I 

109TH CONGRESS 

2D SESSION H. R. 4993 

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

Nation by ensuring adequate public-private infrastructure and to resolve 

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

and exploitation, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 16, 2006 

Mr. KING of New York (for himself, Mr. EMANUEL, Mr. MCHUGH, Mr. LANTOS, Mrs. MALONEY, Ms. SCHAKOWSKY, Mr. KIND, Ms. BALDWIN, Mrs. 

NAPOLITANO, Mr. STARK, Mr. VAN HOLLEN, Mr. WEINER, Mr. OBERSTAR, Mr. OWENS, Mr. GRIJALVA, Mr. MORAN of Virginia, Mr. 

DOGGETT, Mr. KENNEDY of Rhode Island, Mr. DELAHUNT, Mr. MCNULTY, Mr. TOWNS, and Mr. RANGEL) introduced the following bill; which 

was referred to the Committee on Ways and Means, and in addition to 

the Committees on the Judiciary, Energy and Commerce, and Education 

and the Workforce, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To 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, 


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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

3 ‘‘Elder Justice Act’’. 

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

5 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. Purposes. 

TITLE I—DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Sec. 101. Amendment to the Social Security Act. 

Sec. 102. 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. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) The proportion of the United States popu9 lation age 60 years or older will drastically increase 

10 in the next 30 years as 77,000,000 baby boomers 

11 approach retirement and old age. 


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

2 5,000,000 elders in the United States are abused, 

3 neglected, or exploited. 

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

5 no boundaries, and cross all racial, social class, gen6 der, and geographic lines. 

7 (4) Victims of elder abuse, neglect, and exploi8 tation are not only subject to injury from mistreat9 ment and neglect, they are also 3.1 times more likely 

10 to die at an earlier age than expected than elders 

11 who were not victims of elder abuse, neglect, and ex12 ploitation. 

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

14 nature and scope of elder abuse, neglect, and exploi15 tation. 

16 (6) Despite the dearth of data in the field, ex17 perts agree that most cases of elder abuse, neglect, 

18 and exploitation are never reported and that abuse 

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

20 a downward spiral of an otherwise productive, self21 sufficient elder’s life. Programs addressing other dif22 ficult issues such as domestic violence and child 

23 abuse and neglect have demonstrated the need for a 

24 multi-faceted law combining public health, social 

25 service, and law enforcement approaches. 


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1 (7) For over 20 years, Congress has been pre2 sented with facts and testimony calling for a coordi3 nated Federal effort to combat elder abuse, neglect, 

4 and exploitation. 

5 (8) The Federal Government has been slow to 

6 respond to the needs of victims of elder abuse, ne7 glect, and exploitation or to undertake prevention ef8 forts. 

9 (9) No Federal law has been enacted that ade10 quately and comprehensively addresses the issues of 

11 elder abuse, neglect, and exploitation and there are 

12 very limited resources available to those in the field 

13 directly dealing with these issues. 

14 (10) Differences in State laws and practices in 

15 the areas of elder abuse, neglect, and exploitation 

16 lead to significant disparities in prevention, protec17 tive and social services, treatment systems, and law 

18 enforcement, and lead to other inequities. 

19 (11) The Federal Government has played an 

20 important role in promoting research, training, pub21 lic safety, data collection, the identification, develop22 ment, and dissemination of promising health care, 

23 social, and protective services, and law enforcement 

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1 eral Government should promote similar efforts and 

2 protections relating to elder abuse, neglect, and ex3 ploitation. 

4 (12) The Federal Government should provide 

5 leadership and assist States and communities in 

6 their efforts to protect elders in the United States 

7 by— 

8 (A) promoting coordinated planning among 

9 all levels of government; 

10 (B) generating and sharing knowledge rel11 evant to protecting elders; 

12 (C) providing leadership to combat the 

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

14 elders; and 

15 (D) providing resources to States and com16 munities to promote elder justice. 

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

18 exploitation requires a comprehensive approach 

19 that— 

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

21 and social service agencies and organizations; 

22 (B) emphasizes the need for prevention, re23 porting, investigation, assessment, treatment, 

24 and prosecution of elder abuse, neglect, and ex25 ploitation at all levels of government; 


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1 (C) ensures that sufficient numbers of 

2 properly trained personnel with specialized 

3 knowledge are in place to treat, assess, and pro4 vide services relating to elder abuse, neglect, 

5 and exploitation, and carry out elder and vul6 nerable adult protection duties; 

7 (D) is sensitive to ethnic and cultural di8 versity; 

9 (E) recognizes the role of mental health, 

10 disability, dementia, substance abuse, medica11 tion mismanagement, and family dysfunction 

12 problems in increasing and exacerbating elder 

13 abuse, neglect, and exploitation; and 

14 (F) balances adults’ right to self-deter15 mination with society’s responsibility to protect 

16 elders and vulnerable adults. 

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

18 elder abuse, neglect, and exploitation is high and in19 cludes unnecessary expenditures of medicare and 

20 medicaid funds. 

21 (15) The failure to coordinate activities relating 

22 to, and comprehensively prevent and treat, elder 

23 abuse, neglect, and exploitation threatens the future 

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

25 States. 


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1 (16) All elements of society in the United 

2 States have a shared responsibility in responding to 

3 the national problem of elder abuse, neglect, and ex4 ploitation. 

5 SEC. 3. PURPOSES. 

6 The purposes of this Act are as follows: 

7 (1) To bring a comprehensive approach to pre8 venting and combating elder abuse, neglect, and ex9 ploitation, a long invisible problem that afflicts the 

10 most vulnerable among the aging population of the 

11 United States. 

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

13 and exploitation to national attention, and to create 

14 the infrastructure at the Federal, State, and local 

15 levels to ensure that individuals and organizations 

16 on the front lines who are fighting elder abuse, ne17 glect, and exploitation with scarce resources and 

18 fragmented systems have the resources and informa19 tion needed to carry out their fight. 

20 (3) To bring a comprehensive multi-disciplinary 

21 approach to elder justice. 

22 (4) To set in motion research and data collec23 tion to fill gaps in knowledge about elder abuse, ne24 glect, and exploitation. 


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1 (5) To supplement the activities of service pro2 viders and programs, to enhance training, and to le3 verage scarce resources efficiently to ensure that 

4 elder justice receives the attention it deserves as the 

5 Nation’s population ages. 

6 (6) To examine the many different laws and 

7 practices relating to elder justice in different States 

8 and jurisdictions to ascertain which among those 

9 laws and practices are the most effective. 

10 (7) To promote the development of an effective 

11 adult fiduciary system, including an adult guardian12 ship system, that protects individuals with dimin13 ished capacity, maximizes their autonomy, and devel14 ops effective resources and an elder rights system. 

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

16 health, disability, dementia, substance abuse, medi17 cation mismanagement, and family dysfunction prob18 lems in increasing and exacerbating elder abuse, ne19 glect, and exploitation. 

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

21 plan for the development and coordination of elder 

22 justice research, programs, studies, training, and 

23 other efforts nationwide. 


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1 (10) To promote collaborative efforts and di2 minish overlap and gaps in efforts in developing the 

3 important field of elder justice. 

4 TITLE I—DEPARTMENT OF 

5 HEALTH AND HUMAN SERVICES 

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

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

8 amended by adding at the end the following: 

9 ‘‘TITLE XXII—ELDER JUSTICE 

10 ‘‘SEC. 2201. DEFINITIONS. 

11 ‘‘In this title: 

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

13 knowing infliction of physical or psychological harm 

14 or the knowing deprivation of goods or services that 

15 are necessary to meet essential needs or to avoid 

16 physical or psychological harm. 

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

18 ‘adult protective services’ means such services pro19 vided to adults as the Secretary may specify and in20 cludes services such as— 

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

22 neglect, or exploitation; 

23 ‘‘(B) investigating the reports described in 

24 subparagraph (A); 


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

2 and other case work and services; and 

3 ‘‘(D) providing, arranging for, or facili4 tating the provision of medical, social service, 

5 economic, legal, housing, law enforcement, or 

6 other protective, emergency, or support services. 

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

8 an individual who has the responsibility for the care 

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

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

11 of law and includes a family member or other indi12 vidual who provides (on behalf of such individual or 

13 of a public or private agency, organization, or insti14 tution) compensated or uncompensated care to an 

15 elder who needs supportive services in any setting. 

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

17 means care by a caregiver who provides assistance or 

18 long-term care services to a recipient. 

19 ‘‘(5) ELDER.—The term ‘elder’ means an indi20 vidual age 60 or older. 

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

22 means— 

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

24 prevent, detect, treat, intervene in, and pros25 ecute elder abuse, neglect, and exploitation and 


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1 to protect elders with diminished capacity while 

2 maximizing their autonomy; and 

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

4 recognition of an elder’s rights, including the 

5 right to be free of abuse, neglect, and exploi6 tation. 

