000,000 for each of fiscal years 

11 2007 through 2013. 

12 ‘‘Subtitle C—Increasing Security, 

13 Quality, and Consumer Informa14 tion for Long-Term Care 

15 ‘‘CHAPTER 1—INCREASING SECURITY FOR 

16 LONG-TERM CARE 

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

18 OCCURRING IN FEDERALLY FUNDED LONG19 TERM CARE FACILITIES. 

20 ‘‘(a) REPORTING REQUIREMENT.— 

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

22 owner, operator, employee, manager, agent, or con23 tractor of a long-term care facility that is described 

24 in subsection (b)(1) shall report to 1 or more law en25 forcement entities for the jurisdiction in which the 
69 

•S 2010 IS

1 facility is located any reasonable suspicion of a crime 

2 (as defined by the law of the applicable political sub3 division) against any person who is a resident of or 

4 receiving care from the facility. 

5 ‘‘(2) TIMING.—If the events that cause the sus6 picion— 

7 ‘‘(A) result in serious bodily injury, the in8 dividual shall report the suspicion immediately; 

9 and 

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

11 the individual shall report the suspicion not 

12 later than 24 hours after forming the suspicion. 

13 ‘‘(b) LONG-TERM CARE FACILITY DESCRIBED.— 

14 ‘‘(1) LONG-TERM CARE FACILITY.—A long-term 

15 care facility is described in this paragraph if such 

16 facility will receive at least $10,000 in Federal funds 

17 during a year. 

18 ‘‘(2) NOTIFICATION.—In the case of a long19 term facility described in paragraph (1), the owner 

20 or operator shall annually notify each individual de21 scribed in subsection (a)(1) of the obligation to com22 ply with subsection(a). 

23 ‘‘(c) PENALTY.— 

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

25 in subsection (a)(1) violates subsection (a)— 
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•S 2010 IS

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

2 than $200,000 or subject to a civil money pen3 alty of not more than $200,000; or 

4 ‘‘(B) the Secretary shall classify the indi5 vidual as an excluded individual for a period of 

6 not more than 3 years. 

7 ‘‘(2) INCREASED HARM.—If an individual de8 scribed in subsection (a)(1) violates subsection (a), 

9 and the violation exacerbates the harm to the victim 

10 of the crime or results in harm to another person— 

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

12 than $300,000 or subject to a civil money pen13 alty of not more than $300,000; and 

14 ‘‘(B) the Secretary shall classify the indi15 vidual as an excluded individual for a period of 

16 not more than 3 years. 

17 ‘‘(3) EXCLUDED INDIVIDUAL.—During any pe18 riod for which an individual is classified as an ex19 cluded individual under this paragraph, an entity 

20 that employs the individual shall be ineligible to re21 ceive Federal funds. 

22 ‘‘(4) EXTENUATING CIRCUMSTANCES.—The 

23 Secretary may take into account the financial bur24 den on providers with underserved populations in de25 termining the penalty. 
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1 ‘‘(d) REGULATIONS.—The Secretary, after consulting 

2 with the Attorney General, shall issue regulations to carry 

3 out this section. 

4 ‘‘CHAPTER 2—IMPROVING THE QUALITY 

5 OF LONG-TERM CARE 

6 ‘‘SEC. 2241. GRANTS AND INCENTIVES TO ENHANCE LONG7 TERM CARE STAFFING. 

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

9 the Centers for Medicare & Medicaid Services (in this sec10 tion referred to as the ‘Administrator’) shall carry out ac11 tivities, including activities described in subsections (b) 

12 and (c), to provide incentives for individuals to train for, 

13 seek, and maintain employment providing direct care in 

14 a long-term care facility. 

15 ‘‘(b) SPECIFIC PROGRAMS TO ENHANCE TRAINING, 

16 RECRUITMENT, AND RETENTION OF STAFF.— 

17 ‘‘(1) COORDINATION WITH OTHER PROGRAMS

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

19 The Administrator shall coordinate activities with 

20 the Secretary of Labor and the Assistant Secretary 

21 for the Administration for Children and Families, in 

22 order to provide incentives to participants in pro23 grams carried out under section 403(a)(5) and part 

24 A of title IV to train for and seek employment pro25 viding direct care in a long-term care facility. 
72 

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

2 INCREASES TO INCREASE STAFFING IN LONG-TERM

3 CARE FACILITIES.— 

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

5 shall make grants to eligible entities to carry 

6 out programs through which the entities— 

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

8 direct care in a long-term care facility, 

9 continuing training and varying levels of 

10 certification, based on observed clinical 

11 care practices and the amount of time the 

12 employees spend providing direct care; and 

13 ‘‘(ii) provide, or make arrangements 

14 with employers to provide, bonuses or 

15 other increased compensation or benefits to 

16 employees who achieve certification under 

17 such a program. 

18 ‘‘(B) APPLICATION.—To be eligible to re19 ceive a grant under this paragraph, an entity 

20 shall submit an application to the Adminis21 trator at such time, in such manner, and con22 taining such information as the Administrator 

23 may require. 

24 ‘‘(c) SPECIFIC PROGRAMS TO IMPROVE MANAGE25 MENT PRACTICES.— 
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•S 2010 IS

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

2 make grants to eligible organizations to enable the 

3 organizations to provide training and technical as4 sistance to eligible persons (including administra5 tors, directors of nursing, staff developers, and 

6 charge nurses) who establish or implement manage7 ment practices for long-term care facilities. 

8 ‘‘(2) USE OF FUNDS.—An organization that re9 ceives a grant under paragraph (1) shall use funds 

10 made available through the grant— 

11 ‘‘(A) to provide training and technical as12 sistance regarding management practices for 

13 employees that provide direct care in a long14 term care facility and that are demonstrated to 

15 promote retention of those employees, such 

16 as— 

17 ‘‘(i) the establishment of basic human 

18 resource policies that reward high perform19 ance, including policies that provide for im20 proved wages and benefits on the basis of 

21 job reviews; 

22 ‘‘(ii) the establishment of motivational 

23 and thoughtful work organization prac24 tices; 
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•S 2010 IS

1 ‘‘(iii) the creation of a workplace cul2 ture that respects and values caregivers 

3 and their needs; 

4 ‘‘(iv) the promotion of a workplace 

5 culture that respects the rights of residents 

6 of a long-term care facility and results in 

7 improved care for the residents; and 

8 ‘‘(v) the establishment of other pro9 grams that promote the provision of high 

10 quality care, such as a continuing edu11 cation program that provides additional 

12 hours of training, including on-the-job 

13 training, for employees who are certified 

14 nurse aides; or 

15 ‘‘(B) to disseminate training materials for 

16 the training described in subparagraph (A), and 

17 to provide the materials to the National Elder 

18 Justice Library established in section 

19 2221(a)(4), so that the materials are available 

20 to other providers of such training. 

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

22 grant under this subsection, an organization shall 

23 submit an application to the Administrator at such 

24 time, in such manner, and containing such informa25 tion as the Administrator may require. 
75 

•S 2010 IS

1 ‘‘(d) EVALUATING PROGRAMS.—After the first pro2 grams developed under this section have been completed, 

3 the Administrator shall evaluate the outcomes of such pro4 grams in determining which future applications to fund. 

5 ‘‘(e) ACCOUNTABILITY MEASURES.—The Adminis6 trator shall develop accountability measures to ensure that 

7 funds made available under this section benefit the staff 

8 who are the intended beneficiaries of the programs pro9 vided under this section, to promote increases in the num10 ber of staff and stability in the long-term care workforce. 

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

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

13 shall comply with all applicable laws, regulations, and 

14 guidelines. 

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

16 are authorized to be appropriated to carry out this section 

17 $10,000,000 for each of fiscal years 2007 through 2013. 

