II 

110TH CONGRESS 

1ST SESSION S. 1070 

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

Nation by ensuring adequate public-private infrastructure and to resolve 

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

and exploitation, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 29, 2007 

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

A BILL 

To amend the Social Security Act to enhance the social 

security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, 

treat, intervene in, and prosecute elder abuse, neglect, 

and exploitation, and for other purposes. 

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

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Elder Justice Act’’. 

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

7 this Act is as follows: 

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Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

Sec. 3. Purposes. 

Sec. 4. Definitions. 

Sec. 5. Elder Justice. 

‘‘Subtitle 2—Elder Justice 

‘‘Sec. 2011. Definitions. 

‘‘Sec. 2012. General provisions. 

‘‘PART A—NATIONAL COORDINATION OF ELDER JUSTICE ACTIVITIES AND

RESEARCH

‘‘SUBPART 1—ELDER JUSTICE COORDINATING COUNCIL AND ADVISORY BOARD

ON ELDER ABUSE, NEGLECT, AND EXPLOITATION

‘‘Sec. 2021. Elder Justice Coordinating Council. 

‘‘Sec. 2022. Advisory Board on Elder Abuse, Neglect, and Exploitation. 

‘‘Sec. 2023. Research protections. 

‘‘Sec. 2024. Authorization of appropriations. 

‘‘SUBPART 2—ELDER ABUSE, NEGLECT, AND EXPLOITATION FORENSIC

CENTERS

‘‘Sec. 2031. Establishment and support of elder abuse, neglect, and Exploitation forensic Centers. 

‘‘PART B—PROGRAMS TO PROMOTE ELDER JUSTICE

‘‘Sec. 2041. Enhancement of long-term care. 

‘‘Sec. 2042. Adult protective services functions and grant programs. 

‘‘Sec. 2043. Long-term care ombudsman program grants and training. 

‘‘Sec. 2044. Provision of information regarding, and evaluations of, elder 

justice programs. 

‘‘Sec. 2045. Report. 

1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) The proportion of the United States popu4 lation age 60 years or older will drastically increase 

5 in the next 30 years as more than 76,000,000 baby 

6 boomers approach retirement and old age. 

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

8 5,000,000 elders in the United States are abused, 

9 neglected, or exploited. 

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

2 no boundaries, and cross all racial, social class, gen3 der, and geographic lines. 

4 (4) Victims of elder abuse, neglect, and exploi5 tation are not only subject to injury from mistreat6 ment and neglect, they are also 3.1 times more likely 

7 than elders who were not victims of elder abuse, ne8 glect, and exploitation to die at an earlier age than 

9 expected. 

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

11 nature and scope of elder abuse, neglect, and exploi12 tation. In recognition of the need to improve data 

13 collection efforts with respect to elder abuse, neglect, 

14 and exploitation, Congress required the Secretary of 

15 Health and Human Services to conduct a study by 

16 the end of 2008 on establishing a uniform national 

17 database on elder abuse under section 405 of title 

18 IV of Division C of the Tax Relief and Health Care 

19 Act of 2006 (Public Law 109–432). 

20 (6) Despite the dearth of data in the field, ex21 perts agree that most cases of elder abuse, neglect, 

22 and exploitation are never reported and that abuse, 

23 neglect, and exploitation shorten a victim’s life, often 

24 triggering a downward spiral of an otherwise pro25 ductive, self-sufficient elder’s life. Programs addressmstockstill on PROD1PC66 with BILLS

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1 ing other difficult issues such as domestic violence 

2 and child abuse and neglect have demonstrated the 

3 need for a multifaceted law, combining public health, 

4 social service, and law enforcement approaches. 

5 (7) For over 20 years, Congress has been pre6 sented with facts and testimony calling for a coordi7 nated Federal effort to combat elder abuse, neglect, 

8 and exploitation. 

9 (8) The Federal Government has been slow to 

10 respond to the needs of victims of elder abuse, ne11 glect, and exploitation or to undertake prevention ef12 forts. 