7 ‘‘(7) ELIGIBLE ENTITY.—The term ‘eligible en8 tity’ means a State or local government agency, In9 dian tribe, or any other public or private entity that 

10 is engaged in and has expertise in issues relating to 

11 elder justice or in a field necessary to promote elder 

12 justice efforts. 

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

14 means the fraudulent or otherwise illegal, unauthor15 ized, or improper act or process of an individual, in16 cluding a caregiver or fiduciary, that uses the re17 sources of an elder for monetary or personal benefit, 

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

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

20 belongings, or assets. 

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

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

23 legal responsibility— 

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

25 and for the benefit of another person; and 


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

2 fairness; and 

3 ‘‘(B) includes a trustee, a guardian, a con4 servator, an executor, an agent under a finan5 cial power of attorney or health care power of 

6 attorney, or a representative payee. 

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

8 contract, cooperative agreement, or other mechanism 

9 for providing financial assistance. 

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

11 ‘granting authority’ means the Secretary, the Attor12 ney General, or the Secretary and the Attorney Gen13 eral jointly, as appropriate. 

14 ‘‘(12) GUARDIANSHIP.—The term ‘guardian15 ship’ means— 

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

17 determines that an adult individual lacks capac18 ity to make decisions about self-care and prop19 erty, and appoints another individual or entity 

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

21 similar term, as surrogate decision maker; 

22 ‘‘(B) the manner in which the court-ap23 pointed surrogate carries out duties to the indi24 vidual and the court; or 


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1 ‘‘(C) the manner in which the court exer2 cises oversight of the surrogate. 

3 ‘‘(13) INDIAN.—The term ‘Indian’ means a per4 son who is a member of an Indian tribe. 

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

6 means any Indian tribe, band, nation, or other orga7 nized group or community, including any Alaska Na8 tive village or regional corporation as defined in or 

9 established pursuant to the Alaska Native Claims 

10 Settlement Act (43 U.S.C. 1601 et seq.), that is rec11 ognized as eligible for the special programs and serv12 ices provided by the United States to Indians be13 cause of their status as Indians. 

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

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

16 title 31, United States Code. 

17 ‘‘(16) LAW ENFORCEMENT.—The term ‘law en18 forcement’ means the full range of potential re19 sponders to elder abuse, neglect, and exploitation in20 cluding— 

21 ‘‘(A) police, sheriffs, detectives, public safe22 ty officers, and corrections personnel; 

23 ‘‘(B) prosecutors; 

24 ‘‘(C) medical examiners; 

25 ‘‘(D) investigators; and 


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1 ‘‘(E) coroners. 

2 ‘‘(17) LONG-TERM CARE.— 

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

4 care’ means supportive and health services spec5 ified by the Secretary for individuals who need 

6 assistance because the individuals have a loss of 

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

8 or vulnerability. 

9 ‘‘(B) LOSS OF CAPACITY FOR SELF10 CARE.—For purposes of subparagraph (A), the 

11 term ‘loss of capacity for self-care’ means an in12 ability to engage in activities of daily living, in13 cluding eating, dressing, bathing, and manage14 ment of one’s financial affairs. 

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

16 ‘long-term care facility’ means a residential care pro17 vider that arranges for, or directly provides, long18 term care. 

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

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

21 to provide the goods or services that are nec22 essary to maintain the health or safety of an 

23 elder; or 

24 ‘‘(B) self-neglect. 


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

2 facility’ has the meaning given such term under sec3 tion 1919(a). 

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

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

6 impairment or diminished capacity, to perform es7 sential self-care tasks including— 

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

9 shelter, and medical care; 

10 ‘‘(B) obtaining goods and services nec11 essary to maintain physical health, mental 

12 health, or general safety; or 

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

14 ‘‘(22) SERIOUS BODILY INJURY.— 

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

16 bodily injury’ means an injury— 

17 ‘‘(i) involving extreme physical pain; 

18 ‘‘(ii) involving substantial risk of 

19 death; 

20 ‘‘(iii) involving protracted loss or im21 pairment of the function of a bodily mem22 ber, organ, or mental faculty; or 

23 ‘‘(iv) requiring medical intervention 

24 such as surgery, hospitalization, or phys25 ical rehabilitation. 


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

2 bodily injury shall be considered to have oc3 curred if the conduct causing the injury is con4 duct constituting aggravated sexual abuse 

5 under section 2241, or sexual abuse under sec6 tion 2242, of title 18, United States Code, or 

7 any similar offense under State law. 

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

9 with respect to a service, includes adult protective 

10 services. 

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

12 the several States, the District of Columbia, the 

13 Commonwealth of Puerto Rico, the United States, 

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

15 Commonwealth of the Mariana Islands. 

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

17 The term ‘State Long-Term Care Ombudsman’ 

18 means the State Long-Term Care Ombudsman de19 scribed in section 712(a)(2) of the Older Americans 

20 Act of 1965. 

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

22 ‘underserved population’ means the population of an 

23 area designated by the Secretary as an area with a 

24 shortage of elder justice programs or a population 

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1 age of such programs. Such areas or groups des2 ignated by the Secretary may include— 

3 ‘‘(A) areas or groups that are geographi4 cally isolated (such as isolated in a rural area); 

5 ‘‘(B) racial and ethnic minority popu6 lations; and 

7 ‘‘(C) populations underserved because of 

8 special needs (such as language barriers, dis9 abilities, alien status, or age). 

10 ‘‘Subtitle A—Federal Elder Justice 

11 System 

12 ‘‘SEC. 2211. OFFICE OF ELDER JUSTICE OF THE DEPART13 MENT OF HEALTH AND HUMAN SERVICES. 

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

15 the Department of Health and Human Services under the 

16 Assistant Secretary for Aging an Office of Elder Justice. 

17 ‘‘(b) DIRECTOR.— 

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

19 advice and consent of the Senate, shall appoint a Di20 rector of the Office of Elder Justice, from among in21 dividuals with experience and expertise in elder jus22 tice issues, to manage the Office of Elder Justice es23 tablished under this section. 

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

25 Elder Justice shall— 


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1 ‘‘(A)(i) develop objectives, priorities, poli2 cies, and a long-term plan for elder justice pro3 grams and activities relating to prevention, de4 tection, training, treatment, evaluation, inter5 vention, research, and improvement of the elder 

6 justice system in the United States; 

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

8 strategy to carry out the plan described in 

9 clause (i); and 

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

11 in carrying out the policies, programs, and ad12 ministrative activities related to the duties 

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

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

15 elder justice issues. 

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

17 of the Office of Elder Justice shall report to the As18 sistant Secretary for Aging. 

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

20 compensated at a rate that shall not exceed the rate 

21 established for level I of the Executive Schedule 

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


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

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

3 the Office of the Secretary an Elder Justice Coordinating 

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

5 ‘‘(b) MEMBERSHIP.— 

6 ‘‘(1) IN GENERAL.—The Council shall be com7 posed of the following members: 

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

9 designee). 

10 ‘‘(B) The Attorney General (or the Attor11 ney General’s designee). 

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

13 or agency or other governmental entity identi14 fied by the Co-Chairs referred to in subsection 

15 (d) as having responsibilities or administering 

16 programs relating to elder abuse, neglect, and 

17 exploitation. 

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

19 Council shall be an officer or employee of the Fed20 eral Government. 

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

22 not affect its powers, but shall be filled in the same man23 ner as the original appointment was made. 

24 ‘‘(d) CO-CHAIRS.—The members described in sub25 paragraphs (A) and (B) of subsection (b)(1) shall be Co26 Chairs of the Council. 


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

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

3 ‘‘(f) DUTIES.— 

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

5 recommendations to the Secretary and the Attorney 

6 General for the coordination of activities of the De7 partment of Health and Human Services, the De8 partment of Justice, and other relevant Federal, 

9 State, local, and private agencies and entities, relat10 ing to elder abuse, neglect, and exploitation and 

11 other crimes against elders. 

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

13 2 years after the date of enactment of the Elder 

14 Justice Act and every 2 years thereafter, the Council 

15 shall submit to Congress a report that— 

16 ‘‘(A) describes the activities of, accomplish17 ments of, and challenges faced by— 

18 ‘‘(i) the Council; and 

19 ‘‘(ii) the entities represented on the 

20 Council; and 

21 ‘‘(B) makes such recommendations for leg22 islation, model laws, or other action as the 

23 Council determines to be appropriate. 

24 ‘‘(g) POWERS OF THE COUNCIL.— 


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1 ‘‘(1) INFORMATION FROM FEDERAL AGEN2 CIES.— 

3 ‘‘(A) IN GENERAL.—Subject to subpara4 graph (B), the Council may secure directly from 

5 any Federal department or agency such infor6 mation as the Council considers necessary to 

7 carry out this section. Upon request of the Co8 Chairs of the Council, the head of such depart9 ment or agency shall furnish such information 

10 to the Council. 