18 ‘‘SEC. 2242. COLLABORATIVE EFFORTS TO ENHANCE COM19 MUNICATION ON PROMOTING QUALITY OF 

20 AND PREVENTING ABUSE AND NEGLECT IN 

21 LONG-TERM CARE. 

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

23 Healthcare Research and Quality (in this section referred 

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

25 General, may establish pilot projects to improve long-term 
76 

•S 2010 IS

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

2 grants to eligible partnerships to develop collaborative and 

3 innovative approaches to improve the quality of, including 

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

5 ‘‘(b) ELIGIBLE PARTNERSHIPS.—To be eligible to re6 ceive a grant under this section, a partnership shall be 

7 a multidisciplinary community partnership, such as a 

8 partnership consisting of representatives in a community 

9 of nursing facility providers, advocates for residents of 

10 long-term care facilities, State Long-Term Care Ombuds11 men, surveyors, the State agency with responsibility for 

12 adult protective services, the State agency with responsi13 bility for licensing long-term care facilities, law enforce14 ment agencies, courts, family councils, residents, certified 

15 nurse aides, registered nurses, physicians, and other ap16 propriate entities and individuals. 

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

18 under this section, a partnership shall submit an applica19 tion to the Director at such time, in such manner, and 

20 containing such information as the Director may require. 

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

22 are authorized to be appropriated to carry out this section 

23 $2,500,000 for each of fiscal years 2007 through 2013. 
77 

•S 2010 IS

1 ‘‘SEC. 2243. COLLABORATIVE EFFORTS TO DEVELOP CON2 SENSUS AROUND THE MANAGEMENT OF CER3 TAIN QUALITY-RELATED FACTORS. 

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

5 Healthcare Research and Quality (in this section referred 

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

7 General and the Advisory Board established under section 

8 2213, shall make grants to eligible entities to establish 

9 multidisciplinary panels to address, and develop consensus 

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

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

12 grants, including at least 1 grant for the establishment 

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

14 methods of managing resident-to-resident abuse in long15 term care. 

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

17 grant under this section shall— 

18 ‘‘(1) establish a multidisciplinary panel to ad19 dress a specific subject; and 

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

21 available through the grant to establish a goal with 

22 respect to the subject, examine relevant research and 

23 data, identify best practices with respect to the sub24 ject, determine the best way to carry out those best 

25 practices in a practical and feasible manner, and de-
78 

•S 2010 IS

1 termine an effective manner of distributing informa2 tion on the subject. 

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

4 under this section, an entity shall submit an application 

5 to the Director at such time, in such manner, and con6 taining such information as the Director may require. 

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

8 are authorized to be appropriated to carry out this section 

9 $2,000,000 for each of fiscal years 2007 through 2013. 

10 ‘‘CHAPTER 3—INCREASING CONSUMER 

11 INFORMATION ABOUT LONG-TERM CARE 

12 ‘‘SEC. 2251. LONG-TERM CARE CONSUMER CLEARING13 HOUSE. 

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

15 Elder Justice in the Department of Health and Human 

16 Services, in coordination with the Director of the Agency 

17 for Healthcare Research and Quality and the Adminis18 trator of the Centers for Medicare & Medicaid Services, 

19 shall establish a long-term care consumer clearinghouse in 

20 the Department of Health and Human Services. 

21 ‘‘(b) INFORMATION.—The clearinghouse shall be es22 tablished as part of the Elder Justice Resource Center es23 tablished under section 2221 and shall provide comprehen24 sive detailed information, in a consumer-friendly form, to 

25 consumers about choices relating to long-term care pro-
79 

•S 2010 IS

1 viders, such as information (including links to Web sites 

2 and other resources that provide information) about— 

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

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

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

7 as— 

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

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

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

13 ‘‘(B) the benefits available through the 

14 programs carried out under titles XVIII and 

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

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

17 ‘‘(C) the care available through specific 

18 long-term care facilities, including data on the 

19 satisfaction level of residents, and families of 

20 residents, of the facilities. 

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

23 shall provide information (from States and other sources) 

24 on assisted living facilities, board and care facilities, con-
80 

•S 2010 IS

1 gregate care facilities, home health care providers, and 

2 other long-term care providers. 

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

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

6 ‘‘(1) $2,000,000 for fiscal year 2007; 

7 ‘‘(2) $3,000,000 for fiscal year 2008; and 

8 ‘‘(3) $4,000,000 for each of fiscal years 2009 

9 through 2013. 

10 ‘‘SEC. 2252. CONSUMER INFORMATION ABOUT THE CON11 TINUUM OF RESIDENTIAL LONG-TERM CARE 

12 FACILITIES. 

13 ‘‘(a) STUDY.— 

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

15 for Healthcare Research and Quality, after consulta16 tion with the Director of the Office of Elder Justice 

17 in the Department of Health and Human Services 

18 and the Director of the Office of Elder Justice in 

19 the Department of Justice, shall, directly or through 

20 a grant, conduct a study on consumer concerns re21 lating to residential long-term care facilities other 

22 than nursing facilities. 

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

24 the study shall— 
81 

•S 2010 IS

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

2 residential long-term care facilities described in 

3 paragraph (1); and 

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

5 level of services provided by, oversight and en6 forcement provisions of, and admission and dis7 charge criteria of the facilities. 

8 ‘‘(b) REPORT.—The Director of the Agency for 

9 Healthcare Research and Quality shall prepare a report 

10 containing the results of the study and, not later than the 

11 date that is 2 years after the date of enactment of the 

12 Elder Justice Act, submit the report to the Elder Justice 

13 Coordinating Council established under section 2212, the 

14 Committee on Ways and Means of the House of Rep15 resentatives, and the Special Committee on Aging of the 

16 Senate. 

17 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

18 are authorized to be appropriated to carry out this section 

19 $3,000,000 for each of fiscal years 2007 through 2013. 

20 ‘‘Subtitle D—Miscellaneous 

21 Provisions 

22 ‘‘SEC. 2261. EVALUATIONS. 

23 ‘‘(a) GRANTS.— 

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

25 provision of this title, the granting authority shall— 
82 

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

2 to— 

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

4 made available through the grant; and 

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

6 an evaluation of the other activities carried 

7 out through the grant; or 

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

9 available for the grant; and 

10 ‘‘(ii) use the reserved funds to provide as11 sistance to an eligible entity to conduct an eval12 uation of the activities carried out through the 

13 grant. 

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

15 described in paragraph (1)(A), or assistance de16 scribed in paragraph (1)(B)(ii), shall use the funds 

17 made available through the grant, or the assistance, 

18 respectively, to conduct a validated evaluation of the 

19 effectiveness of the activities described in subpara20 graph (A) or (B), respectively, of paragraph (1). 

21 ‘‘(3) APPLICATIONS.— 

22 ‘‘(A) SUBMISSION.— 

23 ‘‘(i) GRANTS FOR PROJECTS CON24 TAINING EVALUATIONS.—To be eligible to 

25 receive a grant for which the granting au-
83 

•S 2010 IS

1 thority requires the reservation described 

2 in paragraph (1)(A)(i), an entity shall in3 clude a proposal for the evaluation in the 

4 application submitted for the grant. 

5 ‘‘(ii) ASSISTANCE FOR EVALUA6 TIONS.—To be eligible to receive assistance 

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

8 submit an application to the granting au9 thority at such time, in such manner, and 

10 containing such information as the grant11 ing authority may require, including a pro12 posal for the evaluation. 

13 ‘‘(B) REVIEW AND ASSISTANCE.—An em14 ployee of the National Institute on Aging and 

15 a private expert with expertise in evaluation 

16 methodology shall review each proposal de17 scribed in clause (i) or (ii) of subparagraph (A), 

18 and determine whether the methodology de19 scribed in the proposal is adequate to gather 

20 meaningful information. If the employee and 

21 expert determine that the methodology is inad22 equate, the employee and expert shall rec23 ommend that the granting authority deny the 

24 application for the grant described in subpara25 graph (A)(i), or the assistance described in sub-
84 

•S 2010 IS

1 paragraph (B)(ii), as appropriate, or make rec2 ommendations for how the application should 

3 be amended. If the granting authority denies 

4 the application on the basis of the proposal, the 

5 granting authority shall inform the applicant 

6 why the application was denied, and offer as7 sistance to the applicant in modifying the pro8 posal. 