13 (9) No Federal law has been enacted that ade14 quately and comprehensively addresses the issues of 

15 elder abuse, neglect, and exploitation and there are 

16 very limited resources available to those in the field 

17 that directly deal with the issues. 

18 (10) Differences in State laws and practices in 

19 the areas of elder abuse, neglect, and exploitation 

20 lead to significant disparities in prevention, protec21 tive and social services, treatment systems, and law 

22 enforcement, and lead to other inequities. 

23 (11) The Federal Government has played an 

24 important role in promoting research, training, pub25 lic safety, and data collection, and the identification, 

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1 development, and dissemination of promising health 

2 care, social, and protective services, and law enforce3 ment practices, relating to child abuse and neglect, 

4 domestic violence, and violence against women. The 

5 Federal Government should promote similar efforts 

6 and protections relating to elder abuse, neglect, and 

7 exploitation. 

8 (12) The Federal Government should provide 

9 leadership and assist States and communities in 

10 their efforts to protect elders in the United States 

11 by— 

12 (A) promoting coordinated planning among 

13 all levels of government; 

14 (B) generating and sharing knowledge rel15 evant to protecting elders; 

16 (C) providing leadership to combat the 

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

18 elders; and 

19 (D) providing resources to States and com20 munities to promote elder justice. 

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

22 exploitation requires a comprehensive approach 

23 that— 

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

25 and social service agencies and organizations; 

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1 (B) emphasizes the need for prevention, re2 porting, investigation, assessment, treatment, 

3 and prosecution of elder abuse, neglect, and ex4 ploitation at all levels of government; 

5 (C) ensures that sufficient numbers of 

6 properly trained personnel with specialized 

7 knowledge are in place to— 

8 (i) treat, assess, and provide services 

9 relating to elder abuse, neglect, and exploi10 tation; and 

11 (ii) carry out elder protection duties; 

12 (D) is sensitive to ethnic and cultural di13 versity; 

14 (E) recognizes the role of mental health, 

15 disability, dementia, substance abuse, medica16 tion mismanagement, and family dysfunction 

17 problems in increasing and exacerbating elder 

18 abuse, neglect, and exploitation; and 

19 (F) balances elders’ right to self-deter20 mination with society’s responsibility to protect 

21 elders. 

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

23 elder abuse, neglect, and exploitation is high and in24 cludes unnecessary expenditures of funds from many 

25 public programs. 

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1 (15) The failure to coordinate activities relating 

2 to, and comprehensively prevent and treat, elder 

3 abuse, neglect, and exploitation threatens the future 

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

5 States. 

6 (16) All elements of society in the United 

7 States have a shared responsibility in responding to 

8 a national problem of elder abuse, neglect, and ex9 ploitation. 

10 SEC. 3. PURPOSES. 

11 The purposes of this Act are as follows: 

12 (1) To enhance the social security of the Nation 

13 by ensuring adequate public-private infrastructure 

14 and resolving to prevent, detect, treat, understand, 

15 and intervene in, and where appropriate, aid in the 

16 prosecution of, elder abuse, neglect, and exploitation. 

17 (2) To bring a comprehensive approach to pre18 venting and combating elder abuse, neglect, and ex19 ploitation, a long invisible problem that afflicts the 

20 most vulnerable among the aging population of the 

21 United States. 

22 (3) To raise the issue of elder abuse, neglect, 

23 and exploitation to national attention, and to create 

24 the infrastructure at the Federal, State, and local 

25 levels, to ensure that individuals and organizations 

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1 on the front lines, who are fighting elder abuse, ne2 glect, and exploitation with scarce resources and 

3 fragmented systems, have the resources and infor4 mation needed to carry out their fight. 

5 (4) To bring a comprehensive multidisciplinary 

6 approach to elder justice. 

7 (5) To set in motion research and data collec8 tion to fill gaps in knowledge about elder abuse, ne9 glect, and exploitation. 