11 ‘‘(B) PROTECTION OF PRIVACY.—The Sec12 retary shall oversee the activities of the Council 

13 under this paragraph in order to ensure the 

14 protection of individual health privacy con15 sistent with the regulations promulgated under 

16 section 264(c) of the Health Insurance Port17 ability and Accountability Act of 1996 and 

18 State and local privacy regulations (as applica19 ble). 

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

21 the United States mails in the same manner and 

22 under the same conditions as other departments and 

23 agencies of the Federal Government. 

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

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

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

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

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

6 business in the performance of services for the Council. 

7 Notwithstanding section 1342 of title 31, United States 

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

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

11 Federal Government employee may be detailed to the 

12 Council without reimbursement, and such detail shall be 

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

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

16 AND EXPLOITATION. 

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

18 to be known as the ‘Advisory Board on Elder Abuse, Ne19 glect, and Exploitation’ (in this section referred to as the 

20 ‘advisory board’) to create a short- and long-term multi21 disciplinary strategic plan for the development of the field 

22 of elder justice, and to make recommendations to the Sec23 retary, the Attorney General, and the Elder Justice Co24 ordinating Council established under section 2212. 


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1 ‘‘(b) SOLICITATION OF NOMINATIONS.—The Sec2 retary shall publish a notice in the Federal Register solic3 iting nominations for the appointment of members of the 

4 advisory board under subsection (c). 

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

6 composed of 27 members appointed by the Secretary from 

7 the general public who are individuals with experience and 

8 expertise in elder abuse, neglect, and exploitation preven9 tion, intervention, treatment, detection, or prosecution. 

10 ‘‘(d) VACANCIES.— 

11 ‘‘(1) IN GENERAL.—Any vacancy in the Advi12 sory Board shall not affect its powers, but shall be 

13 filled in the same manner as the original appoint14 ment was made. 

15 ‘‘(2) FILLING UNEXPIRED TERM.—An indi16 vidual chosen to fill a vacancy shall be appointed for 

17 the unexpired term of the member replaced. 

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

19 shall elect a chairperson and vice chairperson from among 

20 the members. The advisory board shall elect its initial 

21 chairperson and vice chairperson at its initial meeting. 

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

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

24 and annually thereafter, the advisory board shall prepare 

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


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1 the appropriate committees of Congress a report con2 taining— 

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

4 State, and local public and private elder justice ac5 tivities; 

6 ‘‘(2) recommendations (including recommended 

7 priorities) regarding— 

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

9 training, services, practice, enforcement, and 

10 coordination; 

11 ‘‘(B) coordination between entities pur12 suing elder justice efforts and those involved in 

13 related areas that may inform or overlap with 

14 elder justice efforts, such as activities to combat 

15 violence against women and child abuse and ne16 glect; and 

17 ‘‘(C) activities relating to adult fiduciary 

18 systems, including guardianship and other fidu19 ciary arrangements, including the development 

20 of State interdisciplinary guardianship commit21 tees; 

22 ‘‘(3) recommendations for specific modifications 

23 to Federal and State laws (including regulations) or 

24 for programs, research, and training to enhance pre25 vention, detection, diagnosis, treatment, intervention 


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1 in, investigation, and prosecution of elder abuse, ne2 glect, and exploitation; 

3 ‘‘(4) recommendations for the most effective co4 ordinated national data collection with respect to 

5 elder justice, and elder abuse, neglect, and exploi6 tation; and 

7 ‘‘(5) recommendations for a multidisciplinary 

8 strategic plan to guide the effective and efficient de9 velopment of the elder justice area. 

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

11 ‘‘(1) INFORMATION FROM FEDERAL AGEN12 CIES.— 

13 ‘‘(A) IN GENERAL.—Subject to subpara14 graph (B), the advisory board may secure di15 rectly from any Federal department or agency 

16 such information as the advisory board con17 siders necessary to carry out this section. Upon 

18 request of the chair, the head of such depart19 ment or agency shall furnish such information 

20 to the advisory board. 

21 ‘‘(B) PROTECTION OF PRIVACY.—The Sec22 retary shall oversee the activities of the advisory 

23 board under this paragraph in order to ensure 

24 the protection of individual health privacy con25 sistent with the regulations promulgated under 


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1 section 264(c) of the Health Insurance Port2 ability and Accountability Act of 1996 and 

3 State and local privacy regulations (as applica4 ble). 

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

6 advisory board may secure from any entity pursuing 

7 elder justice activities under the Elder Justice Act or 

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

9 or recommendations generated in connection with 

10 such activities. 

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

12 may use the United States mails in the same man13 ner and under the same conditions as other depart14 ments and agencies of the Federal Government. 

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

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

17 property. 

18 ‘‘(h) TRAVEL EXPENSES.—The members of the advi19 sory board shall not receive compensation for the perform20 ance of services for the advisory board, but shall be al21 lowed travel expenses, including per diem in lieu of sub22 sistence, at rates authorized for employees of agencies 

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

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

25 business in the performance of services for the advisory 


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1 board. Notwithstanding section 1342 of title 31, United 

2 States Code, the Secretary and the Attorney General may 

3 accept the voluntary and uncompensated services of the 

4 members of the advisory board. 

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

6 Federal Government employee may be detailed to the advi7 sory board without reimbursement, and such detail shall 

8 be without interruption or loss of civil service status or 

9 privilege. 

10 ‘‘(j) STATUS AS PERMANENT ADVISORY COM11 MITTEE.—Section 14 of the Federal Advisory Committee 

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

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

14 are authorized to be appropriated to carry out this sub15 section— 

16 ‘‘(1) $6,000,000 for fiscal year 2007; and 

17 ‘‘(2) $7,500,000 for each of fiscal years 2008 

18 through 2013. 

19 ‘‘Subtitle B—Activities to Promote 

20 Elder Justice 

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

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

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

24 consultation with the Attorney General, shall estab25 lish within the Office of Elder Justice, an Elder JusVerDate Aug 31 2005 20:37 Mar 20, 2006 Jkt 049200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\H4993.IH H4993

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1 tice Resource Center (in this section referred to as 

2 the ‘Center’) to be the central repository for infor3 mation regarding elder abuse, neglect, and exploi4 tation. 

5 ‘‘(2) DUTIES.—The Center shall— 

6 ‘‘(A) develop the capacity and procedures 

7 to collect, maintain, and disseminate informa8 tion relevant to consumers, families, providers, 

9 clinicians, advocates, regulators, law enforce10 ment, policymakers, researchers, fiduciaries in11 cluding guardians, judges, and lawyers, relevant 

12 to the prevention, detection, assessment, identi13 fication, and treatment of, intervention in, and 

14 prosecution of, elder abuse, neglect, and exploi15 tation; 

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

17 information on— 

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

19 face of aging or diminishing capacity and 

20 mobility; 

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

22 of elder abuse, neglect, or exploitation; and 

23 ‘‘(iii) advance planning and how to 

24 avoid the need for a fiduciary; 


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

2 sources of information; 

3 ‘‘(D) compile, analyze, and publish a sum4 mary of research conducted on elder abuse, ne5 glect, and exploitation and information on how 

6 to obtain the original research materials; 

7 ‘‘(E) solicit public comment and comment 

8 from the advisory board established under sec9 tion 2213 on the activities of the Center; 

10 ‘‘(F) establish a toll-free number for infor11 mation and referrals; 

12 ‘‘(G) coordinate activities with resource 

13 centers and clearinghouses on elder justice top14 ics; and 

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

16 agencies and entities to develop or continue the 

17 efforts of specialized elder justice-related clear18 inghouses and information repositories, to be 

19 linked to the Center, that address topics such 

20 as those enumerated in subparagraphs (A) and 

21 (B) and that provide effective services. 

22 ‘‘(3) COORDINATION OF AVAILABLE RE23 SOURCES.—In establishing the Center under this 

24 subsection the Secretary, after consultation with the 

25 Attorney General, shall— 


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1 ‘‘(A) consult with other Federal agencies 

2 that operate similar resource centers; 

3 ‘‘(B) consult with private entities that op4 erate resource centers or clearinghouses on 

5 elder justice-related topics; 

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

7 participating in the Elder Justice Coordinating 

8 Council established under section 2212, as well 

9 as other agencies with clearinghouses com10 parable to the Center, such as clearinghouses 

11 relating to child abuse and neglect, to deter12 mine the most efficient and effective manner for 

13 collecting, maintaining, and disseminating in14 formation on elder abuse, neglect, and exploi15 tation; and 

16 ‘‘(D) solicit public comment on the compo17 nents of such Center. 