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

10 make grants to appropriate entities to conduct validated 

11 evaluations of activities to reduce elder abuse, neglect, and 

12 exploitation that are not funded under this title. 

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

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

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

16 sections 3729 through 3733 of title 31, United States 

17 Code, and other applicable laws. 

18 ‘‘SEC. 2262. HUMAN SUBJECT RESEARCH. 

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

20 of subpart A of part 46 of title 45, Code of Federal Regu21 lations, to research conducted under this title, the term 

22 ‘legally authorized representative’ means, unless otherwise 

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

24 authorized under the applicable law to consent to medical 

25 treatment on behalf of another person. 
85 

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1 ‘‘(b) GUIDELINES.—The Secretary, through the Di2 rector of the National Institute on Aging, after consulta3 tion with the Director of the Office for Human Research 

4 Protections, shall promulgate guidelines to assist research5 ers working in the area of elder abuse, neglect, and exploi6 tation, with issues relating to human subject protections. 

7 ‘‘SEC. 2263. REGULATIONS. 

8 ‘‘The Secretary may issue such regulations as may 

9 be necessary to carry out this title. 

10 ‘‘SEC. 2264. RULE OF CONSTRUCTION. 

11 ‘‘Nothing in this title shall be construed to interfere 

12 with or abridge an elder’s right to practice his or her reli13 gion through reliance on prayer alone for healing when 

14 this choice— 

15 ‘‘(1) is contemporaneously expressed, either 

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

17 or injury which the elder has at the time of the deci18 sion by an elder who is competent at the time of the 

19 decision; 

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

21 health care proxy, or other advance directive docu22 ment that is validly executed and applied under 

23 State law; or 

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

25 elder’s life history. 
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•S 2010 IS

1 ‘‘SEC. 2265. AUTHORIZATION OF APPROPRIATION. 

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

3 this subtitle $7,000,000 for each of fiscal years 2007 

4 through 2013.’’. 

5 SEC. 102. SUPPORTING THE LONG-TERM CARE OMBUDS6 MAN PROGRAM. 

7 (a) SUPPORTING THE LONG-TERM CARE OMBUDS8 MAN PROGRAM.— 

9 (1) IN GENERAL.—Section 712(h) of the Older 

10 Americans Act of 1965 (42 U.S.C. 3058g(h)) is 

11 amended— 

12 (A) in paragraph (8), by striking ‘‘; and’’ 

13 at the end and inserting a semicolon; 

14 (B) in paragraph (9), by striking the pe15 riod at the end and inserting ‘‘; and’’; and 

16 (C) by adding at the end the following new 

17 paragraph: 

18 ‘‘(10) make grants, in consultation with the Di19 rector of the Office of Elder Justice in the Depart20 ment of Health and Human Services and the Direc21 tor of the Office of Elder Justice in the Department 

22 of Justice, to eligible entities with relevant expertise 

23 and experience to conduct evaluations and pilot 

24 studies relating to various programs and methods 

25 carried out by the Office of the State Long-Term 

26 Care Ombudsman or a local Ombudsman entity 
87 

•S 2010 IS

1 under section 307(a)(9) or this chapter, or to pro2 vide support (such as an ombudsman resource cen3 ter).’’. 

4 (2) AUTHORIZATION OF APPROPRIATIONS.— 

5 There are authorized to be appropriated to carry out 

6 the amendments made by this subsection— 

7 (A) $5,000,000 in fiscal year 2007; 

8 (B) $7,500,000 in fiscal year 2008; and 

9 (C) $10,000,000 in each of fiscal years 

10 2009 through 2013. 

11 (b) OMBUDSMAN TRAINING PROGRAMS.— 

12 (1) IN GENERAL.—The Secretary of Health and 

13 Human Services (in this Act referred to as the ‘‘Sec14 retary’’) shall establish programs to provide and im15 prove ombudsman training with respect to elder 

16 abuse, neglect, and exploitation for national organi17 zations and for State Long-Term Care Ombudsman 

18 programs. 

19 (2) AUTHORIZATION OF APPROPRIATIONS.— 

20 There are authorized to be appropriated to carry out 

21 this subsection $10,000,000 for each of fiscal years 

22 2007 through 2013. 
88 

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1 SEC. 103. ADULT PROTECTIVE SERVICES FUNCTIONS AND 

2 GRANT PROGRAMS. 

3 Part A of title XI of the Social Security Act (42 

4 U.S.C. 1301 et seq.) is amended by adding at the end 

5 the following new section: 

6 ‘‘ADULT PROTECTIVE SERVICES FUNCTIONS

7 ‘‘SEC. 1150A. (a) FUNCTIONS.— 

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

9 that the Department of Health and Human Serv10 ices— 

11 ‘‘(A) provides funding authorized by this 

12 title to State and local adult protective services 

13 offices that investigate reports of the abuse, ne14 glect, and exploitation of elders; 

15 ‘‘(B) collects and disseminates data annu16 ally relating to the abuse, exploitation, and ne17 glect of elders in coordination with the Bureau 

18 of Justice Statistics of the Office of Justice 

19 Programs of the Department of Justice efforts 

20 to collect national data under section 2221; 

21 ‘‘(C) develops and disseminates informa22 tion on best practices regarding, and provides 

23 training on, carrying out adult protective serv24 ices; 
89 

•S 2010 IS

1 ‘‘(D) in conjunction with the necessary ex2 perts, conducts research related to the provision 

3 of adult protective services; and 

4 ‘‘(E) provides technical assistance to 

5 States and other entities that provide or fund 

6 the provision of adult protective services, in7 cluding through grants made under subsections 

8 (b) and (c). 

9 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

10 There are authorized to be appropriated to carry out 

11 this subsection— 

12 ‘‘(A) $2,000,000 for fiscal year 2007; and 

13 ‘‘(B) $3,000,000 for each of fiscal years 

14 2008 through 2013. 

15 ‘‘(b) GRANT PROGRAM.— 

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

17 adult protective services grant program under which 

18 the Secretary shall annually award grants to States 

19 in the amounts calculated under paragraph (2) for 

20 the purposes of enhancing adult protective services 

21 provided by States and local units of government. 

22 ‘‘(2) AMOUNT OF PAYMENT.— 

23 ‘‘(A) IN GENERAL.—Subject to subpara24 graphs (B) and (C), with respect to a fiscal 
90 

•S 2010 IS

1 year, each State shall be paid an amount equal 

2 to the product of— 

3 ‘‘(i) the amount appropriated for the 

4 year under paragraph (5); and 

5 ‘‘(ii) the ratio (expressed as a percent6 age) of— 

7 ‘‘(I) the total number of elders 

8 who reside in the State, to 

9 ‘‘(II) the total number of elders 

10 who reside in the United States. 

11 ‘‘(B) GUARANTEED MINIMUM PAYMENT

12 AMOUNT.— 

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

14 (ii), if the amount determined under sub15 paragraph (A) for a State for a year is less 

16 than 0.75 percent of the amount appro17 priated under paragraph (5), the Secretary 

18 shall increase such determined amount so 

19 that the total amount paid under this sub20 section to the State for the year is equal 

21 to 0.75 percent of the amount so appro22 priated. 

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

24 State other than 1 of the 50 States, clause 
91 

•S 2010 IS

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

2 ‘0.75’ were a reference to ‘0.1’. 

3 ‘‘(C) PRO RATA REDUCTIONS.—The Sec4 retary shall make such pro rata reductions to 

5 the amounts described in subparagraph (A) as 

6 are necessary to comply with the requirements 

7 of subparagraph (B). 

8 ‘‘(3) AUTHORIZED ACTIVITIES.— 

9 ‘‘(A) ADULT PROTECTIVE SERVICES.— 

10 Funds made available pursuant to this sub11 section may only be used by States and local 

12 units of government to provide adult protective 

13 services and may not be used for any other pur14 pose. 

15 ‘‘(B) USE BY AGENCY.—Each State receiv16 ing funds pursuant to this subsection shall pro17 vide such funds to the agency or unit of State 

18 government having legal responsibility for pro19 viding adult protective services within the State. 

