II 

117TH CONGRESS 

1ST SESSION S. 2674 

To reauthorize funding for programs to prevent, investigate, and prosecute 

elder abuse, neglect, and exploitation, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 7, 2021 

Mr. WYDEN (for himself and Mr. CASEY) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

To reauthorize funding for programs to prevent, investigate, 

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. 

4 This Act may be cited as the ‘‘Elder Justice Reau5 thorization and Modernization Act of 2021’’. 


kjohnson on DSK79L0C42PROD with BILLS
2 

•S 2674 IS

1 SEC. 2. REAUTHORIZATION OF FUNDING FOR PROGRAMS 

2 TO PREVENT, AND INVESTIGATE ELDER 

3 ABUSE, NEGLECT, AND EXPLOITATION. 

4 (a) NURSING HOME WORKER TRAINING GRANTS.— 

5 Section 2041 of the Social Security Act (42 U.S.C. 

6 1397m) is amended to read as follows: 

7 ‘‘SEC. 2041. NURSING HOME WORKER TRAINING GRANTS. 

8 ‘‘(a) IN GENERAL.— 

9 ‘‘(1) STATE ENTITLEMENT.— 

10 ‘‘(A) IN GENERAL.—Each State shall be 

11 entitled to receive from the Secretary for each 

12 fiscal year specified in subsection (e)(1) a grant 

13 in an amount equal to the amount allotted to 

14 the State under subparagraph (B). 

15 ‘‘(B) STATE ALLOTMENTS.— 

16 ‘‘(i) IN GENERAL.—Subject to clauses 

17 (ii) and (iii), the amount allotted to a 

18 State under this subparagraph for a fiscal 

19 year shall be— 

20 ‘‘(I) the number of State resi21 dents who have attained 65 years of 

22 age or are under a disability (as de23 fined in section 216(i)(1)), as deter24 mined by the Secretary using the 

25 most recent version of the American 

26 Community Survey published by the 


kjohnson on DSK79L0C42PROD with BILLS
3 

•S 2674 IS

1 Bureau of the Census or a successor 

2 data set, divided by 

3 ‘‘(II) the total number of such 

4 residents of all States. 

5 ‘‘(ii) LIMITATION.—The amount allot6 ted to a State under this subparagraph for 

7 a fiscal year shall be not less than 0.25 

8 percent of the available amount for the fis9 cal year. 

10 ‘‘(iii) ADJUSTMENT OF STATE ALLOT11 MENTS.—Subject to clause (ii), the Sec12 retary shall proportionately increase or de13 crease the amounts allotted under this sub14 paragraph for a fiscal year as necessary to 

15 ensure that the available amount for the 

16 fiscal year is allotted among the States. 

17 ‘‘(iv) REDETERMINATIONS.— 

18 ‘‘(I) FREQUENCY.—The Sec19 retary shall make the determination 

20 referred to in clause (i)(I) every 5 

21 years. 

22 ‘‘(II) LIMITATION.—Subject to 

23 clause (ii), the amount allotted to a 

24 State under this subparagraph, on the 

25 basis of such a determination, for a 


kjohnson on DSK79L0C42PROD with BILLS
4 

•S 2674 IS

1 fiscal year after fiscal year 2026 shall 

2 be— 

3 ‘‘(aa) not less than 90 per4 cent of the amount of the grant 

5 made to the State under this 

6 subparagraph for the then pre7 ceding fiscal year; and 

8 ‘‘(bb) not more than 110 

9 percent of the amount referred to 

10 in item (aa). 

11 ‘‘(2) GRANTS TO INDIAN TRIBES AND TRIBAL

12 ORGANIZATIONS.— 

13 ‘‘(A) IN GENERAL.—The Secretary, in con14 sultation with the Secretary of the Interior, 

15 shall make grants in accordance with this sec16 tion to Indian tribes and tribal organizations 

17 who operate at least 1 eligible setting. 

18 ‘‘(B) GRANT FORMULA.—The Secretary, in 

19 consultation with the Secretary of the Interior, 

20 shall devise a formula for distributing among 

21 Indian tribes and tribal organizations the 

22 amount required to be reserved by subsection 

23 (e)(1) for each fiscal year. 