10 (6) To supplement the activities of service pro11 viders and programs, to enhance training, and to le12 verage scarce resources efficiently, in order to ensure 

13 that elder justice receives the attention it deserves as 

14 the Nation’s population ages. 

15 (7) 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 (8) To create short- and long-term strategic 

21 plans for the development and coordination of elder 

22 justice research, programs, studies, training, and 

23 other efforts nationwide. 

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1 (9) To promote collaborative efforts and dimin2 ish overlap and gaps in efforts in developing the im3 portant field of elder justice. 

4 (10) To honor and respect the right of all indi5 viduals with diminished capacity to decisionmaking 

6 autonomy, self-determination, and dignity of choice. 

7 (11) To respect the wishes of individuals with 

8 diminished capacity and their family members in 

9 providing supportive services and care plans in10 tended to protect elders from abuse, neglect (includ11 ing self-neglect), and exploitation. 

12 SEC. 4. DEFINITIONS. 

13 Except as otherwise specifically provided, any term 

14 that is defined in section 2011 of the Social Security Act 

15 (as added by section 5(a)) and is used in this Act has 

16 the meaning given such term by such section. 

17 SEC. 5. ELDER JUSTICE. 

18 (a) ELDER JUSTICE.— 

19 (1) IN GENERAL.—Title XX of the Social Secu20 rity Act (42 U.S.C. 1397 et seq.) is amended— 

21 (A) in the heading, by inserting ‘‘AND 

22 ELDER JUSTICE’’ after ‘‘SOCIAL 

23 SERVICES’’; 

24 (B) by inserting before section 2001 the 

25 following: 

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1 ‘‘Subtitle 1—Block Grants to States 

2 for Social Services’’; 

3 and 

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

5 ‘‘Subtitle 2—Elder Justice 

6 ‘‘SEC. 2011. DEFINITIONS. 

7 ‘‘In this subtitle: 

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

9 knowing infliction of physical or psychological harm 

10 or the knowing deprivation of goods or services that 

11 are necessary to meet essential needs or to avoid 

12 physical or psychological harm. 

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

14 ‘adult protective services’ means such services pro15 vided to adults as the Secretary may specify and in16 cludes services such as— 

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

18 neglect, or exploitation; 

19 ‘‘(B) investigating the reports described in 

20 subparagraph (A); 

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

22 and other case work and services; and 

23 ‘‘(D) providing, arranging for, or facili24 tating the provision of medical, social service, 

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1 economic, legal, housing, law enforcement, or 

2 other protective, emergency, or support services. 

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

4 an individual who has the responsibility for the care 

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

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

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

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

11 elder who needs supportive services in any setting. 

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

13 means care by an employee or contractor who pro14 vides assistance or long-term care services to a re15 cipient. 

16 ‘‘(5) ELDER.—The term ‘elder’ means an indi17 vidual age 60 or older. 

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

19 means— 

20 ‘‘(A) from a societal perspective, efforts 

21 to— 

22 ‘‘(i) prevent, detect, treat, intervene 

23 in, and prosecute elder abuse, neglect, and 

24 exploitation; and 

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1 ‘‘(ii) protect elders with diminished 

2 capacity while maximizing their autonomy; 

3 and 

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

5 recognition of an elder’s rights, including the 

6 right to be free of abuse, neglect, and exploi7 tation. 

8 ‘‘(7) ELIGIBLE ENTITY.—The term ‘eligible en9 tity’ means a State or local government agency, In10 dian tribe or tribal organization, or any other public 

11 or private entity that is engaged in and has expertise 

12 in issues relating to elder justice or in a field nec13 essary to promote elder justice efforts. 

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

15 means the fraudulent or otherwise illegal, unauthor16 ized, or improper act or process of an individual, in17 cluding a caregiver or fiduciary, that uses the re18 sources of an elder for monetary or personal benefit, 

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

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

21 belongings, or assets. 