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

21 State or local unit of government shall use 

22 funds made available pursuant to this sub23 section to supplement and not supplant other 

24 Federal, State, and local public funds expended 

25 to provide adult protective services in the State. 
92 

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1 ‘‘(4) REPORTS.— 

2 ‘‘(A) STATE REPORTS.—Each State receiv3 ing funds under this subsection shall submit to 

4 the Secretary, at such time and in such manner 

5 as the Secretary may require, a report on the 

6 number of elders served by the award of grants 

7 under this subsection. 

8 ‘‘(B) REPORT BY THE SECRETARY.—Not 

9 later than October 1, 2011, the Secretary shall 

10 submit to the appropriate committees of Con11 gress a report compiling, summarizing, and 

12 analyzing the information contained in the re13 ports submitted under subparagraph (A) to14 gether with such recommendations for legisla15 tive or administrative action as the Secretary 

16 determines to be appropriate. 

17 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

18 There is authorized to be appropriated to carry out 

19 this subsection $300,000,000 for each of fiscal years 

20 2007 through 2011.’’. 

21 SEC. 104. ASSURING SAFETY OF RESIDENTS WHEN NURS22 ING FACILITIES CLOSE. 

23 (a) NURSING FACILITY CLOSURE UNDER MED24 ICAID.—Section 1919(c)(2) of the Social Security Act (42 
93 

•S 2010 IS

1 U.S.C. 1396r(c)(2)) is amended by adding at the end the 

2 following new subparagraph: 

3 ‘‘(G) NOTICE OF NURSING FACILITY CLO4 SURE AND RESIDENT TRANSFER PLAN.— 

5 ‘‘(i) IN GENERAL.—The owner or op6 erator of a nursing facility shall— 

7 ‘‘(I) submit to the Secretary and 

8 the State (including the State Long9 Term Care Ombudsman) in which the 

10 facility is located written notification 

11 of an impending closure not later than 

12 the date that is 60 days prior to the 

13 date of such closure; 

14 ‘‘(II) include in the notice a plan 

15 for the transfer and adequate reloca16 tion of the residents prior to closure, 

17 including assurances that residents 

18 will not be transferred to facilities 

19 providing substandard care for which 

20 administrative or law enforcement ac21 tion is pending; and 

22 ‘‘(III) not later than 10 days 

23 after the facility closure, submit to the 

24 Secretary and the State information 

25 identifying where residents of the 
94 

•S 2010 IS

1 closed facility were transferred and on 

2 what date. 

3 ‘‘(ii) SANCTIONS.—Any person owning 

4 a nursing facility that fails to comply with 

5 the requirements of clause (i) shall be sub6 ject to— 

7 ‘‘(I) a civil monetary penalty of 

8 up to $1,000,000; 

9 ‘‘(II) exclusion from participation 

10 in the programs under this Act (in ac11 cordance with the procedures of sec12 tion 1128); and 

13 ‘‘(III) any other applicable civil 

14 monetary penalties and assessments. 

15 ‘‘(iii) PROCEDURE.—A civil monetary 

16 penalty or assessment authorized under 

17 clause (ii) shall be imposed against a per18 son in the same manner as a civil mone19 tary penalty, assessment, or exclusion is 

20 imposed under section 1128A.’’. 

21 (b) SKILLED NURSING FACILITY CLOSURE UNDER

22 MEDICARE.—Section 1819(c)(2) of the Social Security 

23 Act (42 U.S.C. 1395i–3(c)(2)) is amended by adding at 

24 the end the following new subparagraph: 
95 

•S 2010 IS

1 ‘‘(D) NOTICE OF SKILLED NURSING FACIL2 ITY CLOSURE AND RESIDENT TRANSFER

3 PLAN.— 

4 ‘‘(i) IN GENERAL.—The owner or op5 erator of a skilled nursing facility shall— 

6 ‘‘(I) submit to the Secretary and 

7 the State in which the facility is lo8 cated written notification of an im9 pending closure not later than the 

10 date that is 60 days prior to the date 

11 of such closure; 

12 ‘‘(II) include in the notice a plan 

13 for the transfer and adequate reloca14 tion of the residents prior to closure, 

15 including assurances that residents 

16 will not be transferred to facilities 

17 providing substandard care for which 

18 administrative or law enforcement ac19 tion is pending; and 

20 ‘‘(III) not later than 10 days 

21 after the facility closure, submit to the 

22 Secretary and the State information 

23 identifying where residents of the 

24 closed facility were transferred and on 

25 what date. 
96 

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1 ‘‘(ii) SANCTIONS.—Any person owning 

2 a nursing facility that fails to comply with 

3 the requirements of clause (i) shall be sub4 ject to— 

5 ‘‘(I) a civil monetary penalty of 

6 up to $1,000,000; 

7 ‘‘(II) exclusion from participation 

8 in the programs under this Act (in ac9 cordance with the procedures of sec10 tion 1128); and 

11 ‘‘(III) any other applicable civil 

12 monetary penalties and assessments. 

13 ‘‘(iii) PROCEDURE.—A civil monetary 

14 penalty or assessment authorized under 

15 clause (ii) shall be imposed against a per16 son in the same manner as a civil mone17 tary penalty, assessment, or exclusion is 

18 imposed under section 1128A.’’. 

19 SEC. 105. NATIONAL NURSE AIDE REGISTRY. 

20 (a) STUDY AND REPORT.— 

21 (1) IN GENERAL.—The Secretary, in consulta22 tion with appropriate government agencies and pri23 vate sector organizations, shall conduct a study on 

24 establishing a national nurse aide registry. 
97 

•S 2010 IS

1 (2) AREAS EVALUATED.—The study conducted 

2 under this subsection shall include an evaluation 

3 of— 

4 (A) who should be included in the registry; 

5 (B) how such a registry would comply with 

6 Federal and State privacy laws and regulations; 

7 (C) how data would be collected for the 

8 registry; 

9 (D) what entities and individuals would 

10 have access to the data collected; 

11 (E) how the registry would provide appro12 priate information regarding violations of Fed13 eral and State law by individuals included in 

14 the registry; and 

15 (F) how the functions of a national nurse 

16 aide registry would be coordinated with the 

17 pilot program for national and State back18 ground checks on direct patient access employ19 ees of long-term care facilities or providers es20 tablished under section 307 of the Medicare 

21 Prescription Drug, Improvement, and Mod22 ernization Act of 2003 (Public Law 108–173) 

23 and the national criminal background check 

24 program established under section 106(c). 
98 

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1 (3) CONSIDERATIONS.—In conducting the study 

2 and preparing the report required under this sub3 section, the Secretary shall take into consideration 

4 the findings and conclusions of relevant reports, in5 cluding the following: 

6 (A) The Department of Health and 

7 Human Services Office of Inspector General 

8 Report, Nurse Aide Registries: State Compli9 ance and Practices (February 2005). 

10 (B) The General Accounting Office (now 

11 known as the Government Accountability Of12 fice) Report, Nursing Homes: More Can Be 

13 Done to Protect Residents from Abuse (March 

14 2002). 

15 (C) The Department of Health and 

16 Human Services Office of the Inspector General 

17 Report, Nurse Aide Registries: Long-Term Care 

18 Facility Compliance and Practices (July 2005). 

19 (D) The Department of Health and 

20 Human Services Health Resources and Services 

21 Administration Report, Nursing Aides, Home 

22 Health Aides, and Related Health Care Occupa23 tions—National and Local Workforce Shortages 

24 and Associated Data Needs (2004)(in par25 ticular with respect to chapter 7 & appendix F). 
99 

•S 2010 IS

1 (E) The 2001 Report to CMS from the 

2 School of Rural Public Health, Texas A&M 

3 University, Preventing Abuse and Neglect in 

4 Nursing Homes: The Role of Nurse Aide Reg5 istries. 

6 (4) REPORT.—Not later than 24 months after 

7 the date of enactment of this Act, the Secretary 

8 shall submit a report to the appropriate Committees 

9 of Congress containing the findings and rec10 ommendations of the study conducted under this 

11 subsection. 