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

19 ‘‘(A) ESTABLISHMENT.—The Secretary 

20 shall establish within the Center a National 

21 Elder Justice Library (in this paragraph re22 ferred to as the ‘Library’) to serve as a central23 ized repository for all types of appropriate ma24 terials concerning training, technical assistance, 


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1 and promising practices relating to elder justice 

2 including— 

3 ‘‘(i) brochures and pamphlets; 

4 ‘‘(ii) video and computer-based re5 sources; 

6 ‘‘(iii) books; and 

7 ‘‘(iv) training materials. 

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

9 and maintain an up-to-date index of the mate10 rials described in subparagraph (A) by title, au11 thor, date, subject, and type of material, and a 

12 brief description of such materials. Such index 

13 shall be available on the Internet as well as in 

14 printed form in order to be easily accessible to 

15 the general public. 

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

17 by the Library shall be available for copying by 

18 individuals and entities nationwide and shall be 

19 disseminated at a nominal or no fee. The mate20 rials shall be copied and disseminated in ac21 cordance with the applicable provisions of title 

22 17, United States Code. 

23 ‘‘(D) DUTIES.— 

24 ‘‘(i) ADDITIONAL MATERIALS.—The 

25 Library shall— 


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1 ‘‘(I) collect data on materials 

2 that would be appropriate for such li3 brary; 

4 ‘‘(II) make efforts to identify and 

5 obtain appropriate materials; and 

6 ‘‘(III) identify and obtain mate7 rials relating to effective methods of 

8 conducting training and providing 

9 technical assistance relating to elder 

10 justice, including conducting training 

11 and providing assistance for under12 served populations. 

13 ‘‘(ii) INFORMATION PACKETS.—After 

14 evaluating the materials described in this 

15 paragraph, the Library shall compile and 

16 develop information packets for use by 

17 groups in various settings, including 

18 groups who are underserved or have other 

19 special needs. Such information packets 

20 shall include information and materials on 

21 training, technical assistance, and prom22 ising practices targeted at specific topics, 

23 groups, and settings. 


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1 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

2 There are authorized to be appropriated to carry out 

3 this subsection— 

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

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

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

7 2009 through 2013. 

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

9 ELDER ABUSE, NEGLECT, AND EXPLOITATION.— 

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

11 is to improve, streamline, and promote uniform col12 lection, maintenance, and dissemination of national 

13 data relating to elder abuse, neglect, and exploi14 tation. 

15 ‘‘(2) PHASE I.— 

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

17 after the date of enactment of the Elder Justice 

18 Act, the Director of the Centers for Disease 

19 Control and Prevention (in this subsection re20 ferred to as the ‘Director’), after consultation 

21 with the Attorney General and working with ex22 perts in relevant disciplines, shall— 

23 ‘‘(i) develop a method for collecting 

24 national data regarding elder abuse, ne25 glect, and exploitation; and 


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1 ‘‘(ii) develop uniform national data re2 porting forms adapted to each relevant en3 tity or discipline (such as health, public 

4 safety, social and protective services, and 

5 law) reflecting— 

6 ‘‘(I) the distinct manner in which 

7 each discipline receives and maintains 

8 information; and 

9 ‘‘(II) the sequence and history of 

10 reports to or involvement of different 

11 disciplines, independently, or the se12 quence and history of reports from 

13 one discipline to another over time. 

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

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

16 incorporate the definitions of this title for use 

17 in determining what is considered a reportable 

18 event. 

19 ‘‘(3) PHASE II.— 

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

21 after the completion of the activities described 

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

23 the national data reporting forms and data col24 lection methods developed in accordance with 


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1 such paragraph are pilot tested in 6 States de2 termined by the Director. 

3 ‘‘(B) ADJUSTMENTS TO THE FORM AND

4 METHODS.—The Director, after considering the 

5 results of the pilot testing described in subpara6 graph (A), and after consultation with the At7 torney General and relevant experts shall adjust 

8 the national data reporting forms and data col9 lection methods as necessary. 

10 ‘‘(4) PHASE III.— 

11 ‘‘(A) DISTRIBUTION OF NATIONAL DATA

12 REPORTING FORMS.—After completion of the 

13 adjustment to the national data reporting forms 

14 under paragraph (3)(B), the Director shall sub15 mit the national data reporting forms along 

16 with instructions to— 

17 ‘‘(i) the heads of the relevant compo18 nents of the Department of Health and 

19 Human Services, the Department of Jus20 tice, and the Department of the Treasury, 

21 and such other Federal entities as may be 

22 appropriate; and 

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

24 State for collection from all relevant State 


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1 entities of data, including health care, so2 cial services, and law enforcement data. 

3 ‘‘(B) DATA COLLECTION GRANTS.— 

4 ‘‘(i) AUTHORIZATION.—The Director 

5 is authorized to award grants to States to 

6 improve data collection activities relating 

7 to elder abuse, neglect, and exploitation. 

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

9 receive a grant under this subparagraph, a 

10 State shall submit to the Director an appli11 cation at such time, in such manner, and 

12 containing such information as the Direc13 tor may require. 

14 ‘‘(iii) REQUIREMENTS.—Each State 

15 receiving a grant under this subparagraph 

16 for a fiscal year is required to report data 

17 for the calendar year that begins during 

18 that fiscal year, using the national data re19 porting forms described in subparagraph 

20 (A). 

21 ‘‘(iv) FUNDING.— 

22 ‘‘(I) FIRST YEAR.—For the first 

23 fiscal year in which a State receives 

24 grant funds under this subsection, the 

25 Secretary shall initially distribute 50 


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1 percent of such funds. The Secretary 

2 shall distribute the remaining funds at 

3 the end of the calendar year that be4 gins during that fiscal year, if the 

5 Secretary determines that the State 

6 has properly reported data required 

7 under this subsection for the calendar 

8 year. 

9 ‘‘(II) SUBSEQUENT YEARS.—Ex10 cept as provided in subclause (I), the 

11 Secretary shall distribute grant funds 

12 to a State under this subsection for a 

13 fiscal year if the Secretary determines 

14 that the State properly reported data 

15 required under this subsection for the 

16 calendar year that ends during that 

17 fiscal year. 

18 ‘‘(C) REQUIRED INFORMATION.—Each re19 port submitted under this paragraph shall— 

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

21 which each event occurred; and 

22 ‘‘(ii) identify— 

23 ‘‘(I) the total number of events 

24 that occurred in each State during the 

25 year; and 


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1 ‘‘(II) the type of each event. 

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

3 date of enactment of the Elder Justice Act and an4 nually thereafter, the Secretary shall prepare and 

5 submit to the appropriate committees of Congress, 

6 including to the Special Committee on Aging and 

7 the Finance Committee of the Senate, a report re8 garding activities conducted under this section. 

9 ‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 

10 There are authorized to be appropriated to carry out 

11 this subsection— 

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

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

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

15 2009 through 2013. 

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

17 STRENGTHENING SERVICES, SYSTEMS, AND 

18 PREVENTION. 

19 ‘‘(a) GENERAL GRANTS AND CENTERS OF EXCEL20 LENCE.— 

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

22 award grants to eligible entities for the prevention, 

23 detection, assessment, and treatment of, intervention 

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

25 neglect, and exploitation including— 


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

2 abuse and neglect by family and other in-home 

3 caregivers; 

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

5 abuse and neglect of residents in institutional 

6 and other residential care facilities; 

7 ‘‘(C) elder sexual abuse; 

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

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

10 ‘‘(F) self-neglect. 

11 ‘‘(2) CENTERS OF EXCELLENCE.— 

12 ‘‘(A) GRANTS AUTHORIZED.—The Sec13 retary, through the Director of the National In14 stitute on Aging, and after consultation with 

15 the Director of the Centers for Disease Control 

16 and Prevention, the Director of the Office of 

17 Elder Justice in the Department of Health and 

18 Human Services, the Director of the Office of 

19 Elder Justice in the Department of Justice, and 

20 the members of the advisory board established 

21 under section 2213, may award grants to insti22 tutions of higher education and other appro23 priate entities to establish 5 Centers of Excel24 lence nationwide that shall specialize in reVerDate Aug 31 2005 20:37 Mar 20, 2006 Jkt 049200 PO 00000 Frm 00039 Fmt 6652 Sfmt 6201 E:\BILLS\H4993.IH H4993

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1 search, clinical practice, and training relating to 

2 elder abuse, neglect, and exploitation. 

3 ‘‘(B) AUTHORIZED ACTIVITIES.—The Cen4 ters of Excellence established with funds pro5 vided under subparagraph (A) shall conduct the 

6 following activities: 

7 ‘‘(i) Examine potential issues relating 

8 to the protection of elders who are the sub9 jects of research on elder abuse, neglect, 

10 and exploitation and provide guidance to 

11 other elder abuse, neglect, or exploitation 

12 researchers regarding human subjects, pro13 tections, and the institutional or peer re14 view boards at research institutions. 

