II 

118TH CONGRESS 

1ST SESSION S. 1198 

To reauthorize funding for programs to prevent and investigate elder abuse, 

neglect, and exploitation, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 19, 2023 

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

was read twice and referred to the Committee on Finance 

A BILL 

To reauthorize funding for programs to prevent and investigate elder abuse, neglect, and exploitation, and for 

other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Elder Justice Reau5 thorization and Modernization Act of 2023’’. 


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1 SEC. 2. REAUTHORIZATION OF FUNDING FOR PROGRAMS 

2 TO PREVENT AND INVESTIGATE ELDER 

3 ABUSE, NEGLECT, AND EXPLOITATION. 

4 (a) NURSING HOME WORKER TRAINING GRANTS.— 

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

6 1397m) is amended to read as follows: 

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

8 ‘‘(a) IN GENERAL.— 

9 ‘‘(1) STATE ENTITLEMENT.— 

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

11 entitled to receive from the Secretary for each 

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

13 in an amount equal to the amount allotted to 

14 the State under subparagraph (B). 

15 ‘‘(B) STATE ALLOTMENTS.— 

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

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

18 State under this subparagraph for a fiscal 

19 year shall be— 

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

22 age or have a disability (as defined in 

23 section 216(i)(1)), as determined by 

24 the Secretary using the most recent 

25 version of the American Community 

26 Survey published by the Bureau of the 


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1 Census (or a successor data set); di2 vided by 

3 ‘‘(II) the total number of such 

4 residents of all States. 

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

7 a fiscal year shall be not less than 0.25 

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

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

15 ensure that the available amount for the 

16 fiscal year is allotted among the States. 

17 ‘‘(iv) REDETERMINATIONS.— 

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

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

21 years. 

22 ‘‘(II) LIMITATION.—Subject to 

23 clause (ii), the amount allotted to a 

24 State under this subparagraph, on the 

25 basis of such a determination, for a 


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1 fiscal year after fiscal year 2028 shall 

2 be— 

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

5 made to the State under this 

6 subparagraph for the then pre7 ceding fiscal year; and 

8 ‘‘(bb) not more than 110 

9 percent of the amount referred to 

10 in item (aa). 

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

12 ORGANIZATIONS.— 

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

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

17 who operate at least 1 eligible setting. 

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

19 consultation with the Secretary of the Interior, 

20 shall devise a formula for distributing among 

21 Indian tribes and tribal organizations the 

22 amount required to be reserved by subsection 

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

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

25 tribal organization to which an amount is paid under 


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

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

4 groups, and workforce development boards for any 

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

7 ‘‘(b) USE OF FUNDS.— 

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

9 amount is paid under this section shall use the 

10 amount to— 

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

13 ‘‘(B) provide tuition assistance to, and di14 rectly pay the cost of applicable licensing exam 

15 fees for, eligible individuals for a degree or cer16 tification in a field relevant to their position re17 ferred to in subsection (f)(1)(A); 

18 ‘‘(C) provide, subsidize, or facilitate access 

19 to child care for eligible individuals, including 

20 help with referrals, co-pays, or other direct as21 sistance as needed; and 

22 ‘‘(D) provide assistance where necessary 

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

25 money or transit vouchers for ride share, taxis, 


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1 and similar types of transportation if public 

2 transportation is unavailable or impractical 

3 based on work hours or location. 

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

5 amount is paid under this section may use the 

6 amount to— 

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

8 assistance to eligible individuals in emergency 

9 situations; 

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

11 such as interview clothing and conference at12 tendance fees; 

13 ‘‘(C) provide assistance with programs and 

14 activities, including legal assistance, deemed 

15 necessary to address arrest or conviction 

16 records that are an employment barrier; 

17 ‘‘(D) support employers operating an eligi18 ble setting in the State in providing employees 

19 with not less than 2 weeks of paid leave per 

20 year; or 

21 ‘‘(E) provide other support services the 

22 Secretary deems necessary to allow for success23 ful recruitment and retention of workers. 

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

25 BENEFIT OF ELIGIBLE INDIVIDUALS IN ELIGIBLE


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

2 under this section may provide the amount to only 

3 an eligible individual or a partner organization serv4 ing an eligible individual. 