12 (5) FUNDING LIMITATION.—Funding for the 

13 study conducted under this subsection shall not ex14 ceed $500,000. 

15 (b) ESTABLISHMENT OF NATIONAL NURSE AIDE

16 REGISTRY.— 

17 (1) IN GENERAL.—Upon completion of the re18 port described in subsection (a)(4), the Secretary 

19 shall take appropriate measures to establish a na20 tional nurse aide registry, taking into account the 

21 findings and recommendations contained in the re22 port. 

23 (2) AUTHORIZATION OF APPROPRIATIONS.— 

24 There are authorized to be appropriated such sums 
100 

•S 2010 IS

1 as are necessary for the purpose of carrying out this 

2 subsection. 

3 SEC. 106. BACKGROUND CHECKS ON DIRECT ACCESS EM4 PLOYEES OF LONG-TERM CARE FACILITIES 

5 OR PROVIDERS. 

6 (a) SCREENING OF SKILLED NURSING FACILITY AND

7 NURSING FACILITY EMPLOYEE APPLICANTS.— 

8 (1) MEDICARE PROGRAM.—Section 1819(b) of 

9 the Social Security Act (42 U.S.C. 1395i–3(b)) is 

10 amended by adding at the end the following: 

11 ‘‘(9) SCREENING OF SKILLED NURSING FACIL12 ITY WORKERS.— 

13 ‘‘(A) BACKGROUND CHECKS ON APPLI14 CANTS.—Before hiring a skilled nursing facility 

15 worker, a skilled nursing facility shall conduct 

16 a background check on the employee in accord17 ance with such procedures as the Secretary 

18 shall establish. 

19 ‘‘(B) PROHIBITION ON HIRING OF ABUSIVE

20 WORKERS.— 

21 ‘‘(i) IN GENERAL.—Subject to clause 

22 (ii), a skilled nursing facility may not 

23 knowingly employ any skilled nursing facil24 ity worker who has any disqualifying infor-
101 

•S 2010 IS

1 mation (as defined in subparagraph 

2 (F)(ii)). 

3 ‘‘(ii) PROVISIONAL EMPLOYMENT.—A 

4 skilled nursing facility may provide for a 

5 provisional period of employment for a 

6 skilled nursing facility worker pending 

7 completion of the background check re8 quired under subparagraph (A). Such facil9 ity shall maintain direct supervision of the 

10 covered individual during the worker’s pro11 visional period of employment. 

12 ‘‘(C) PROCEDURES.—The procedures es13 tablished by the Secretary under subparagraph 

14 (A) shall— 

15 ‘‘(i) provide a process by which a 

16 skilled nursing facility worker may appeal 

17 or dispute the accuracy of the information 

18 obtained in a background check conducted 

19 under this paragraph; 

20 ‘‘(ii) take into account the needs of 

21 skilled nursing facilities located in rural 

22 areas and skilled nursing facilities that 

23 serve a low volume of patients (as deter24 mined by the Secretary) with respect to 

25 providing supervision for provisional em-
102 

•S 2010 IS

1 ployees who are awaiting the results of a 

2 background check conducted under this 

3 paragraph; and 

4 ‘‘(iii) provide for the reimbursement 

5 of nursing facilities for 100 percent of the 

6 costs incurred by such facilities in com7 plying with the requirements of this sec8 tion. 

9 ‘‘(D) IMMUNITY FROM LIABILITY.—A 

10 skilled nursing facility that, in denying employ11 ment for an applicant, reasonably relies upon 

12 information about such applicant provided by 

13 the criminal background check shall not be lia14 ble in any action brought by such applicant 

15 based on the employment determination result16 ing from the information. 

17 ‘‘(E) CIVIL PENALTY.— 

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

19 facility that violates the provisions of this 

20 paragraph shall be subject to a civil pen21 alty in an amount not to exceed— 

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

23 $2,000; and 
103 

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1 ‘‘(II) for the second and each 

2 subsequent violation within any 5-year 

3 period, $5,000. 

4 ‘‘(ii) KNOWING RETENTION OF WORK5 ER.—In addition to any civil penalty under 

6 clause (i), a skilled nursing facility that 

7 knowingly continues to employ a skilled 

8 nursing facility worker in violation of sub9 paragraph (A) or (B) shall be subject to a 

10 civil penalty in an amount not to exceed 

11 $5,000 for the first such violation, and 

12 $10,000 for the second and each subse13 quent violation within any 5-year period. 

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

15 ‘‘(i) CONVICTION FOR A RELEVANT

16 CRIME.—The term ‘conviction for a rel17 evant crime’ means any Federal or State 

18 criminal conviction for— 

19 ‘‘(I) any offense described in sec20 tion 1128(a); and 

21 ‘‘(II) such other types of offenses 

22 as the Secretary may specify in regu23 lations. 

24 ‘‘(ii) DISQUALIFYING INFORMATION.— 

25 The term ‘disqualifying information’ means 
104 

•S 2010 IS

1 information about a conviction for a rel2 evant crime or a finding of patient or resi3 dent abuse. 

4 ‘‘(iii) SKILLED NURSING FACILITY

5 WORKER.—The term ‘skilled nursing facil6 ity worker’ means any individual (other 

7 than a volunteer) that has direct access to 

8 a patient of a skilled nursing facility under 

9 an employment or other contract, or both, 

10 with such facility. Such term includes indi11 viduals who are licensed or certified by the 

12 State to provide long-term care services, 

13 and nonlicensed individuals providing such 

14 services, as defined by the Secretary, in15 cluding nurse assistants, nurse aides, home 

16 health aides, and personal care workers 

17 and attendants.’’. 

18 (2) MEDICAID PROGRAM.—Section 1919(b) of 

19 the Social Security Act (42 U.S.C. 1396r(b)) is 

20 amended by adding at the end the following new 

21 paragraph: 

22 ‘‘(9) SCREENING OF NURSING FACILITY WORK23 ERS.— 

24 ‘‘(A) BACKGROUND CHECKS ON APPLI25 CANTS.—Before hiring a nursing facility work-
105 

•S 2010 IS

1 er, a nursing facility shall conduct a back2 ground check on the employee in accordance 

3 with such procedures as the Secretary shall es4 tablish. 

5 ‘‘(B) PROHIBITION ON HIRING OF ABUSIVE

6 WORKERS.— 

7 ‘‘(i) IN GENERAL.—Subject to clause 

8 (ii), a nursing facility may not knowingly 

9 employ any nursing facility worker who 

10 has any disqualifying information (as de11 fined in subparagraph (F)(ii)). 

12 ‘‘(ii) PROVISIONAL EMPLOYMENT.—A 

13 nursing facility may provide for a provi14 sional period of employment for a nursing 

15 facility worker pending completion of the 

16 background check required under subpara17 graph (A). Such facility shall maintain di18 rect supervision of the covered individual 

19 during the worker’s provisional period of 

20 employment. 

21 ‘‘(C) PROCEDURES.—The procedures es22 tablished by the Secretary under subparagraph 

23 (A) shall— 

24 ‘‘(i) provide a process by which a 

25 nursing facility worker may appeal or dis-
106 

•S 2010 IS

1 pute the accuracy of the information ob2 tained in a background check conducted 

3 under this paragraph; 

4 ‘‘(ii) take into account the needs of 

5 nursing facilities located in rural areas and 

6 nursing facilities that serve a low volume 

7 of patients (as determined by the Sec8 retary) with respect to providing super9 vision for provisional employees who are 

10 awaiting the results of a background check 

11 conducted under this paragraph; and 

12 ‘‘(iii) provide for the reimbursement 

13 of nursing facilities for 100 percent of the 

14 costs incurred by such facilities in com15 plying with the requirements of this sec16 tion. 

17 ‘‘(D) IMMUNITY FROM LIABILITY.—A 

18 nursing facility that, in denying employment for 

19 an applicant, reasonably relies upon information 

20 about such applicant provided by the criminal 

21 background check shall not be liable in any ac22 tion brought by such applicant based on the 

23 employment determination resulting from the 

24 information. 