24 ‘‘(3) SUB-GRANTS.—A State, Indian tribe, or 

25 tribal organization to which an amount is paid under 


kjohnson on DSK79L0C42PROD with BILLS
5 

•S 2674 IS

1 this section may use the amount to make sub-grants 

2 to local organizations, including community organi3 zations, local non-profits, elder rights and justice 

4 groups, and workforce development boards for any 

5 purpose described in paragraph (1) or (2) of sub6 section (b). 

7 ‘‘(b) USE OF FUNDS.— 

8 ‘‘(1) REQUIRED USES.—A State to which an 

9 amount is paid under this section shall use the 

10 amount to— 

11 ‘‘(A) provide wage subsidies to eligible in12 dividuals; 

13 ‘‘(B) provide student loan repayment or 

14 tuition assistance to eligible individuals for a 

15 degree or certification in a field relevant to 

16 their position referred to in subsection 

17 (f)(1)(A); 

18 ‘‘(C) guarantee affordable and accessible 

19 child care for eligible individuals, including help 

20 with referrals, co-pays, or other direct assist21 ance; and 

22 ‘‘(D) provide assistance where necessary 

23 with obtaining appropriate transportation, in24 cluding public transportation if available, or gas 


kjohnson on DSK79L0C42PROD with BILLS
6 

•S 2674 IS

1 money if public transportation is unavailable or 

2 impractical based on work hours or location. 

3 ‘‘(2) AUTHORIZED USES.—A State to which an 

4 amount is paid under this section may use the 

5 amount to— 

6 ‘‘(A) establish a reserve fund for financial 

7 assistance to eligible individuals in emergency 

8 situations; 

9 ‘‘(B) provide in-kind resource donations, 

10 such as interview clothing and conference at11 tendance fees; 

12 ‘‘(C) provide assistance with programs and 

13 activities, including legal assistance, deemed 

14 necessary to address arrest or conviction 

15 records that are an employment barrier; 

16 ‘‘(D) support employers operating an eligi17 ble setting in the State in providing employees 

18 with not less than 2 weeks of paid leave per 

19 year; or 

20 ‘‘(E) provide other support services the 

21 Secretary deems necessary to allow for success22 ful recruitment and retention of workers. 

23 ‘‘(3) PROVISION OF FUNDS ONLY FOR THE

24 BENEFIT OF ELIGIBLE INDIVIDUALS IN ELIGIBLE

25 SETTINGS.—A State to which an amount is paid 


kjohnson on DSK79L0C42PROD with BILLS
7 

•S 2674 IS

1 under this section may provide the amount to only 

2 an eligible individual or a partner organization serv3 ing an eligible individual. 

4 ‘‘(4) NONSUPPLANTATION.—A State to which 

5 an amount is paid under this section shall not use 

6 the amount to supplant the expenditure of any State 

7 funds for recruiting or retaining employees in an eli8 gible setting. 

9 ‘‘(5) OBLIGATION DEADLINE.—A State, Indian 

10 tribe, or tribal organization shall remit to the Sec11 retary for reallotment under this section any amount 

12 paid under this section for a fiscal year that is not 

13 obligated within 2 years after the end of the fiscal 

14 year. 

15 ‘‘(c) ADMINISTRATION.—A State to which a grant is 

16 made under this section shall reserve not more than 10 

17 percent of the grant to— 

18 ‘‘(1) administer subgrants in accordance with 

19 this section; 

20 ‘‘(2) provide technical assistance and support 

21 for applying for and accessing such a subgrant op22 portunity; 

23 ‘‘(3) publicize the availability of the subgrants; 

24 ‘‘(4) carry out activities to increase the supply 

25 of eligible individuals; and 


kjohnson on DSK79L0C42PROD with BILLS
8 

•S 2674 IS

1 ‘‘(5) provide technical assistance to help sub2 grantees find and train individuals to provide the 

3 services for which they are contracted. 