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

6 an amount is paid under this section shall not use 

7 the amount to supplant the expenditure of any State 

8 funds for recruiting, supporting, or retaining em9 ployees in an eligible setting. 

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

11 tribe, or tribal organization shall remit to the Sec12 retary for reallotment under this section any amount 

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

14 obligated within 2 years after the end of the fiscal 

15 year. 

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

17 made under this section shall reserve not more than 10 

18 percent of the grant to— 

19 ‘‘(1) administer subgrants in accordance with 

20 this section; 

21 ‘‘(2) provide technical assistance and support 

22 for applying for and accessing such a subgrant op23 portunity; 

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


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

2 of eligible individuals; and 

3 ‘‘(5) provide technical assistance to help sub4 grantees find and train individuals to provide the 

5 services for which such individuals are contracted. 

6 ‘‘(d) REPORTS.— 

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

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

9 made under this section shall transmit to the Sec10 retary a written report describing the activities un11 dertaken by the State pursuant to this section dur12 ing the period covered by the report, which shall in13 clude a specification of— 

14 ‘‘(A) the total amount expended in the 

15 State for each type of use described in para16 graph (1) or (2) of subsection (b); 

17 ‘‘(B) the total number of non-State organi18 zations in the State to which grant funds were 

19 provided, and the amount so provided to each 

20 such organization; 

21 ‘‘(C) the change in the number of individ22 uals working in each job category described in 

23 subsection (f)(1)(A) in an eligible setting in the 

24 State due to programs or services funded with 

25 grants under this section; 


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1 ‘‘(D) the average duration of employment 

2 for each such job category for individuals re3 ceiving, or who previously received, services or 

4 supports from a grant under this section; 

5 ‘‘(E) wages of workers in each job category 

6 described in subsection (f)(1)(A) in an eligible 

7 setting in the State with support from grants 

8 under this section, as compared to all other 

9 workers in the same eligible setting in the 

10 State; 

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

12 to which a worker in each job category de13 scribed in subsection (f)(1)(A) in an eligible set14 ting in the State is entitled by their contract 

15 among workers with support from a grant 

16 under this section, as compared to all workers 

17 in eligible settings in the State; and 

18 ‘‘(G) such other data elements as the Sec19 retary deems relevant. 

20 ‘‘(2) REPORT TO CONGRESS.—Not later than 3 

21 years after the date of the enactment of this section, 

22 and every 4 years thereafter, the Secretary shall 

23 submit to Congress a written report outlining how 

24 the States have used the grants made under this 


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1 section during the period covered by the report, 

2 which shall include— 

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

4 State for each type of use described in para5 graph (1) or (2) of subsection (b); 

6 ‘‘(B) the total number of non-State organi7 zations in each State to which grant funds were 

8 provided, and the amount so provided to each 

9 such organization; 

10 ‘‘(C) an analysis of the data provided in 

11 the State reports; and 

12 ‘‘(D) such other data elements as the Sec13 retary deems relevant. 

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

15 Treasury not otherwise appropriated, there is appro16 priated to the Secretary $400,000,000 for each of fiscal 

17 years 2024 through 2027 to carry out this section, of 

18 which 2 percent shall be reserved for grants to Indian 

19 tribes and tribal organizations. 

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

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

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

23 amount specified in subsection (e) that remains after 

24 the reservation required by such subsection for the 

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1 retary under subsection (b)(5) that have not been 

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

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

4 individual’ means an individual who— 

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

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

7 Federal Regulations; 

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

9 as meeting the requirements of sections 

10 483.150 through 483.154 of such title, and is 

11 listed in good standing on the State nurse aide 

12 registry; 

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

14 the State, and furnishes personal care services, 

15 as defined in section 440.167 of such title; 

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

17 in section 418.76 of such title; 

18 ‘‘(v) is a licensed practical nurse or a li19 censed or certified social worker; or 

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

21 licensed as such an aide, nurse, or social work22 er; and 

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

24 intends to provide) services as such an aide, 

25 nurse, or social worker in an eligible setting. 