25 ‘‘(E) CIVIL PENALTY.— 
107 

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

2 that violates the provisions of this para3 graph shall be subject to a civil penalty in 

4 an amount not to exceed— 

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

6 $2,000; and 

7 ‘‘(II) for the second and each 

8 subsequent violation within any 5-year 

9 period, $5,000. 

10 ‘‘(ii) KNOWING RETENTION OF WORK11 ER.—In addition to any civil penalty under 

12 clause (i), a nursing facility that knowingly 

13 continues to employ a nursing facility 

14 worker in violation of subparagraph (A) or 

15 (B) shall be subject to a civil penalty in an 

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

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

18 and each subsequent violation within any 

19 5-year period. 

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

21 ‘‘(i) CONVICTION FOR A RELEVANT

22 CRIME.—The term ‘conviction for a rel23 evant crime’ means any Federal or State 

24 criminal conviction for— 
108 

•S 2010 IS

1 ‘‘(I) any offense described in sec2 tion 1128(a); and 

3 ‘‘(II) such other types of offenses 

4 as the Secretary may specify in regu5 lations. 

6 ‘‘(ii) DISQUALIFYING INFORMATION.— 

7 The term ‘disqualifying information’ means 

8 information about a conviction for a rel9 evant crime or a finding of patient or resi10 dent abuse. 

11 ‘‘(iii) NURSING FACILITY WORKER.— 

12 The term ‘nursing facility worker’ means 

13 any individual (other than a volunteer) 

14 that has direct access to a patient of a 

15 nursing facility under an employment or 

16 other contract, or both, with such facility. 

17 Such term includes individuals who are li18 censed or certified by the State to provide 

19 long-term care services, and nonlicensed 

20 individuals providing such services, as de21 fined by the Secretary, including nurse as22 sistants, nurse aides, home health aides, 

23 and personal care workers and attend24 ants.’’. 
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1 (3) EFFECTIVE DATE.—The amendments made 

2 by this subsection shall take effect on the date that 

3 is 1 year after the date on which the evaluation is 

4 completed under subsection (c)(1). 

5 (b) APPLICATION TO OTHER LONG-TERM CARE FA6 CILITIES OR PROVIDERS.— 

7 (1) MEDICARE.—Part E of title XVIII of the 

8 Social Security Act (42 U.S.C. 1395x et seq.) is 

9 amended by adding at the end the following: 

10 ‘‘APPLICATION OF SKILLED NURSING FACILITY PREVEN11 TIVE ABUSE PROVISIONS TO LONG-TERM CARE FA12 CILITIES AND PROVIDERS

13 ‘‘SEC. 1898. (a) The provisions of section 1819(b)(9) 

14 shall apply to a long-term care facility or provider (as de15 fined in subsection (b)) in the same manner as such provi16 sions apply to a skilled nursing facility. 

17 ‘‘(b) LONG-TERM CARE FACILITY OR PROVIDER.— 

18 In this section, the term ‘long-term care facility or pro19 vider’ means the following facilities or providers which re20 ceive payment for services under this title or title XIX: 

21 ‘‘(1) A home health agency. 

22 ‘‘(2) A provider of hospice care. 

23 ‘‘(3) A long-term care hospital. 

24 ‘‘(4) A provider of personal care services. 

25 ‘‘(5) A residential care provider that arranges 

26 for, or directly provides, long-term care services. 
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•S 2010 IS

1 ‘‘(6) An intermediate care facility for the men2 tally retarded (as defined in section 1905(d)).’’. 

3 (2) MEDICAID.—Section 1902(a) of the Social 

4 Security Act (42 U.S.C. 1396a) is amended— 

5 (A) in paragraph (66), by striking ‘‘and’’ 

6 at the end; 

7 (B) in paragraph (67), by striking the pe8 riod and inserting ‘‘; and’’; and 

9 (C) by inserting after paragraph (67) the 

10 following: 

11 ‘‘(68) provide that the provisions of section 

12 1919(b)(9) apply to a long-term care facility or pro13 vider (as defined in section 1898(b)) in the same 

14 manner as such provisions apply to a nursing facil15 ity.’’. 

16 (3) EFFECTIVE DATE.—The amendments made 

17 by this subsection shall take effect on the date that 

18 is 1 year after the date on which the evaluation is 

19 completed under subsection (c)(1). 

20 (c) NATIONAL CRIMINAL BACKGROUND CHECK PRO21 GRAM.— 

22 (1) COMPLETION OF PILOT PROGRAM EVALUA23 TION.—Not later than the date that is 6 months 

24 after the completion of the pilot program for na25 tional and State background checks on direct patient 
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•S 2010 IS

1 access employees of long-term care facilities or pro2 viders established under section 307 of the Medicare 

3 Prescription Drug, Improvement, and Modernization 

4 Act of 2003 (Public Law 108–173), the Secretary 

5 shall complete the evaluation required under sub6 section (e) of such section of such Act. 

7 (2) ESTABLISHMENT.— 

8 (A) IN GENERAL.—Not later than the date 

9 that is 1 year after the completion of the eval10 uation of the program described in paragraph 

11 (1), the Secretary, in consultation with the At12 torney General, shall establish a national crimi13 nal background check program in order to pre14 vent abuse of nursing facility and skilled nurs15 ing facility residents and individuals receiving 

16 home health care services and other long-term 

17 care services under the medicare or medicaid 

18 programs, taking into account the findings and 

19 recommendations contained in the evaluation. 

20 (B) USE IN CONDUCTING REQUIRED BACK21 GROUND CHECKS.—The national criminal back22 ground check program shall be made available 

23 to a long-term care facility or provider for the 

24 purpose of conducting criminal background 

25 checks, including the criminal background 
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•S 2010 IS

1 checks required under sections 1819(b)(9) and 

2 1919(b)(9) of the Social Security Act (42 

3 U.S.C. 1395i–3(b), 1396r(b)) (as added by sub4 section (a)). 

5 (C) CONDUCT OF BACKGROUND CHECKS

6 BY THE FEDERAL BUREAU OF INVESTIGA7 TION.—The Secretary, in consultation with the 

8 Attorney General, shall establish procedures for 

9 the background checks to be conducted by the 

10 Federal Bureau of Investigation, in cooperation 

11 with appropriate State and Federal agencies. 

12 (D) CONSULTATION.—In establishing the 

13 national criminal background check program, 

14 the Secretary shall consult with appropriate in15 terested parties, including— 

16 (i) representatives of long-term care 

17 facilities or providers; 

18 (ii) representatives of employees of 

19 long-term care facilities or providers; 

20 (iii) consumers of long-term care serv21 ices; 

22 (iv) consumer advocates; and 

23 (v) appropriate Federal and State of24 ficials. 
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1 (E) INTEGRATION.—The Secretary shall 

2 take appropriate measures to integrate the na3 tional criminal background check program and 

4 the national nurse aide registry established 

5 under section 105(b) into a single system. The 

6 integration of the program and the registry 

7 shall be done in such a manner as to efficiently 

8 and accurately provide timely responses to long9 term care facilities and providers utilizing the 

10 integrated system. 

11 (3) DEFINITIONS.—In this subsection: 

12 (A) LONG-TERM CARE FACILITY OR PRO13 VIDER.—The term ‘‘long-term care facility or 

14 provider’’ means the following facilities or pro15 viders which receive payment for services under 

16 title XVIII or XIX of the Social Security Act: 

17 (i) A nursing facility (as defined in 

18 subparagraph (B)). 

19 (ii) A skilled nursing facility (as de20 fined in subparagraph (C)). 

21 (iii) A home health agency. 

22 (iv) A provider of hospice care (as de23 fined in section 1861(dd)(1) of the Social 

24 Security Act) (42 U.S.C. 1395x(dd)(1)). 
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•S 2010 IS

1 (v) A long-term care hospital (as de2 scribed in section 1886(d)(1)(B)(iv) of 

3 such Act) (42 U.S.C. 