4 ‘‘(d) REPORTS.— 

5 ‘‘(1) STATE REPORTS.—Not less frequently 

6 than annually, each State to which a grant has been 

7 made under this section shall transmit to the Sec8 retary a written report describing the activities un9 dertaken by the State pursuant to this section dur10 ing the period covered by the report. 

11 ‘‘(2) REPORT TO THE CONGRESS.—Not later 

12 than 3 years after the date of the enactment of this 

13 section, and every 4 years thereafter, the Secretary 

14 shall submit to the Congress a written report out15 lining how the States have used the grants made 

16 under this section during the period covered by the 

17 report, which shall include— 

18 ‘‘(A) the total amount expended in each 

19 State for each type of use described in para20 graph (1) or (2) of subsection (b); 

21 ‘‘(B) the total number of non-State organi22 zations in each State to which grant funds were 

23 provided, and the amount so provided to each 

24 such organization; 


kjohnson on DSK79L0C42PROD with BILLS
9 

•S 2674 IS

1 ‘‘(C) the change in the number of individ2 uals working in each job category described in 

3 subsection (f)(1)(A) in an eligible setting; 

4 ‘‘(D) the average duration of employment 

5 for each such job category, by State; 

6 ‘‘(E) the average annual wage of workers 

7 in each job category described in subsection 

8 (f)(1)(A) in an eligible setting; 

9 ‘‘(F) the average amount of paid time off 

10 to which a worker in each job category de11 scribed in subsection (f)(1)(A) in an eligible set12 ting is entitled by their contract; and 

13 ‘‘(G) such other data elements as the Sec14 retary deems relevant. 

15 ‘‘(e) APPROPRIATION.—Out of any funds in the 

16 Treasury not otherwise appropriated, there is appro17 priated to the Secretary $400,000,000 for each of fiscal 

18 years 2022 through 2025 to carry out this section, of 

19 which 2 percent shall be reserved for grants to Indian 

20 tribes and tribal organizations. 

21 ‘‘(f) DEFINITIONS.—In this section: 

22 ‘‘(1) AVAILABLE AMOUNT.—The term ‘available 

23 amount’ means, with respect to a fiscal year, the 

24 amount specified in subsection (e) that remains after 

25 the reservation required by such subsection for the 


kjohnson on DSK79L0C42PROD with BILLS
10 

•S 2674 IS

1 fiscal year, plus all amounts remitted to the Sec2 retary under subsection (b)(5) that have not been 

3 reallotted under subsection (a)(1)(B)(iii). 

4 ‘‘(2) ELIGIBLE INDIVIDUAL.—The term ‘eligible 

5 individual’ means an individual who— 

6 ‘‘(A)(i) is a qualified home health aide, as 

7 defined in section 484.80(a) of title 42, Code of 

8 Federal Regulations; 

9 ‘‘(ii) is a nurse aide approved by the State 

10 as meeting the requirements of sections 

11 483.150 through 483.154 of such title, and is 

12 listed in good standing on the State nurse aide 

13 registry; 

14 ‘‘(iii) is a personal care aide approved by 

15 the State, and furnishes personal care services, 

16 as defined in section 440.167 of such title; 

17 ‘‘(iv) is a qualified hospice aide, as defined 

18 in section 418.76 of such title; 

19 ‘‘(v) is a licensed practical nurse or a li20 censed or certified social worker; or 

21 ‘‘(vi) is receiving training to be certified or 

22 licensed as such an aide, nurse, or social work23 er; and 


kjohnson on DSK79L0C42PROD with BILLS
11 

•S 2674 IS

1 ‘‘(B) provides (or, in the case of a trainee, 

2 intends to provide) services as such an aide, 

3 nurse, or social worker in an eligible setting. 

4 ‘‘(3) ELIGIBLE SETTING.—The term ‘eligible 

5 setting’ means— 

6 ‘‘(A) a skilled nursing facility, as defined 

7 in section 1819; 

8 ‘‘(B) a nursing facility, as defined in sec9 tion 1919; 

10 ‘‘(C) a home health agency, as defined in 

11 section 1891; 

12 ‘‘(D) a facility approved to deliver home or 

13 community-based services authorized under 

14 State options described in subsection (c) or (i) 

15 of section 1915 or, as relevant, demonstration 

16 projects authorized under section 1115; 

17 ‘‘(E) a hospice, as defined in section 1814; 

18 or 

19 ‘‘(F) a tribal assisted living facility. 