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

2 setting’ means— 

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

4 in section 1819; 

5 ‘‘(B) a nursing facility, as defined in sec6 tion 1919; 

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

8 section 1891; 

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

10 community-based services authorized under 

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

12 of section 1915 or, as relevant, demonstration 

13 projects authorized under section 1115; 

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

15 or 

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

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

18 organization’ has the meaning given the term in sec19 tion 4 of the Indian Self-Determination and Edu20 cation Assistance Act.’’. 

21 (b) ADULT PROTECTIVE SERVICES FUNCTIONS AND

22 GRANT PROGRAMS.— 

23 (1) DIRECT FUNDING; STATE ENTITLEMENT.— 

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

25 1397m–1) is amended— 


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1 (A) in subsection (a), by striking para2 graph (2) and inserting the following: 

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

4 the Treasury not otherwise appropriated, there are 

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

6 fiscal years 2024 through 2027 to carry out this sec7 tion.’’; 

8 (B) in subsection (b)— 

9 (i) in paragraph (2)(A), by striking 

10 ‘‘the availability of appropriations and’’; 

11 and 

12 (ii) by striking paragraph (5) and in13 serting the following: 

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

15 the Treasury not otherwise appropriated, there are 

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

17 of fiscal years 2024 through 2027 to carry out this 

18 section.’’; and 

19 (C) in subsection (c), by striking para20 graph (6) and inserting the following: 

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

22 the Treasury not otherwise appropriated, there are 

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

24 of fiscal years 2024 through 2027 to carry out this 

25 section.’’. 


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1 (2) STATE ENTITLEMENT; GRANTS TO INDIAN

2 TRIBES AND TRIBAL ORGANIZATIONS.—Section 2042 

3 of such Act (42 U.S.C. 1397m–1), as amended by 

4 paragraph (1), is amended— 

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

6 ‘‘State and local’’ and inserting ‘‘State, local, 

7 and tribal’’; 

8 (B) in subsection (b)— 

9 (i) in paragraph (1), by striking ‘‘the 

10 Secretary shall annually award grants to 

11 States in the amounts calculated under 

12 paragraph (2)’’ and inserting ‘‘each State 

13 shall be entitled to annually receive from 

14 the Secretary in the amounts calculated 

15 under paragraph (2), and the Secretary 

16 may annually award to each Indian tribe 

17 and tribal organization in accordance with 

18 paragraph (3), grants’’; 

19 (ii) in paragraph (2)— 

20 (I) in the paragraph heading, by 

21 inserting ‘‘FOR A STATE’’ after ‘‘PAY22 MENT’’; 

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1 ervation under paragraph (3)(B)’’ be2 fore ‘‘multiplied’’; and 

3 (III) in subparagraph (B)(i)— 

4 (aa) by inserting ‘‘that so 

5 remains’’ after ‘‘such year’’; and 

6 (bb) by striking ‘‘amount so 

7 appropriated’’ and inserting ‘‘re8 maining amount’’; and 

9 (iii) by redesignating paragraphs (3) 

10 through (5) as paragraphs (4) through (6), 

11 respectively, and inserting after paragraph 

12 (2) the following: 

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

14 OR TRIBAL ORGANIZATION.— 

15 ‘‘(A) IN GENERAL.—The Secretary, in con16 sultation with Indian tribes and tribal organiza17 tions, shall determine the amount of any grant 

18 to be made to each Indian tribe and tribal orga19 nization from the amount reserved under sub20 paragraph (B). Paragraphs (4) and (5) shall 

21 apply to grantees under this paragraph in the 

22 same manner in which such paragraphs apply 

23 to States. 