15 ‘‘(ii) After consultation with the Di16 rector of the National Institute on Aging, 

17 and the Director of the Office of Human 

18 Research Protections, develop and rec19 ommend to the Secretary guidelines to as20 sist the institutional or peer review boards 

21 in the review of research conducted under 

22 this title. 

23 ‘‘(iii) Coordinate activities, to the ex24 tent feasible, among the Centers and with 

25 other researchers of elder abuse, neglect, 


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1 and exploitation and related areas, and 

2 designate 1 such Center to lead such co3 ordination. 

4 ‘‘(C) ADDITIONAL ACTIVITIES.—The Cen5 ters of Excellence established under subpara6 graph (A) may conduct activities including the 

7 following: 

8 ‘‘(i) Carrying out a study to deter9 mine the national incidence and prevalence 

10 of elder abuse, neglect, and exploitation in 

11 all settings. 

12 ‘‘(ii) Developing uniform, validated 

13 screening tools to assist individuals, fami14 lies, practitioners, institutions, and com15 munities in detecting ongoing or potential 

16 elder abuse, neglect, and exploitation. The 

17 tools that may be developed include— 

18 ‘‘(I) a screening tool to determine 

19 whether a particular elder is at risk 

20 for becoming, or is, a victim of elder 

21 abuse, neglect, or exploitation; 

22 ‘‘(II) a screening tool to measure 

23 whether caregivers are at risk of com24 mitting elder abuse, neglect, or exploi25 tation; 


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1 ‘‘(III) a screening tool to meas2 ure whether families are at risk for 

3 elder abuse, neglect, and exploitation; 

4 and 

5 ‘‘(IV) a screening tool to assess 

6 communities, evaluating how each in7 dividual agency or system relating to 

8 elder abuse, neglect, or exploitation 

9 operates in such a community and 

10 how all of such agencies or systems 

11 communicate and operate in relation12 ship to each other within such com13 munity. 

14 ‘‘(iii) Carrying out various types of 

15 intervention research. 

16 ‘‘(iv) Identifying steps that can be 

17 taken (and replicated) to make homes, 

18 neighborhoods, communities, and facilities 

19 safer for elders, and to enhance elders’ 

20 sense of security in all kinds of environ21 ments. 

22 ‘‘(v) Researching successful fiduciary 

23 practices and systems to enhance the well24 being of persons with diminished capacity. 


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1 ‘‘(D) COLLABORATION AND ACCESS TO

2 RECORDS.—In awarding a grant under this 

3 paragraph the Secretary shall— 

4 ‘‘(i) consider the potential for collabo5 ration among researchers and other rel6 evant entities, such as State agencies with 

7 statutory responsibility for adult protective 

8 services and State Long-Term Care Om9 budsmen, that receive reports of elder 

10 abuse, neglect, and exploitation, but that 

11 may be restricted from participating in re12 search as a result of State law, confiden13 tiality requirements, or other provisions; 

14 and 

15 ‘‘(ii) require that each institution of 

16 higher education desiring a grant under 

17 this subsection ensure that the researchers 

18 working at such institution will have access 

19 to records necessary to conduct research in 

20 accordance with this paragraph. 

21 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

22 There are authorized to be appropriated for the pur23 pose of carrying out paragraphs (1) and (2) of this 

24 subsection— 

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


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

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

3 2009 through 2013. 

4 ‘‘(b) SAFE HAVEN AND LEGAL ADVOCACY

5 GRANTS.— 

6 ‘‘(1) SAFE HAVEN GRANTS.— 

7 ‘‘(A) GRANTS AUTHORIZED.—The Sec8 retary may award grants to 6 diverse commu9 nities to examine various types of elder shelters 

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

11 and to test various models for establishing safe 

12 havens at home or elsewhere. 

13 ‘‘(B) AUTHORIZED ACTIVITIES.—Grant 

14 funds awarded pursuant to subparagraph (A) 

15 shall be used to establish safe havens that— 

16 ‘‘(i) provide a comprehensive, cul17 turally sensitive, and multidisciplinary 

18 team response to allegations of elder 

19 abuse, neglect, or exploitation; 

20 ‘‘(ii) provide a dedicated, elder-friend21 ly setting; 

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

23 needs of elders for care; and 

24 ‘‘(iv) provide various services includ25 ing— 


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1 ‘‘(I) nursing and forensic evalua2 tion; 

3 ‘‘(II) therapeutic intervention; 

4 ‘‘(III) victim support and advo5 cacy; and 

6 ‘‘(IV) case review and assistance 

7 to make the elder safer at home or to 

8 find appropriate placement in safer 

9 environments, including shelters, and, 

10 in some circumstances, long-term care 

11 facilities, other residential care facili12 ties, and hospitals. 

13 ‘‘(2) LEGAL ADVOCACY GRANTS.— 

14 ‘‘(A) GRANTS AUTHORIZED.—The Sec15 retary, after consultation with the Attorney 

16 General, may award grants— 

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

18 resources in order to provide assistance for 

19 legal and related services for victims of 

20 elder abuse, neglect, or exploitation; and 

21 ‘‘(ii) to provide assistance for such 

22 services by awarding grants for demonstra23 tion projects in diverse communities. 


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1 ‘‘(B) AUTHORIZED ACTIVITIES.—Grant 

2 funds awarded pursuant to subparagraph (A) 

3 shall be used to provide— 

4 ‘‘(i) court-appointed advocates; 

5 ‘‘(ii) authorized fiduciaries, including 

6 public guardians; 

7 ‘‘(iii) monitoring and oversight of fi8 duciaries; 

9 ‘‘(iv) legal services; and 

10 ‘‘(v) such other services as the Sec11 retary, after consultation with the Attorney 

12 General, determines appropriate. 

13 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

14 There are authorized to be appropriated to carry out 

15 this subsection— 

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

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

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

19 2009 through 2013. 

20 ‘‘(c) GRANTS TO ENHANCE VOLUNTEER SERV21 ICES.— 

22 ‘‘(1) GRANTS.—The Secretary, after consulta23 tion with the Attorney General, may award grants to 

24 nonprofit organizations and faith-based organiza25 tions to encourage such organizations to establish or 


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1 continue volunteer programs that focus on the issues 

2 of elder abuse, neglect, and exploitation, or that pro3 vide related services. 

4 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

5 There are authorized to be appropriated to carry out 

6 this subsection— 

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

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

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

10 2009 through 2013. 

11 ‘‘(d) MULTIDISCIPLINARY EFFORTS.— 

12 ‘‘(1) GRANTS.— 

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

14 award grants to fund various multidisciplinary 

15 elder justice activities, including the following: 

16 ‘‘(i) Supporting and studying team 

17 approaches for bringing a coordinated mul18 tidisciplinary or interdisciplinary response 

19 to elder abuse, neglect, and exploitation, 

20 including a response from individuals in 

21 social service, health care, public safety, 

22 and legal disciplines. 

23 ‘‘(ii) Establishing State coordinating 

24 councils modeled after the national Elder 

25 Justice Coordinating Council established 


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1 under section 2212. Such State coordi2 nating councils shall identify the individual 

3 States’ needs and provide the national 

4 Elder Justice Coordinating Council with 

5 information and recommendations relating 

6 to State efforts to combat elder abuse, ne7 glect, and exploitation. 

8 ‘‘(iii) Providing training, technical as9 sistance, and other methods of support to 

10 groups carrying out multidisciplinary ef11 forts at the State level (referred to in some 

12 States as ‘State Working Groups’). 

13 ‘‘(iv) Broadening and studying various 

14 models for elder fatality and serious injury 

15 review teams, to make recommendations 

16 about their composition, protocols, func17 tions, timing, roles, and responsibilities, 

18 with a goal of producing models and infor19 mation that will allow for replication based 

20 on the needs of other States and commu21 nities. 

22 ‘‘(v) Carrying out such other inter23 disciplinary or multidisciplinary efforts as 

24 the Secretary determines to be appropriate. 


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1 ‘‘(B) AUTHORIZATION OF APPROPRIA2 TIONS.—There are authorized to be appro3 priated to carry out this paragraph, $5,000,000 

4 for each of fiscal years 2007 through 2013. 

5 ‘‘(2) INTERDISCIPLINARY STUDY.— 

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

7 Centers for Disease Control and Prevention, 

8 after consultation with the Director of the Of9 fice of Elder Justice in the Department of 

10 Health and Human Services and the Director 

11 of the Office of Elder Justice in the Depart12 ment of Justice, shall conduct an intensive 

13 interdisciplinary study of entities that conduct 

14 elder justice activities in several different com15 munities, examining how the entities address 

16 elder abuse, neglect, and exploitation issues 

17 (such as an assessment of various types of 

18 health care and social service providers, public 

19 safety agencies, law enforcement agencies, pros20 ecutor offices, and the judiciary). 