20 ‘‘(4) TRIBAL ORGANIZATION.—The term ‘tribal 

21 organization’ has the meaning given the term in sec22 tion 4 of the Indian Self-Determination and Edu23 cation Assistance Act.’’. 

24 (b) ADULT PROTECTIVE SERVICES FUNCTIONS AND

25 GRANT PROGRAMS.— 


kjohnson on DSK79L0C42PROD with BILLS
12 

•S 2674 IS

1 (1) DIRECT FUNDING; STATE ENTITLEMENT.— 

2 Section 2042 of the Social Security Act (42 U.S.C. 

3 1397m–1) is amended— 

4 (A) in subsection (a), by striking para5 graph (2) and inserting the following: 

6 ‘‘(2) APPROPRIATION.—Out of any money in 

7 the Treasury not otherwise appropriated, there are 

8 appropriated to the Secretary $8,000,000 for each of 

9 fiscal years 2023 through 2025 to carry out this sec10 tion.’’; 

11 (B) in subsection (b)— 

12 (i) in paragraph (2), by striking ‘‘the 

13 availability of appropriations and’’; and 

14 (ii) by striking paragraph (5) and in15 serting the following: 

16 ‘‘(5) APPROPRIATION.—Out of any money in 

17 the Treasury not otherwise appropriated, there are 

18 appropriated to the Secretary $400,000,000 for each 

19 of fiscal years 2023 through 2025 to carry out this 

20 section.’’; and 

21 (C) in subsection (c), by striking para22 graph (6) and inserting the following: 

23 ‘‘(6) APPROPRIATION.—Out of any money in 

24 the Treasury not otherwise appropriated, there are 

25 appropriated to the Secretary $75,000,000 for each 


kjohnson on DSK79L0C42PROD with BILLS
13 

•S 2674 IS

1 of fiscal years 2023 through 2025 to carry out this 

2 section.’’. 

3 (2) STATE ENTITLEMENT; GRANTS TO INDIAN

4 TRIBES AND TRIBAL ORGANIZATIONS.—Section 2042 

5 of such Act (42 U.S.C. 1397m–1) is amended— 

6 (A) in subsection (a)(1)(A), by striking 

7 ‘‘State and local’’ and inserting ‘‘State, local, 

8 and tribal’’; 

9 (B) in subsection (b)(1), by striking ‘‘the 

10 Secretary shall annually award grants to States 

11 in the amounts calculated under paragraph (2)’’ 

12 and inserting ‘‘each State shall be entitled to 

13 annually receive from the Secretary in the 

14 amounts calculated under paragraph (2), and 

15 the Secretary may annually award to each In16 dian tribe and tribal organization in accordance 

17 with paragraph (3), grants’’; 

18 (C) in subsection (b)(2)— 

19 (i) in the paragraph heading, by in20 serting ‘‘FOR A STATE’’ after ‘‘PAYMENT’’; 

21 (ii) by inserting ‘‘that remains after 

22 the reservation under paragraph (3)(B)’’ 

23 before ‘‘multiplied’’; and 

24 (iii) in subparagraph (B)(i)— 


kjohnson on DSK79L0C42PROD with BILLS
14 

•S 2674 IS

1 (I) by inserting ‘‘that so re2 mains’’ after ‘‘such year’’; and 

3 (II) by inserting ‘‘amount so ap4 propriated’’ and inserting ‘‘remaining 

5 amount’’; and 

6 (D) in subsection (b), by redesignating 

7 paragraphs (3) through (5) as paragraphs (4) 

8 through (6), respectively, and inserting after 

9 paragraph (2) the following: 

10 ‘‘(3) AMOUNT OF PAYMENT TO INDIAN TRIBE

11 OR TRIBAL ORGANIZATION.— 

12 ‘‘(A) IN GENERAL.—The Secretary, in con13 sultation with Indian tribes and tribal organiza14 tions, shall determine the amount of any grant 

15 to be made to each Indian tribe and tribal orga16 nization from the amount reserved under sub17 paragraph (B) of this paragraph. Paragraphs 

18 (4) and (5) shall apply to grantees under this 

19 paragraph in the same manner in which the 

20 paragraphs apply to States. 