24 ‘‘(B) RESERVATION OF FUNDS.—The Sec25 retary shall reserve 2 percent of the amount 


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1 made available by subsection (b)(6) for each fis2 cal year for grants under this paragraph.’’; 

3 (C) in subsection (c)— 

4 (i) in paragraph (1), by striking ‘‘to 

5 States’’ and inserting ‘‘to States, Indian 

6 tribes, and tribal organizations’’; 

7 (ii) in paragraph (2)— 

8 (I) in the matter preceding sub9 paragraph (A), by inserting ‘‘and In10 dian tribes and tribal organizations’’ 

11 after ‘‘government’’; and 

12 (II) in subparagraph (D), by in13 serting ‘‘or Indian tribe or tribal orga14 nization, as the case may be’’ after 

15 ‘‘government’’; 

16 (iii) in paragraph (4), by inserting ‘‘or 

17 Indian tribe or tribal organization’’ after 

18 ‘‘a State’’ the first place it appears; and 

19 (iv) in paragraph (5)— 

20 (I) by inserting ‘‘or Indian tribe 

21 or tribal organization’’ after ‘‘Each 

22 State’’; and 

23 (II) by inserting ‘‘or Indian tribe 

24 or tribal organization, as the case may 

25 be’’ after ‘‘the State’’; and 


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1 (D) by adding at the end the following: 

2 ‘‘(d) DEFINITION OF TRIBAL ORGANIZATION.—In 

3 this section, the term ‘tribal organization’ has the meaning 

4 given the term in section 4 of the Indian Self-Determina5 tion and Education Assistance Act.’’. 

6 (c) LONG-TERM CARE OMBUDSMAN PROGRAM

7 GRANTS AND TRAINING.—Section 2043 of the Social Se8 curity Act (42 U.S.C. 1397m–2) is amended— 

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

10 and inserting the following: 

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

12 the Treasury not otherwise appropriated, there are 

13 appropriated to the Secretary to carry out this sub14 section— 

15 ‘‘(A) $22,500,000 for fiscal year 2024; and 

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

17 2025 and 2026.’’; and 

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

19 and inserting the following: 

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

21 the Treasury not otherwise appropriated, there are 

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

23 of fiscal years 2024 through 2027 to carry out this 

24 subsection.’’. 


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1 (d) INCENTIVES FOR DEVELOPING AND SUSTAINING

2 STRUCTURAL COMPETENCY IN PROVIDING HEALTH AND

3 HUMAN SERVICES.— 

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

5 XX of the Social Security Act (42 U.S.C. 397m–5) 

6 is amended by adding at the end the following: 

7 ‘‘SEC. 2047. INCENTIVES FOR DEVELOPING AND SUS8 TAINING STRUCTURAL COMPETENCY IN PRO9 VIDING HEALTH AND HUMAN SERVICES. 

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

11 LEGAL SERVICES AND MEDICAL LEGAL PARTNER12 SHIPS.— 

13 ‘‘(1) IN GENERAL.—Not later than 2 years 

14 after the date of the enactment of this section, the 

15 Secretary shall establish and administer a program 

16 of grants to States to support the development or 

17 adoption of approaches to maintain or improve link18 ages between health services, human services, and 

19 legal services for older adults and adults with dis20 abilities, including through the following: 

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

22 The establishment and support of medical-legal 

23 partnerships, the incorporation of the partner24 ships in the elder justice framework and health 

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1 mentation and operation of such a partnership 

2 by an eligible grantee— 

3 ‘‘(i) at the option of a State, in con4 junction with an area agency on aging; 

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

6 health professional shortage area (as de7 fined in section 332(a) of the Public 

8 Health Service Act), a medically under9 served community (as defined in section 

10 399B of such Act), or a rural area (as de11 fined in section 330J(e) of such Act); 

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

13 (defined for purposes of this section as an 

14 eligible institution described in section 

15 371(a) of the Higher Education Act of 

16 1965) with health, law, and social services 

17 professional programs; 

18 ‘‘(iv) in an entity receiving funding 

19 section 330 of the Public Health Service 

20 Act or a look-alike, as described in section 

21 1905(l)(2)(B); or 

22 ‘‘(v) in certain hospitals that are crit23 ical access hospitals (as defined in section 

24 1861(mm)(1)), medicare-dependent, small 

25 rural hospitals (as defined in subsection 


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1 (d)(5)(G)(iv)), sole community hospitals 

2 (as defined in section 1886(d)(5)(D)(iii)), 

3 rural emergency hospitals (as defined in 

4 section 1861(kkk)), or hospitals that re5 ceive disproportionate share hospital pay6 ments under section 1886(d)(5)(F) or sec7 tion 1923. 