4 1395ww(d)(1)(B)(iv)). 

5 (vi) A provider of personal care serv6 ices. 

7 (vii) A residential care provider that 

8 arranges for, or directly provides, long9 term care services. 

10 (viii) An intermediate care facility for 

11 the mentally retarded (as defined in sec12 tion 1905(d) of such Act) (42 U.S.C. 

13 1396d(d)). 

14 (B) NURSING FACILITY.—The term ‘‘nurs15 ing facility’’ has the meaning given such term 

16 in section 1919(a) of the Social Security Act 

17 (42 U.S.C. 1396r(a)). 

18 (C) SKILLED NURSING FACILITY.—The 

19 term ‘‘skilled nursing facility’’ has the meaning 

20 given such term in 1819(a) of the Social Secu21 rity Act (42 U.S.C. 1395i–3(a)). 
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•S 2010 IS

1 TITLE II—DEPARTMENT OF 

2 JUSTICE 

3 SEC. 201. MODEL STATE LAWS AND PRACTICES. 

4 (a) IN GENERAL.—The Attorney General, after con5 sultation with the Secretary, shall carry out the following 

6 duties: 

7 (1) STUDY.—Conduct a study of State laws and 

8 practices relating to elder abuse, neglect, and exploi9 tation. 

10 (2) REPORT TO ELDER JUSTICE RESOURCE

11 CENTER.—Prepare and submit a report or periodic 

12 reports containing the findings of the study con13 ducted under paragraph (1) to the Elder Justice Re14 source Center established under section 2221 of the 

15 Social Security Act, to be made available to the pub16 lic. 

17 (3) REPORT TO CONGRESS.—Not later than 2 

18 years after the date of enactment of this Act, submit 

19 to the Chairman and Ranking Member of the Spe20 cial Committee on Aging of the Senate, and the 

21 Speaker and Minority leader of the House of Rep22 resentatives a report that contains— 

23 (A) a comprehensive description of State 

24 laws and practices relating to elder abuse, ne25 glect, and exploitation; 
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•S 2010 IS

1 (B) a comprehensive analysis of the effec2 tiveness of such State laws and practices; and 

3 (C) recommendations— 

4 (i) for model State laws and practices 

5 relating to elder abuse, neglect, and exploi6 tation; and 

7 (ii) with respect to the definitions re8 ferred to in subsection (b)(1). 

9 (b) STATE LAWS AND PRACTICES.—The Attorney 

10 General shall examine State laws and practices under sub11 section (a) on issues including— 

12 (1) the definition of— 

13 (A) ‘‘elder’’; 

14 (B) ‘‘abuse’’; 

15 (C) ‘‘neglect’’; 

16 (D) ‘‘exploitation’’; and 

17 (E) such related terms the Attorney Gen18 eral determines to be appropriate; 

19 (2) mandatory reporting laws, with respect to— 

20 (A) who is a mandated reporter; 

21 (B) to whom must they report and within 

22 what time frame; and 

23 (C) any consequences for not reporting; 

24 (3) evidentiary, procedural, sentencing, choice 

25 of remedies, and data retention issues relating to 
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•S 2010 IS

1 pursuing cases relating to elder abuse, neglect, and 

2 exploitation; 

3 (4) laws requiring immediate reporting of all 

4 nursing home deaths to the county coroner or to 

5 some other individual or entity; 

6 (5) fiduciary laws, including guardianship and 

7 power of attorney laws; 

8 (6) laws that permit or encourage banks and 

9 bank employees to prevent and report suspected 

10 elder abuse, neglect, and exploitation; 

11 (7) laws that may impede research on elder 

12 abuse, neglect, and exploitation; 

13 (8) practices relating to the enforcement of laws 

14 relating to elder abuse, neglect, and exploitation; and 

15 (9) practices relating to other aspects of elder 

16 justice. 

17 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

18 are authorized to be appropriated to carry out this sec19 tion— 

20 (1) $1,000,000 in fiscal year 2007; and 

21 (2) $2,000,000 for each of fiscal years 2008 

22 through 2013. 
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•S 2010 IS

1 SEC. 202. OFFICE OF ELDER JUSTICE OF THE DEPARTMENT 

2 OF JUSTICE. 

3 (a) ESTABLISHMENT.—There is established within 

4 the Department of Justice, under the Assistant Attorney 

5 General and the Office of Justice Programs, an Office of 

6 Elder Justice. 

7 (b) DIRECTOR OF THE OFFICE OF ELDER JUS8 TICE.— 

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

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

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

16 Elder Justice shall— 

17 (A)(i) develop objectives, priorities, poli18 cies, and a long-term plan for elder justice pro19 grams and activities relating to prevention, de20 tection, training, treatment, evaluation, inter21 vention, research, and improvement of the elder 

22 justice system in the United States; 

23 (ii) implement the overall policies and a 

24 strategy to carry out the plan described in 

25 clause (i); and 
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•S 2010 IS

1 (iii) hire personnel to assist the director in 

2 carrying out the policies, programs, and admin3 istrative activities related to the duties under 

4 clauses (i) and (ii); 

5 (B) provide advice to the Attorney General 

6 on elder justice issues; and 

7 (C) coordinate activities with the Director 

8 of the Office of Elder Justice within the De9 partment of Health and Human Services. 

10 (3) REPORTING RELATIONSHIP.—The Director 

11 of the Office of Elder Justice shall have the same 

12 reporting relationship with the Attorney General, the 

13 Assistant Attorney General, and the Office of Jus14 tice Programs as the directors of the other offices 

15 headed by Presidential appointees within the Office 

16 of Justice Programs. 

17 (4) COMPENSATION.—The Director of the Of18 fice of Elder Justice shall be compensated at a rate 

19 that shall not exceed the rate established for level I 

20 of the Executive Schedule under section 5312 of title 

21 5, United States Code. 

22 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

23 are authorized to be appropriated to carry out this section 

24 $3,000,000 for each of fiscal years 2007 through 2013. 
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•S 2010 IS

1 SEC. 203. VICTIM ADVOCACY GRANTS. 

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

3 after consultation with the Secretary, may award grants 

4 to eligible entities to study the special needs of victims 

5 of elder abuse, neglect, and exploitation. 

6 (b) AUTHORIZED ACTIVITIES.—Funds awarded pur7 suant to subsection (a) shall be used for pilot programs 

8 that— 

9 (1) develop programs, provide training to health 

10 care, social, and protective services providers, law 

11 enforcement, fiduciaries (including guardians), 

12 judges and court personnel, and victim advocates; 

13 and 

14 (2) examine special approaches designed to 

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

16 and exploitation. 

17 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

18 are authorized to be appropriated to carry out this sec19 tion— 

20 (1) $2,500,000 for fiscal year 2007; and 

21 (2) $3,000,000 for each of fiscal years 2008 

22 through 2013. 

23 SEC. 204. SUPPORTING LOCAL PROSECUTORS IN ELDER 

24 JUSTICE MATTERS. 

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

26 after consultation with the Director of the Office of Elder 
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•S 2010 IS

1 Justice in the Department of Health and Human Services, 

2 shall award grants to provide training, technical assist3 ance, policy development, multidisciplinary coordination, 

4 and other types of support to local prosecutors handling 

5 elder justice-related cases, including— 

6 (1) funding specially designated elder justice 

7 positions or units; or 

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

9 Prosecution of Elder Abuse, Neglect, and Exploi10 tation by the American Prosecutor Research Insti11 tute of the National District Attorneys Association, 

12 or any other similarly situated entity, to advise and 

13 support local prosecutors nationwide in their pursuit 

14 of cases involving elder abuse, neglect, and exploi15 tation. 

16 (b) DUTIES.—The Center created under subsection 

17 (a) shall, among other things— 

18 (1) collaborate with experts in elder abuse, ne19 glect, and exploitation; 

20 (2) collaborate with the Advisory Board created 

21 by section 2213 of the Social Security Act; and 

22 (3) provide local prosecutors and personnel as23 sisting such prosecutors with training, technical as24 sistance, multidisciplinary teams, and input in the 

25 handling, prevention and prosecution of, and special 
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•S 2010 IS

1 circumstances surrounding, elder abuse, neglect, and 

2 exploitation. 