21 ‘‘(B) RESERVATION OF FUNDS.—The Sec22 retary shall reserve 2 percent of the amount 

23 made available by subsection (b)(6) for each fis24 cal year for grants under this paragraph.’’; 

25 (3) in subsection (c)— 


kjohnson on DSK79L0C42PROD with BILLS
15 

•S 2674 IS

1 (A) in paragraph (1), by striking ‘‘to 

2 States’’ and inserting ‘‘to States, Indian tribes, 

3 and tribal organizations’’; 

4 (B) in paragraph (2)— 

5 (i) in the matter preceding subpara6 graph (A), by inserting ‘‘and Indian tribes 

7 and tribal organizations’’ after ‘‘govern8 ment’’; and 

9 (ii) in subparagraph (D), by inserting 

10 ‘‘or Indian tribe or tribal organization, as 

11 the case may be’’ after ‘‘government’’; 

12 (C) in paragraph (4), by inserting ‘‘or In13 dian tribe or tribal organization’’ after ‘‘a 

14 State’’ the 1st place it appears; and 

15 (D) in paragraph (5)— 

16 (i) by inserting ‘‘or Indian tribe or 

17 tribal organization’’ after ‘‘Each State’’; 

18 and 

19 (ii) by inserting ‘‘or Indian tribe or 

20 tribal organization, as the case may be’’ 

21 after ‘‘the State’’; and 

22 (4) by adding at the end the following: 

23 ‘‘(d) DEFINITIONS OF INDIAN TRIBE AND TRIBAL

24 ORGANIZATION.—In this section, the terms ‘Indian tribe’ 


kjohnson on DSK79L0C42PROD with BILLS
16 

•S 2674 IS

1 and ‘tribal organization’ have the meanings given the 

2 terms in section 419.’’. 

3 (c) LONG-TERM CARE OMBUDSMAN PROGRAM

4 GRANTS AND TRAINING.—Section 2043 of the Social Se5 curity Act (42 U.S.C. 1397m–2) is amended— 

6 (1) in subsection (a), by striking paragraph (2) 

7 and inserting the following: 

8 ‘‘(2) APPROPRIATION.—Out of any money in 

9 the Treasury not otherwise appropriated, there are 

10 appropriated to the Secretary to carry out this sub11 section— 

12 ‘‘(A) $22,500,000 for fiscal year 2023; and 

13 ‘‘(B) $30,000,000 for each of fiscal years 

14 2024 and 2025.’’; and 

15 (2) in subsection (b), by striking paragraph (2) 

16 and inserting the following: 

17 ‘‘(2) APPROPRIATION.—Out of any money in 

18 the Treasury not otherwise appropriated, there are 

19 appropriated to the Secretary $30,000,000 for each 

20 of fiscal years 2023 through 2025 to carry out this 

21 subsection.’’. 

22 (d) INCENTIVES FOR DEVELOPING AND SUSTAINING

23 STRUCTURAL COMPETENCY IN PROVIDING HEALTH AND

24 HUMAN SERVICES.— 


kjohnson on DSK79L0C42PROD with BILLS
17 

•S 2674 IS

1 (1) IN GENERAL.—Part II of subtitle B of title 

2 XX of the Social Security Act (42 U.S.C. 1397m– 

3 5) is amended by adding at the end the following: 

4 ‘‘SEC. 2047. INCENTIVES FOR DEVELOPING AND SUS5 TAINING STRUCTURAL COMPETENCY IN PRO6 VIDING HEALTH AND HUMAN SERVICES. 