21 ‘‘(B) GOAL.—The goals of the study de22 scribed in subparagraph (A) include— 

23 ‘‘(i) making an assessment of the 

24 functioning and effectiveness of each entity 

25 in a community that conducts elder justice 


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1 activities, and the interdisciplinary commu2 nications and collaborations among such 

3 entities; and 

4 ‘‘(ii) developing a procedure for com5 munities to conduct a self-assessment to 

6 assist them in identifying the manner in 

7 which the entities described in clause (i) in 

8 such communities respond to elder justice 

9 issues, the needs of such communities re10 lating to elder justice issues, and ways to 

11 improve the response systems of such com12 munities for elder abuse, neglect, and ex13 ploitation. 

14 ‘‘(C) AUTHORIZATION OF APPROPRIA15 TIONS.—There are authorized to be appro16 priated to carry out this paragraph— 

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

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

19 and 

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

21 years 2009 through 2013. 

22 ‘‘(e) TRAINING GRANTS.— 

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

24 may award grants to groups representing the tar25 geted disciplines described in paragraph (2)(B) to 


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1 train individuals with respect to issues of elder 

2 abuse, neglect, and exploitation. 

3 ‘‘(2) AUTHORIZED ACTIVITIES.— 

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

5 under paragraph (1) shall be used for training 

6 within a discipline as well as cross-training ac7 tivities that permit individuals in multiple dis8 ciplines to train together, fostering communica9 tion, coordinating efforts, and ensuring collabo10 ration. 

11 ‘‘(B) TARGETED DISCIPLINES.—Groups 

12 representing disciplines that will be targeted for 

13 training through grants awarded under para14 graph (1) include— 

15 ‘‘(i) physicians, including geriatri16 cians, medical residents, interns, and fel17 lows; 

18 ‘‘(ii) nurses and nurse’s aides, includ19 ing geriatric nurse practitioners, directors 

20 of nursing, and Sexual Abuse Nurse Ex21 aminers (SANE) nurses; 

22 ‘‘(iii) social workers; 

23 ‘‘(iv) public health and safety profes24 sionals, including Emergency Medical Serv25 ices professionals; 


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1 ‘‘(v) therapists, including creative 

2 arts, occupational, speech, and physical 

3 therapists; 

4 ‘‘(vi) State surveyors of nursing facili5 ties and other long-term care facilities; 

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

7 or hospitals; 

8 ‘‘(viii) coroners and funeral home op9 erators; 

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

11 with responsibility for elder justice or long12 term care matters; 

13 ‘‘(x) employees or contractors of State 

14 and local agencies with responsibility for 

15 training persons who provide adult protec16 tive services; 

17 ‘‘(xi) State Long-Term Care Ombuds18 men; 

19 ‘‘(xii) victim advocates and advocates 

20 for elders and individuals with disabilities; 

21 ‘‘(xiii) individuals involved in volun22 teer organizations (including faith-based 

23 organizations) who are involved in issues of 

24 elder abuse, neglect, and exploitation; 


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1 ‘‘(xiv) police officers, sheriffs, detec2 tives, firefighters, Federal and State inves3 tigators, public safety officers, and correc4 tions personnel; 

5 ‘‘(xv) Federal, State, and local pros6 ecutors, attorneys in private practice in7 volved in elder justice issues, judges, and 

8 court employees; 

9 ‘‘(xvi) federally recognized partner10 ships of elders, sheriff departments, and 

11 the American Association of Retired Per12 sons (commonly referred to as TRIADs); 

13 ‘‘(xvii) elder service officers; 

14 ‘‘(xviii) individuals who work with the 

15 public, including bank personnel, postal 

16 workers, utility workers, providers of 

17 home-delivered meals, and others who may 

18 work with elders; 

19 ‘‘(xix) students in professional and 

20 paraprofessional schools, internships, fel21 lowships, and other training programs in a 

22 relevant profession; 

23 ‘‘(xx) fiduciaries, including guardians, 

24 conservators, and agents under powers of 

25 attorney; and 


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1 ‘‘(xxi) staff and volunteers of domestic 

2 violence and child abuse and neglect pro3 grams. 

4 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

5 There are authorized to be appropriated to carry out 

6 this subsection— 

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

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

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

10 2009 through 2013. 

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

12 PROFESSIONALS WITH GERIATRIC TRAINING.— 

13 ‘‘(1) INCREASING THE NUMBER OF HEALTH

14 CARE PROFESSIONALS WITH GERIATRIC TRAINING.— 

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

16 establish programs to increase— 

17 ‘‘(i) the number of health care profes18 sionals (including physicians, nurses, nurs19 ing personnel, social workers, and thera20 pists) and students in the health care pro21 fessions, who receive education and train22 ing related to geriatrics; and 

23 ‘‘(ii) the number of such professionals 

24 who provide health care related to geri25 atrics. 


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1 ‘‘(B) INCLUSION OF GERIATRIC SERVICES

2 AS PART OF OBLIGATED SERVICE UNDER THE

3 PUBLIC HEALTH SERVICE ACT.—For purposes 

4 of applying sections 338B and 338C of the 

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

6 254m), the term ‘obligated service’ shall include 

7 any period during which an individual who has 

8 entered into a written contract with the Sec9 retary under such section 338B (42 U.S.C. 

10 254l) is enrolled and participating in an accred11 ited (as determined by the Secretary) edu12 cational program that provides geriatric train13 ing. Upon the completion of such training, the 

14 individual, after consultation with the Sec15 retary, shall provide geriatric services as appro16 priate during the remainder of the period of ob17 ligated service of such individual. 

18 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

19 There are authorized to be appropriated to carry out 

20 this subsection— 

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

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

23 2008 through 2013. 

24 ‘‘(g) DEMENTIA TRAINING GRANTS.— 


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

2 may award grants to eligible entities to provide 

3 training within the health and social science dis4 ciplines, as well as cross-training activities that per5 mit individuals in multiple such disciplines to train 

6 together, to foster communication, coordinate ef7 forts, and ensure collaboration on best practices in 

8 caring for individuals with dementia. 

9 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

10 There are authorized to be appropriated to carry out 

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

12 2007 through 2013. 

13 ‘‘(h) SPECIAL NEEDS GRANTS.— 

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

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

17 special needs of underserved populations of elders. 

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

19 funds awarded pursuant to paragraph (1) shall be 

20 used to fund programs including the following: 

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

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

25 shall include— 


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1 ‘‘(i) strategies to decrease isolation; 

2 ‘‘(ii) training for informal caregivers 

3 and fiduciaries; 

4 ‘‘(iii) activities involving collaboration 

5 between the entities and local secondary 

6 schools and institutions of higher education 

7 to offer classes for credit, focusing on 

8 training individuals to work with elders 

9 and caregivers; 

10 ‘‘(iv) training for volunteers to serve 

11 in rural communities; and 

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

13 planning to avoid the need for a guardian 

14 or other fiduciary. 

15 ‘‘(B) MINORITY POPULATIONS.—Programs 

16 designed to meet the needs of elders in minority 

17 populations, including culturally and linguis18 tically appropriate programs. 

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

20 to provide necessary services to elders who are 

21 members of Indian tribes, including successful 

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

25 programs shall deliver services and distribute 


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1 educational information on elder abuse, neglect, 

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

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

6 Indian tribes. 

7 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

8 There are authorized to be appropriated to carry out 

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

10 2007 through 2013. 

11 ‘‘(i) PUBLIC AWARENESS GRANTS.— 

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

13 and the Attorney General, after consultation with 

14 the advisory board established under section 2213 

15 and the coordinating council established under sec16 tion 2212, shall jointly award 1 grant to a national 

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

18 to conduct a national multimedia campaign designed 

19 to raise awareness about elder abuse, neglect, and 

20 exploitation. 

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

22 awarded under paragraph (1) shall be used for ac23 tivities including the following: 

24 ‘‘(A) Raising public awareness regarding 

25 financial schemes that target elders. 


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1 ‘‘(B) Pilot testing the effectiveness of var2 ious types of multimedia campaigns in raising 

3 awareness about— 

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

5 and exploitation; 

6 ‘‘(ii) steps to take if an individual sus7 pects elder abuse, neglect, or exploitation 

8 has occurred; and 

9 ‘‘(iii) ways to prevent elder abuse, ne10 glect, or exploitation. 

11 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

12 There are authorized to be appropriated to carry out 

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

14 2007 through 2013. 