3 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

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

6 (1) $3,000,000 for fiscal year 2007; and 

7 (2) $4,00,000 for each of fiscal years 2008 

8 through 2013. 

9 SEC. 205. SUPPORTING STATE PROSECUTORS IN ELDER 

10 JUSTICE MATTERS. 

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

12 consultation with the Secretary, award grants to provide 

13 training, technical assistance, multidisciplinary coordina14 tion, policy development, and other types of support to 

15 State prosecutors, including employees of State Attorneys 

16 General and Medicaid Fraud Control Units handling elder 

17 justice-related 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; or 

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

23 justice-related cases, training, technical assistance, 

24 and policy development for State prosecutors, by the 
123 

•S 2010 IS

1 National Association of Attorneys General (NAAG) 

2 or any other similarly situated entity. 

3 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

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

6 (1) $3,000,000 for fiscal year 2007; and 

7 (2) $4,000,000 for each of fiscal years 2008 

8 through 2013. 

9 SEC. 206. INCREASED SUPPORT FOR FEDERAL CASES IN10 VOLVING ELDER JUSTICE. 

11 (a) SUPPORT AND ASSISTANCE.— 

12 (1) IN GENERAL.—The Attorney General shall 

13 establish procedures to ensure that the Department 

14 of Justice dedicates resources to supporting cases re15 lating to elder justice. 

16 (2) ADDITIONAL STAFF.—The Attorney General 

17 shall have additional Federal prosecutors and make 

18 funding available to Federal prosecutors to hire 

19 nurse-investigators or other experts needed to iden20 tify, assist with, or pursue cases relating to elder 

21 justice. 

22 (3) RESOURCE GROUP.—The Attorney General 

23 may fund through the Executive Office of United 

24 States Attorneys a Resource Group to assist pros25 ecutors throughout the Nation in pursuing failure of 
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•S 2010 IS

1 care and other cases relating to elder justice mat2 ters. 

3 (b) OFFICE OF INSPECTOR GENERAL.—The Office of 

4 Inspector General of the Department of Health and 

5 Human Services shall hire nurse investigators and other 

6 experts to investigate and pursue failure of care allega7 tions. 

8 (c) AUTHORIZATION OF APPROPRIATIONS.—There 

9 are authorized to be appropriated to carry out this sec10 tion— 

11 (1) $3,000,000 for fiscal year 2007; and 

12 (2) $4,000,000 for each of fiscal years 2008 

13 through 2013. 

14 SEC. 207. SUPPORTING LAW ENFORCEMENT IN ELDER JUS15 TICE MATTERS. 

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

17 consultation with the Secretary, award grants to provide 

18 training, technical assistance, multidisciplinary coordina19 tion, policy development, and other types of support to po20 lice, sheriffs, detectives, public safety officers, corrections 

21 personnel, and other frontline law enforcement responders 

22 who handle elder justice-related matters, to fund specially 

23 designated elder justice positions or units designed to sup24 port front line law enforcement in elder justice matters. 
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•S 2010 IS

1 (b) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out this sec3 tion— 

4 (1) $6,000,000 for fiscal year 2007; and 

5 (2) $8,000,000 for each of fiscal years 2008 

6 through 2013. 

7 SEC. 208. EVALUATIONS. 

8 (a) GRANTS.— 

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

10 provision of this title, the granting authority shall— 

11 (A) require the recipient of the grant to— 

12 (i) reserve a portion of the funds 

13 made available through the grant; and 

14 (ii) use the reserved funds to conduct 

15 an evaluation of the other activities carried 

16 out through the grant; or 

17 (B)(i) reserve a portion of the funds avail18 able for the grant; and 

19 (ii) use the reserved funds to provide as20 sistance to an eligible entity to conduct an eval21 uation of the activities carried out through the 

22 grant. 

23 (2) USE OF FUNDS.—A recipient of a grant de24 scribed in paragraph (1)(A), or assistance described 

25 in paragraph (1)(B)(ii), shall use the funds made 
126 

•S 2010 IS

1 available through the grant, or the assistance, re2 spectively, to conduct a validated evaluation of the 

3 effectiveness of the activities described in subpara4 graph (A) or (B), respectively, of paragraph (1). 

5 (3) APPLICATIONS.— 

6 (A) SUBMISSION.— 

7 (i) GRANTS FOR PROJECTS CON8 TAINING EVALUATIONS.—To be eligible to 

9 receive a grant for which the granting au10 thority requires the reservation described 

11 in paragraph (1)(A)(i), an entity shall in12 clude a proposal for the evaluation in the 

13 application submitted for the grant. 

14 (ii) ASSISTANCE FOR EVALUATIONS.— 

15 To be eligible to receive assistance under 

16 paragraph (1)(B)(ii), an entity shall sub17 mit an application to the granting author18 ity at such time, in such manner, and con19 taining such information as the granting 

20 authority may require, including a proposal 

21 for the evaluation. 

22 (B) REVIEW AND ASSISTANCE.— 

23 (i) IN GENERAL.—An employee of the 

24 Department of Justice, after consultation 

25 with an employee of the Department of 
127 

•S 2010 IS

1 Health and Human Services and a non2 governmental member of the advisory 

3 board established under section 2213 of 

4 the Social Security Act with expertise in 

5 evaluation methodology, shall review each 

6 proposal described in clause (i) or (ii) of 

7 subparagraph (A), and determine whether 

8 the methodology described in the proposal 

9 is adequate to gather meaningful informa10 tion. 

11 (ii) DENIAL.—If the reviewing em12 ployee determines the methodology de13 scribed in the proposal is inadequate under 

14 clause (i), they shall recommend that the 

15 granting authority deny the application for 

16 the grant described in subparagraph 

17 (A)(i), or the assistance described in sub18 paragraph (B)(ii), as appropriate, or make 

19 recommendations for how the application 

20 should be amended. 

21 (iii) NOTICE TO APPLICANT.—If the 

22 granting authority denies the application 

23 on the basis of the proposal under this 

24 subparagraph, the granting authority shall 

25 inform the applicant why the application 
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•S 2010 IS

1 was denied and offer assistance to the ap2 plicant in modifying the proposal. 

3 (b) OTHER GRANTS.—The granting authority shall 

4 make grants to appropriate entities to conduct validated 

5 evaluations of activities to reduce elder abuse, neglect, and 

6 exploitation that are not funded under this title. 

7 (c) CONDITION OF PARTICIPATION.—As a condition 

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

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

10 the provisions of section 571 of title 18, United States 

11 Code, as added by this Act. 

12 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

13 are authorized to be appropriated to carry out this section 

14 $7,000,000 for each of fiscal years 2007 through 2013. 

15 TITLE III—TAX PROVISIONS 

16 SEC. 301. LONG-TERM CARE FACILITY WORKER EMPLOY17 MENT TAX CREDIT. 

18 (a) WORK OPPORTUNITY TAX CREDIT.— 

19 (1) IN GENERAL.—Section 51(d)(1) of the In20 ternal Revenue Code of 1986 (relating to members 

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

22 the end of subparagraph (G), by striking the period 

23 at the end of subparagraph (H) and inserting ‘‘or’’, 

24 and by adding at the end the following: 
129 

•S 2010 IS

1 ‘‘(I) a qualified long-term care facility 

2 worker.’’. 

3 (2) QUALIFIED LONG-TERM CARE FACILITY

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

5 by redesignating paragraphs (10) through (12) as 

6 paragraphs (11) through (13), respectively, and by 

7 inserting after paragraph (9) the following: 

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

9 WORKER.—The term ‘qualified long-term care facil10 ity worker’ means any individual who— 

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

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

13 of the Social Security Act); and 

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

15 agency as being qualified to provide long-term 

16 care (as defined in paragraph (17) of such sec17 tion 2201).’’. 

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

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

20 for an employer after the date of enactment of this Act. 

Æ