7 ‘‘(a) GRANTS TO STATES TO SUPPORT LINKAGES TO

8 LEGAL SERVICES AND MEDICAL LEGAL PARTNER9 SHIPS.— 

10 ‘‘(1) IN GENERAL.—Within 2 years after the 

11 date of the enactment of this section, the Secretary 

12 shall establish and administer a program of grants 

13 to States to support the adoption of evidence-based 

14 approaches to establishing or improving and main15 taining real-time linkages between health and social 

16 services and supports for vulnerable elders or in con17 junction with authorized representatives of vulner18 able elders, including through the following: 

19 ‘‘(A) MEDICAL-LEGAL PARTNERSHIPS.— 

20 The establishment and support of medical-legal 

21 partnerships, the incorporation of the partner22 ships in the elder justice framework and health 

23 and human services safety net, and the imple24 mentation and operation of such a partnership 

25 by an eligible grantee— 


kjohnson on DSK79L0C42PROD with BILLS
18 

•S 2674 IS

1 ‘‘(i) at the option of a State, in con2 junction with an area agency on aging; 

3 ‘‘(ii) in a solo provider practice in a 

4 health professional shortage area (as de5 fined in section 332(a) of the Public 

6 Health Service Act), a medically under7 served community (as defined in section 

8 399V of such Act), or a rural area (as de9 fined in section 330J of such Act); 

10 ‘‘(iii) in a minority-serving institution 

11 of higher learning with health, law, and so12 cial services professional programs; 

13 ‘‘(iv) in a federally qualified health 

14 center, as described in section 330 of the 

15 Public Health Service Act, or look-alike, as 

16 described in section 1905(l)(2)(B) of this 

17 Act; or 

18 ‘‘(v) in certain hospitals that are crit19 ical access hospitals, Medicare-dependent 

20 hospitals, sole community hospitals, rural 

21 emergency hospitals, or that serve a high 

22 proportion of Medicare or Medicaid pa23 tients. 

24 ‘‘(B) LEGAL HOTLINES DEVELOPMENT OR

25 EXPANSION.—The provision of incentives to deVerDate Sep 11 2014 05:22 Aug 12, 2021 Jkt 019200 PO 00000 Frm 00018 Fmt 6652 Sfmt 6201 E:\BILLS\S2674.IS S2674

kjohnson on DSK79L0C42PROD with BILLS
19 

•S 2674 IS

1 velop, enhance, and integrate platforms, such as 

2 legal assistance hotlines, that help to facilitate 

3 the identification of older adults who could ben4 efit from linkages to available legal services 

5 such as those described in subparagraph (A). 

6 ‘‘(2) STATE REPORTS.—Each State to which a 

7 grant is made under this subsection shall submit to 

8 the Secretary biannual reports on the activities car9 ried out by the State pursuant to this subsection, 

10 which shall include assessments of the effectiveness 

11 of the activities with respect to— 

12 ‘‘(A) the number of unique individuals 

13 identified through the mechanism outlined in 

14 paragraph (1)(B) who are referred to services 

15 described in paragraph (1)(A), and the average 

16 time period associated with resolving issues; 

17 ‘‘(B) the success rate for referrals to com18 munity-based resources; and 

19 ‘‘(C) other factors determined relevant by 

20 the Secretary. 

21 ‘‘(3) EVALUATION.—The Secretary shall, by 

22 grant, contract, or interagency agreement, evaluate 

23 the activities conducted pursuant to this subsection, 

24 which shall include a comparison among the States. 


kjohnson on DSK79L0C42PROD with BILLS
20 

•S 2674 IS

1 ‘‘(4) REPORT TO THE CONGRESS.—Every 4 

2 years, the Secretary shall submit to the Congress a 

3 written report on the activities conducted under this 

4 subsection. 

5 ‘‘(5) APPROPRIATION.—Out of any money in 

6 the Treasury not otherwise appropriated, there are 

7 appropriated to the Secretary $125,000,000 for each 

8 of fiscal years 2022 through 2025 to carry out this 

9 subsection. 

10 ‘‘(6) SUPPLEMENT NOT SUPPLANT.—Support 

11 provided to area agencies on aging, State units on 

12 aging, eligible entities, or other community-based or13 ganizations pursuant to this subsection shall be used 

14 to supplement and not supplant any other Federal, 

15 State, or local funds expended to provide the same 

16 or comparable services described in this subsection. 