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

16 ‘‘(1) IN GENERAL.—The Secretary and the At17 torney General are authorized to jointly award 

18 grants to individuals or entities working in the elder 

19 justice field or related fields for research, a dem20 onstration project, development or implementation of 

21 a promising program or practice, or another innova22 tive effort related to the identification or prevention 

23 of elder abuse, neglect, or exploitation that might 

24 not otherwise be funded or pursued in the absence 

25 of a grant under this subsection. 


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1 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

2 There are authorized to be appropriated to carry out 

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

4 2007 through 2013. 

5 ‘‘SEC. 2223. STUDIES. 

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

7 ABUSE, NEGLECT, AND EXPLOITATION.— 

8 ‘‘(1) IN GENERAL.—The Secretary and the At9 torney General shall jointly sponsor or conduct a 

10 study of the roles and responsibilities of Government 

11 and Government-funded entities responsible for re12 sponding to, investigating, and taking other actions 

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

14 exploitation including— 

15 ‘‘(A) State and local agencies with the re16 sponsibility for adult protective services; 

17 ‘‘(B) the State Long-Term Care Ombuds18 men; 

19 ‘‘(C) law enforcement (including prosecu20 tors); 

21 ‘‘(D) fiduciaries; 

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

23 ‘‘(F) such other social and protective serv24 ice, advocacy, and protection organizations as 


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1 the Secretary and the Attorney General deter2 mine to be appropriate. 

3 ‘‘(2) GOALS.—The goals of the study author4 ized in paragraph (1) (which may be conducted in 

5 distinct sections, if there is overall coordination) 

6 are— 

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

8 investigation of, and intervention in elder abuse, 

9 neglect, and exploitation; 

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

11 abuse, neglect, and exploitation; and 

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

13 consequences by assessing and improving the 

14 systems created to address reports of elder 

15 abuse, neglect, and exploitation. 

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

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

18 shall— 

19 ‘‘(A) conduct an evaluation of— 

20 ‘‘(i) how the social and protective 

21 service, advocacy, protection, judicial, and 

22 law enforcement entities and systems are 

23 operating; 

24 ‘‘(ii) the interplay and allocation of re25 sponsibilities among those entities; 


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1 ‘‘(iii) how that allocation differs from 

2 community to community and State to 

3 State; and 

4 ‘‘(iv) how those differences impact the 

5 population intended to be protected by the 

6 entities and systems; 

7 ‘‘(B) make recommendations on how to 

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

9 such as State agencies with responsibility for 

10 adult protective services, the State Long-Term 

11 Care Ombudsmen, and other protection and ad12 vocacy entities to enhance efficiency, eliminate 

13 gaps in service, and identify conflicting man14 dates and duplication of efforts; and 

15 ‘‘(C) evaluate how various communities de16 lineate the roles and responsibilities of the types 

17 of entities described in subparagraph (A) in 

18 order to identify and recommend effective mod19 els and methods to duplicate the delineation ef20 forts (such as duplication through memoranda 

21 of understanding). 

22 ‘‘(4) AUTHORIZATION OF APPROPRIATIONS.— 

23 There are authorized to be appropriated to carry out 

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

25 2007 through 2013. 


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1 ‘‘(b) FAMILY ELDER ABUSE, NEGLECT, AND EX2 PLOITATION STUDY.— 

3 ‘‘(1) IN GENERAL.—The Director of the Cen4 ters for Disease Control and Prevention (in this sub5 section referred to as the ‘Director’), after consulta6 tion with the Director of the Office of Elder Justice 

7 in the Department of Health and Human Services 

8 and the Director of the Office of Elder Justice in 

9 the Department of Justice, shall conduct a study to 

10 determine the best method to address elder abuse, 

11 neglect, and exploitation from a public health per12 spective, including examining methods to reduce 

13 elder abuse, neglect, and exploitation committed by 

14 family members. 

15 ‘‘(2) COLLABORATION.—The Director, in car16 rying out activities under this subsection, shall col17 laborate with the Director of the National Institute 

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

19 in the Department of Health and Human Services, 

20 the Director of the Office of Elder Justice in the 

21 Department of Justice, the heads of State agencies 

22 with responsibility for adult protective services, and 

23 the heads of such other entities as the Director de24 termines appropriate. 


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1 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

2 There are authorized to be appropriated to carry out 

3 this subsection— 

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

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

6 2008 through 2013. 

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

8 TRAINING. 

9 ‘‘(a) FORENSIC CENTERS.— 

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

11 grants to appropriate entities to establish and oper12 ate stationary and mobile forensic centers, to de13 velop forensic expertise regarding, and provide serv14 ices relating to, elder abuse, neglect, and exploi15 tation. 

16 ‘‘(2) COORDINATION AMONG FORENSIC CEN17 TERS AND CENTERS OF EXCELLENCE.—The entities 

18 establishing and operating the forensic centers shall 

19 coordinate activities on an ongoing basis with the 

20 Centers of Excellence described in section 

21 2222(b)(1). Such coordination shall include ongoing 

22 communication among the entities and the Centers 

23 of Excellence. The entities shall adhere to proce24 dures and mechanisms developed by the Secretary, 


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1 including procedures and mechanisms relating to the 

2 sharing of data. 

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

4 Secretary shall make 4 of the grants described in 

5 paragraph (1) to institutions of higher education 

6 with demonstrated expertise in forensics or commit7 ment to preventing or treating elder abuse, neglect, 

8 or exploitation, to establish and operate stationary 

9 forensic centers. The Secretary shall make at least 

10 2 of the 4 grants to an entity operating a Center of 

11 Excellence described in section 2222(b)(1) at an in12 stitution of higher education. 

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

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

15 appropriate entities to establish and operate mobile 

16 forensic centers. 

17 ‘‘(5) USE OF FUNDS.— 

18 ‘‘(A) DEVELOPMENT OF FORENSIC MARK19 ERS AND METHODOLOGIES.—An entity that re20 ceives a grant under this subsection shall use 

21 funds made available through the grant to as22 sist in the determination of whether abuse or 

23 neglect occurred, or a crime was committed, 

24 and to conduct research to describe and dis25 seminate information on— 


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1 ‘‘(i) forensic markers that indicate a 

2 case in which elder abuse, neglect, or ex3 ploitation may have occurred; and 

4 ‘‘(ii) methodologies for determining, in 

5 such a case, when and how health care, 

6 emergency service, social and protective 

7 service, and legal service providers should 

8 intervene and when the providers should 

9 report the case to law enforcement authori10 ties. 

11 ‘‘(B) APPLICATIONS.—An entity that re12 ceives a grant under this subsection shall use 

13 funds made available through the grant to de14 velop forensic expertise regarding elder abuse, 

15 neglect, and exploitation, in order to provide 

16 medical and forensic evaluation, therapeutic 

17 intervention, victim support and advocacy, case 

18 review, and case tracking. 

19 ‘‘(C) COLLECTION OF EVIDENCE.—An en20 tity operating a Center of Excellence described 

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

22 under this subsection shall use funds made 

23 available through the grant to develop the ca24 pacity to collect forensic evidence, including col25 lecting forensic evidence relating to a potential 


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1 determination of elder abuse, neglect, or exploi2 tation. 

3 ‘‘(6) AUTHORIZATION OF APPROPRIATIONS.— 

4 There are authorized to be appropriated to carry out 

5 this subsection— 

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

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

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

9 2009 through 2013. 

10 ‘‘(b) TRAINING TO DEVELOP EXPERTISE IN GERI11 ATRIC FORENSICS.— 

12 ‘‘(1) FELLOWSHIP PROGRAMS.— 

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

14 award fellowships to eligible individuals, to en15 able the individuals to obtain training through 

16 a standard forensic science training program. 

17 ‘‘(B) ELIGIBLE INDIVIDUALS.—To be eligi18 ble to receive a fellowship under this paragraph, 

19 an individual shall be a physician who— 

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

21 in internal medicine or family practice; 

22 ‘‘(ii) has completed a program in geri23 atrics that meets such criteria as the Sec24 retary may prescribe; and 


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1 ‘‘(iii) has entered into an agreement 

2 with the Secretary to provide the team 

3 training described in subparagraph (C), 

4 after receiving the training described in 

5 subparagraph (A). 

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

7 receives a fellowship under this paragraph shall 

8 provide training in forensic geriatrics to inter9 disciplinary teams of health care professionals. 

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

11 the fellowships awarded under paragraph (1), the 

12 Secretary shall establish programs, and make grants 

13 to carry out such programs, that are designed to 

14 provide forensic training to experienced geriatricians. 

15 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

16 There are authorized to be appropriated to carry out 

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

18 2007 through 2013. 