8 ‘‘(B) LEGAL HOTLINES DEVELOPMENT OR

9 EXPANSION.—The provision of incentives to de10 velop, enhance, and integrate platforms, such as 

11 legal assistance hotlines, that help to facilitate 

12 the identification of older adults and adults 

13 with disabilities who could benefit from linkages 

14 to available legal services such as those de15 scribed in subparagraph (A). 

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

17 grant is made under this subsection shall submit to 

18 the Secretary biannual reports on the activities car19 ried out by the State pursuant to this subsection, 

20 which shall include assessments of the effectiveness 

21 of the activities with respect to— 

22 ‘‘(A) the number of unique individuals 

23 identified through the mechanism outlined in 

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


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

2 time period associated with resolving issues; 

3 ‘‘(B) the success rate for referrals to com4 munity-based resources; and 

5 ‘‘(C) other factors determined relevant by 

6 the Secretary. 

7 ‘‘(3) REPORT TO CONGRESS.—Not less than 

8 once every 2 years, the Secretary shall submit to 

9 Congress a report that analyzes the data provided by 

10 the State reports and the extent to which grantees 

11 are establishing linkages to medical-legal partner12 ships and other legal services for older adults and 

13 adults with disabilities. 

14 ‘‘(4) REPORT TO CONGRESS.—Not less that 

15 once every 4 years, the Secretary shall submit to 

16 Congress a written report on the activities conducted 

17 under this subsection. 

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

19 the Treasury not otherwise appropriated, there are 

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

21 of fiscal years 2024 through 2027 to carry out this 

22 subsection. 

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

24 provided to area agencies on aging, State units on 

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1 ganizations pursuant to this subsection shall be used 

2 to supplement and not supplant any other Federal, 

3 State, or local funds expended to provide the same 

4 or comparable services described in this subsection. 

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

6 AGENCIES ON AGING OR OTHER COMMUNITY-BASED OR7 GANIZATIONS TO ADDRESS SOCIAL ISOLATION AMONG

8 OLDER ADULTS AND ADULTS WITH DISABILITIES.— 

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

10 grants to eligible area agencies on aging or other 

11 community-based organizations for the purpose of— 

12 ‘‘(A) conducting outreach to individuals at 

13 risk for, or already experiencing, social isolation 

14 or loneliness, through established screening 

15 tools or other methods identified by the Sec16 retary; 

17 ‘‘(B) developing community-based interven18 tions for the purposes of mitigating loneliness 

19 or social isolation (including evidence-based pro20 grams, as defined by the Secretary, developed 

21 with multi-stakeholder input for the purposes of 

22 promoting social connection, mitigating social 

23 isolation or loneliness, or preventing social iso24 lation or loneliness) among at-risk individuals; 


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

2 community social and clinical supports; and 

3 ‘‘(D) evaluating the effect of programs de4 veloped and implemented under subparagraphs 

5 (B) and (C). 

6 ‘‘(2) TRAINING.— 

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

8 establish programs to provide and improve 

9 training for area agencies on aging or commu10 nity-based organizations with respect to ad11 dressing and preventing social isolation and 

12 loneliness among older adults and adults with 

13 disabilities. 

14 ‘‘(B) PRIORITIZATION AUTHORITY.—For 

15 purposes of connecting at-risk individuals with 

16 existing community social and clinical supports, 

17 the Secretary may, in carrying out subpara18 graph (A), prioritize models that incorporate 

19 training and service delivery in coordination 

20 with medical-legal partnerships. 

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

22 after the date of the enactment of this section and 

23 every 3 years thereafter, the Secretary shall submit 

24 to Congress a written report that assesses the extent 

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1 section address social isolation and loneliness among 

2 older adults and adults with disabilities. 