17 ‘‘(b) GRANTS AND TRAINING TO SUPPORT AREA

18 AGENCIES ON AGING OR OTHER COMMUNITY-BASED OR19 GANIZATIONS TO ADDRESS SOCIAL ISOLATION AMONG

20 VULNERABLE OLDER ADULTS AND PEOPLE WITH DIS21 ABILITIES.— 

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

23 grants to eligible area agencies on aging or other 

24 community-based organizations for the purpose of— 


kjohnson on DSK79L0C42PROD with BILLS
21 

•S 2674 IS

1 ‘‘(A) conducting outreach to individuals at 

2 risk for, or already experiencing, social isolation 

3 or loneliness, through established screening 

4 tools or other methods identified by the Sec5 retary; 

6 ‘‘(B) developing community-based interven7 tions for the purposes of mitigating loneliness 

8 or social isolation (including evidence-based pro9 grams, as defined by the Secretary, developed 

10 with multi-stakeholder input for the purposes of 

11 promoting social connection, mitigating social 

12 isolation or loneliness, or preventing social iso13 lation or loneliness) among at-risk individuals; 

14 ‘‘(C) connecting at-risk individuals with 

15 community social and clinical supports; and 

16 ‘‘(D) evaluating the effect of programs de17 veloped and implemented under subparagraphs 

18 (B) and (C). 

19 ‘‘(2) TRAINING.— 

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

21 establish programs to provide and improve 

22 training for area agencies on aging or commu23 nity-based organizations with respect to ad24 dressing and preventing social isolation and 


kjohnson on DSK79L0C42PROD with BILLS
22 

•S 2674 IS

1 loneliness among older adults and people with 

2 disabilities. 

3 ‘‘(B) PRIORITIZATION AUTHORITY.—For 

4 purposes of connecting at-risk individuals with 

5 existing community social and clinical supports, 

6 the Secretary may, in carrying out subpara7 graph (A), prioritize models that incorporate 

8 training and service delivery in coordination 

9 with medical-legal partnerships. 

10 ‘‘(3) EVALUATION.—Not later than 3 years 

11 after the date of the enactment of this section and 

12 every 3 years thereafter, the Secretary shall submit 

13 to the Congress a written report which assesses the 

14 extent to which the programs established under this 

15 subsection address social isolation and loneliness 

16 among older adults and people with disabilities. 

17 ‘‘(4) APPROPRIATION.—Out of any money in 

18 the Treasury not otherwise appropriated, there are 

19 appropriated to the Secretary $62,500,000 for each 

20 of fiscal years 2022 through 2025 to carry out this 

21 subsection. 

22 ‘‘(5) COORDINATION.—The Secretary shall co23 ordinate with resource centers, grant programs, or 

24 other funding mechanisms established under section 

25 411(a)(18) of the Older Americans Act (42 U.S.C. 


kjohnson on DSK79L0C42PROD with BILLS
23 

•S 2674 IS

1 3032(a)(18)), section 417(a)(1) of such Act (42 

2 U.S.C. 3032F(a)(1)), or other programs as deter3 mined by the Secretary. 

4 ‘‘(c) DEFINITIONS.—In this section: 

5 ‘‘(1) AREA AGENCY ON AGING.—The term ‘area 

6 agency on aging’ means an area agency on aging 

7 designated under section 305 of the Older Ameri8 cans Act of 1965. 

9 ‘‘(2) SOCIAL ISOLATION.—The term ‘social iso10 lation’ means objectively being alone, or having few 

11 relationships or infrequent social contact. 

12 ‘‘(3) LONELINESS.—The term ‘loneliness’ 

13 means subjectively feeling alone, or the discrepancy 

14 between one’s desired level of social connection and 

15 one’s actual level of social connection. 

16 ‘‘(4) SOCIAL CONNECTION.—The term ‘social 

17 connection’ means the variety of ways one can con18 nect to others socially, through physical, behavioral, 

19 social-cognitive, and emotional channels. 