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1 ‘‘Subtitle C—Increasing Security, 

2 Quality, and Consumer Informa3 tion for Long-Term Care 

4 ‘‘CHAPTER 1—INCREASING SECURITY FOR 

5 LONG-TERM CARE 

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

7 OCCURRING IN FEDERALLY FUNDED LONG8 TERM CARE FACILITIES. 

9 ‘‘(a) REPORTING REQUIREMENT.— 

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

11 owner, operator, employee, manager, agent, or con12 tractor of a long-term care facility that is described 

13 in subsection (b)(1) shall report to 1 or more law en14 forcement entities for the jurisdiction in which the 

15 facility is located any reasonable suspicion of a crime 

16 (as defined by the law of the applicable political sub17 division) against any person who is a resident of or 

18 receiving care from the facility. 

19 ‘‘(2) TIMING.—If the events that cause the sus20 picion— 

21 ‘‘(A) result in serious bodily injury, the in22 dividual shall report the suspicion immediately; 

23 and 


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

2 the individual shall report the suspicion not 

3 later than 24 hours after forming the suspicion. 

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

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

6 care facility is described in this paragraph if such 

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

8 during a year. 

9 ‘‘(2) NOTIFICATION.—In the case of a long10 term facility described in paragraph (1), the owner 

11 or operator shall annually notify each individual de12 scribed in subsection (a)(1) of the obligation to com13 ply with subsection(a). 

14 ‘‘(c) PENALTY.— 

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

16 in subsection (a)(1) violates subsection (a)— 

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

18 than $200,000 or subject to a civil money pen19 alty of not more than $200,000; or 

20 ‘‘(B) the Secretary shall classify the indi21 vidual as an excluded individual for a period of 

22 not more than 3 years. 

23 ‘‘(2) INCREASED HARM.—If an individual de24 scribed in subsection (a)(1) violates subsection (a), 


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1 and the violation exacerbates the harm to the victim 

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

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

4 than $300,000 or subject to a civil money pen5 alty of not more than $300,000; and 

6 ‘‘(B) the Secretary shall classify the indi7 vidual as an excluded individual for a period of 

8 not more than 3 years. 

9 ‘‘(3) EXCLUDED INDIVIDUAL.—During any pe10 riod for which an individual is classified as an ex11 cluded individual under this paragraph, an entity 

12 that employs the individual shall be ineligible to re13 ceive Federal funds. 

14 ‘‘(4) EXTENUATING CIRCUMSTANCES.—The 

15 Secretary may take into account the financial bur16 den on providers with underserved populations in de17 termining the penalty. 

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

19 with the Attorney General, shall issue regulations to carry 

20 out this section. 


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1 ‘‘CHAPTER 2—IMPROVING THE QUALITY 

2 OF LONG-TERM CARE 

3 ‘‘SEC. 2241. GRANTS AND INCENTIVES TO ENHANCE LONG4 TERM CARE STAFFING. 

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

6 the Centers for Medicare & Medicaid Services (in this sec7 tion referred to as the ‘Administrator’) shall carry out ac8 tivities, including activities described in subsections (b) 

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

10 seek, and maintain employment providing direct care in 

11 a long-term care facility. 

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

13 RECRUITMENT, AND RETENTION OF STAFF.— 

14 ‘‘(1) COORDINATION WITH OTHER PROGRAMS

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

16 The Administrator shall coordinate activities with 

17 the Secretary of Labor and the Assistant Secretary 

18 for the Administration for Children and Families, in 

19 order to provide incentives to participants in pro20 grams carried out under section 403(a)(5) and part 

21 A of title IV to train for and seek employment pro22 viding direct care in a long-term care facility. 

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

24 INCREASES TO INCREASE STAFFING IN LONG-TERM

25 CARE FACILITIES.— 


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

2 shall make grants to eligible entities to carry 

3 out programs through which the entities— 

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

5 direct care in a long-term care facility, 

6 continuing training and varying levels of 

7 certification, based on observed clinical 

8 care practices and the amount of time the 

9 employees spend providing direct care; and 

10 ‘‘(ii) provide, or make arrangements 

11 with employers to provide, bonuses or 

12 other increased compensation or benefits to 

13 employees who achieve certification under 

14 such a program. 

15 ‘‘(B) APPLICATION.—To be eligible to re16 ceive a grant under this paragraph, an entity 

17 shall submit an application to the Adminis18 trator at such time, in such manner, and con19 taining such information as the Administrator 

20 may require. 

21 ‘‘(c) SPECIFIC PROGRAMS TO IMPROVE MANAGE22 MENT PRACTICES.— 

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

24 make grants to eligible organizations to enable the 

25 organizations to provide training and technical asVerDate Aug 31 2005 20:37 Mar 20, 2006 Jkt 049200 PO 00000 Frm 00073 Fmt 6652 Sfmt 6201 E:\BILLS\H4993.IH H4993

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1 sistance to eligible persons (including administra2 tors, directors of nursing, staff developers, and 

3 charge nurses) who establish or implement manage4 ment practices for long-term care facilities. 

5 ‘‘(2) USE OF FUNDS.—An organization that re6 ceives a grant under paragraph (1) shall use funds 

7 made available through the grant— 

8 ‘‘(A) to provide training and technical as9 sistance regarding management practices for 

10 employees that provide direct care in a long11 term care facility and that are demonstrated to 

12 promote retention of those employees, such 

13 as— 

14 ‘‘(i) the establishment of basic human 

15 resource policies that reward high perform16 ance, including policies that provide for im17 proved wages and benefits on the basis of 

18 job reviews; 

19 ‘‘(ii) the establishment of motivational 

20 and thoughtful work organization prac21 tices; 

22 ‘‘(iii) the creation of a workplace cul23 ture that respects and values caregivers 

24 and their needs; 


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1 ‘‘(iv) the promotion of a workplace 

2 culture that respects the rights of residents 

3 of a long-term care facility and results in 

4 improved care for the residents; and 

5 ‘‘(v) the establishment of other pro6 grams that promote the provision of high 

7 quality care, such as a continuing edu8 cation program that provides additional 

9 hours of training, including on-the-job 

10 training, for employees who are certified 

11 nurse aides; or 

12 ‘‘(B) to disseminate training materials for 

13 the training described in subparagraph (A), and 

14 to provide the materials to the National Elder 

15 Justice Library established in section 

16 2221(a)(4), so that the materials are available 

17 to other providers of such training. 

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

19 grant under this subsection, an organization shall 

20 submit an application to the Administrator at such 

21 time, in such manner, and containing such informa22 tion as the Administrator may require. 

23 ‘‘(d) EVALUATING PROGRAMS.—After the first pro24 grams developed under this section have been completed, 


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1 the Administrator shall evaluate the outcomes of such pro2 grams in determining which future applications to fund. 

3 ‘‘(e) ACCOUNTABILITY MEASURES.—The Adminis4 trator shall develop accountability measures to ensure that 

5 funds made available under this section benefit the staff 

6 who are the intended beneficiaries of the programs pro7 vided under this section, to promote increases in the num8 ber of staff and stability in the long-term care workforce. 

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

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

11 shall comply with all applicable laws, regulations, and 

12 guidelines. 

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

14 are authorized to be appropriated to carry out this section 

15 $10,000,000 for each of fiscal years 2007 through 2013. 

16 ‘‘SEC. 2242. COLLABORATIVE EFFORTS TO ENHANCE COM17 MUNICATION ON PROMOTING QUALITY OF 

18 AND PREVENTING ABUSE AND NEGLECT IN 

19 LONG-TERM CARE. 

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

21 Healthcare Research and Quality (in this section referred 

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

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

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

25 grants to eligible partnerships to develop collaborative and 


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1 innovative approaches to improve the quality of, including 

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

3 ‘‘(b) ELIGIBLE PARTNERSHIPS.—To be eligible to re4 ceive a grant under this section, a partnership shall be 

5 a multidisciplinary community partnership, such as a 

6 partnership consisting of representatives in a community 

7 of nursing facility providers, advocates for residents of 

8 long-term care facilities, State Long-Term Care Ombuds9 men, surveyors, the State agency with responsibility for 

10 adult protective services, the State agency with responsi11 bility for licensing long-term care facilities, law enforce12 ment agencies, courts, family councils, residents, certified 

13 nurse aides, registered nurses, physicians, and other ap14 propriate entities and individuals. 

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

16 under this section, a partnership shall submit an applica17 tion to the Director at such time, in such manner, and 

18 containing such information as the Director may require. 

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

20 are authorized to be appropriated to carry out this section 

21 $2,500,000 for each of fiscal years 2007 through 2013. 


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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 

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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 

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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) 

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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— 


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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— 


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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 

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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 

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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. 


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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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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 


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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. 


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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; 


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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 


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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 


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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. 


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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 


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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 


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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: 


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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. 


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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. 


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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). 


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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). 


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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 


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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 

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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 

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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 


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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 


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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.— 

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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 

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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.— 


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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— 


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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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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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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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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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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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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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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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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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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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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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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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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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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 


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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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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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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 


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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 


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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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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: 


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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 


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