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

4 the Treasury not otherwise appropriated, there are 

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

6 of fiscal years 2024 through 2027 to carry out this 

7 subsection. 

8 ‘‘(5) COORDINATION.—The Secretary shall co9 ordinate with resource centers, grant programs, or 

10 other funding mechanisms established under section 

11 411(a)(18) of the Older Americans Act (42 U.S.C. 

12 3032(a)(18)), section 417(a)(1) of such Act (42 

13 U.S.C. 3032F(a)(1)), or other programs as deter14 mined by the Secretary. 

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

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

17 agency on aging’ means an area agency on aging 

18 designated under section 305 of the Older Ameri19 cans Act of 1965 (42 U.S.C. 3025). 

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

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

24 of nonprofit community-based organizations, a na25 tional nonprofit organization acting as an interVerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\S1198.IS S1198

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•S 1198 IS

1 mediary for a community-based organization, or a 

2 community-based organization that has a fiscal 

3 sponsor that allows the organization to function as 

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

5 Internal Revenue Code of 1986 and exempt from 

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

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

8 means subjectively feeling alone, or the discrepancy 

9 between one’s desired level of social connection and 

10 one’s actual level of social connection. 

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

12 connection’ means the variety of ways one can con13 nect with others socially, through physical, behav14 ioral, social-cognitive, and emotional channels. 

15 ‘‘(5) SOCIAL ISOLATION.—The term ‘social iso16 lation’ means objectively being alone, or having few 

17 relationships or infrequent social contact.’’. 

18 (2) CLARIFICATION THAT MEDICAL-LEGAL

19 PARTNERSHIPS ARE AUTHORIZED ADULT PROTEC20 TIVE SERVICES ACTIVITIES.—Section 2011 of such 

21 Act (42 U.S.C. 1397j) is amended— 

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

23 including through a medical-legal partnership’’ 

24 before the period; and 


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•S 1198 IS

1 (B) by redesignating paragraphs (16) 

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

3 respectively, and inserting after paragraph (15) 

4 the following: 

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

6 term ‘medical-legal partnership’ means an arrange7 ment in a health care or human services setting that 

8 integrates lawyers and social workers to address the 

9 needs of an individual patient related to social deter10 minants of health, and to help clinicians, case man11 agers, and social workers address structural prob12 lems at the root of many health inequities, including 

13 a multidisciplinary team integrated into such a set14 ting to address such needs and to establish and 

15 maintain structural competence among clinicians, 

16 case managers, and social workers to best address 

17 structural problems at the root of many health in18 equities.’’. 

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

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

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

22 SEC. 3. ASSESSMENT REPORTS. 

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

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

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


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1 Human Services shall submit a report to the Committee 

2 on Ways and Means of the House of Representatives and 

3 the Committee on Finance and the Special Committee on 

4 Aging of the Senate on the programs, coordinating bodies, 

5 registries, and activities established or authorized under 

6 subtitle B of title XX of the Social Security Act (42 

7 U.S.C. 1397l et seq.), as amended by sections 2 and 3, 

8 section 1150B of such Act (42 U.S.C. 1320b–25, or para9 graphs (1) and (2) of section 6703(b) of the Patient Pro10 tection and Affordable Care Act (42 U.S.C. 1395i–3a(b)). 

11 Each such report shall assess the extent to which such 

12 programs, coordinating bodies, registries, and activities 

13 have improved access to, and the quality of, resources 

14 available to older adults, adults with disabilities, and their 

15 caregivers to ultimately prevent, detect, and treat abuse, 

16 neglect, and exploitation, and shall include, as appro17 priate, recommendations to Congress on funding levels 

18 and policy changes to help these programs, coordinating 

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

20 treat abuse, neglect, and exploitation of older adults and 

21 adults with disabilities. 

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

23 Treasury not otherwise appropriated, there are appro24 priated to the Secretary of Health and Human Services 


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1 $5,000,000 for each of fiscal years 2024 through 2027 

2 to carry out this section. 

Æ 


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