20 ‘‘(5) COMMUNITY-BASED ORGANIZATION.—The 

21 term ‘community-based organization’ includes, ex22 cept as otherwise provided by the Secretary, a non23 profit community-based organization, a consortium 

24 of nonprofit community-based organizations, a na25 tional nonprofit organization acting as an interVerDate Sep 11 2014 05:22 Aug 12, 2021 Jkt 019200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\S2674.IS S2674

kjohnson on DSK79L0C42PROD with BILLS
24 

•S 2674 IS

1 mediary for a community-based organization, or a 

2 community-based organization that has a fiscal 

3 sponsor that allows the organization to function as 

4 an organization described in section 501(c)(3) of the 

5 Internal Revenue Code of 1986 and exempt from 

6 taxation under section 501(a) of such Code.’’. 

7 (2) CLARIFICATION THAT MEDICAL-LEGAL

8 PARTNERSHIPS ARE AUTHORIZED ADULT PROTEC9 TIVE SERVICES ACTIVITIES.—Section 2011 of such 

10 Act (42 U.S.C. 1397j) is amended— 

11 (A) in paragraph (2)(D), by inserting ‘‘, 

12 including through a medical-legal partnership’’ 

13 before the period; and 

14 (B) by redesignating paragraphs (16) 

15 through (22) as paragraphs (17) through (23), 

16 respectively, and inserting after paragraph (15) 

17 the following: 

18 ‘‘(16) MEDICAL-LEGAL PARTNERSHIP.—The 

19 term ‘medical-legal partnership’ means an arrange20 ment in a health care or social services setting which 

21 integrates lawyers and social workers to address the 

22 needs of an individual patient related to social deter23 minants of health, and to help clinicians, case man24 agers, and social workers address structural prob25 lems at the root of many health inequities, including 


kjohnson on DSK79L0C42PROD with BILLS
25 

•S 2674 IS

1 a multidisciplinary team integrated into such a set2 ting to address the needs and establish and maintain 

3 structural competence within clinicians, case man4 agers, and social workers to best address structural 

5 problems at the root of many health inequities.’’. 

6 (e) TECHNICAL AMENDMENT.—Section 2011(12)(A) 

7 of the Social Security Act (42 U.S.C. 1397j(12)(A)) is 

8 amended by striking ‘‘450b’’ and inserting ‘‘5304’’. 

9 SEC. 3. ASSESSMENT REPORTS. 

10 (a) IN GENERAL.—Not later than 2 years after the 

11 date of enactment of this Act, and not less frequently than 

12 once every 2 years thereafter, the Secretary of Health and 

13 Human Services shall submit a report to the Committee 

14 on Ways and Means of the House of Representatives and 

15 the Committee on Finance of the Senate on the programs, 

16 coordinating bodies, registries, and activities established 

17 or authorized under subtitle B of title XX of the Social 

18 Security Act (42 U.S.C. 1397l et seq.) or section 6703(b) 

19 of the Patient Protection and Affordable Care Act (42 

20 U.S.C. 1395i–3a(b)). Each such report shall assess the ex21 tent to which such programs, coordinating bodies, reg22 istries, and activities have improved access to, and the 

23 quality of, resources available to aging Americans and 

24 their caregivers to ultimately prevent, detect, and treat 

25 abuse, neglect, and exploitation, and shall include, as apVerDate Sep 11 2014 05:22 Aug 12, 2021 Jkt 019200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S2674.IS S2674

kjohnson on DSK79L0C42PROD with BILLS
26 

•S 2674 IS

1 propriate, recommendations to Congress on funding levels 

2 and policy changes to help these programs, coordinating 

3 bodies, registries, and activities better prevent, detect, and 

4 treat abuse, neglect, and exploitation of aging Americans. 

5 (b) APPROPRIATION.—Out of any money in the 

6 Treasury not otherwise appropriated, there are appro7 priated to the Secretary of Health and Human Services 

8 $5,000,000 for each of fiscal years 2022 through 2025 

9 to carry out this section. 

Æ 


kjohnson on DSK79L0C42PROD with BILLS