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

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

24 legal responsibility— 

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

2 and for the benefit of another person; and 

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

4 fairness; and 

5 ‘‘(B) includes a trustee, a guardian, a con6 servator, an executor, an agent under a finan7 cial power of attorney or health care power of 

8 attorney, or a representative payee. 

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

10 contract, cooperative agreement, or other mechanism 

11 for providing financial assistance. 

12 ‘‘(11) GUARDIANSHIP.—The term ‘guardian13 ship’ means— 

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

15 determines that an adult individual lacks capac16 ity to make decisions about self-care and prop17 erty, and appoints another individual or entity 

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

19 similar term, as a surrogate decisionmaker; 

20 ‘‘(B) the manner in which the court-ap21 pointed surrogate decisionmaker carries out du22 ties to the individual and the court; or 

23 ‘‘(C) the manner in which the court exer24 cises oversight of the surrogate decisionmaker. 

25 ‘‘(12) INDIAN TRIBE.— 

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1 ‘‘(A) IN GENERAL.—The term ‘Indian 

2 tribe’ has the meaning given such term in sec3 tion 4 of the Indian Self-Determination and 

4 Education Assistance Act (25 U.S.C. 450b). 

5 ‘‘(B) INCLUSION OF PUEBLO AND

6 RANCHERIA.—The term ‘Indian tribe’ includes 

7 any Pueblo or Rancheria. 

8 ‘‘(13) LAW ENFORCEMENT.—The term ‘law en9 forcement’ means the full range of potential re10 sponders to elder abuse, neglect, and exploitation in11 cluding— 

12 ‘‘(A) police, sheriffs, detectives, public safe13 ty officers, and corrections personnel; 

14 ‘‘(B) prosecutors; 

15 ‘‘(C) medical examiners; 

16 ‘‘(D) investigators; and 

17 ‘‘(E) coroners. 

18 ‘‘(14) LONG-TERM CARE.— 

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

20 care’ means supportive and health services spec21 ified by the Secretary for individuals who need 

22 assistance because the individuals have a loss of 

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

24 or vulnerability. 

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1 ‘‘(B) LOSS OF CAPACITY FOR SELF2 CARE.—For purposes of subparagraph (A), the 

3 term ‘loss of capacity for self-care’ means an in4 ability to engage in 1 or more activities of daily 

5 living, including eating, dressing, bathing, and 

6 management of one’s financial affairs. 

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

8 ‘long-term care facility’ means a residential care pro9 vider that arranges for, or directly provides, long10 term care. 

11 ‘‘(16) NEGLECT.—The term ‘neglect’ means— 

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

13 to provide the goods or services that are nec14 essary to maintain the health or safety of an 

15 elder; or 

16 ‘‘(B) self-neglect. 

17 ‘‘(17) NURSING FACILITY.— 

18 ‘‘(A) IN GENERAL.—The term ‘nursing fa19 cility’ has the meaning given such term under 

20 section 1919(a). 

21 ‘‘(B) INCLUSION OF SKILLED NURSING FA22 CILITY.—The term ‘nursing facility’ includes a 

23 skilled nursing facility (as defined in section 

24 1819(a)). 

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1 ‘‘(18) SELF-NEGLECT.—The term ‘self-neglect’ 

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

3 impairment or diminished capacity, to perform es4 sential self-care tasks including— 

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

6 shelter, and medical care; 

7 ‘‘(B) obtaining goods and services nec8 essary to maintain physical health, mental 

9 health, or general safety; or 

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

11 ‘‘(19) SERIOUS BODILY INJURY.— 

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

13 bodily injury’ means an injury— 

14 ‘‘(i) involving extreme physical pain; 

15 ‘‘(ii) involving substantial risk of 

16 death; 

17 ‘‘(iii) involving protracted loss or im18 pairment of the function of a bodily mem19 ber, organ, or mental faculty; or 

20 ‘‘(iv) requiring medical intervention 

21 such as surgery, hospitalization, or phys22 ical rehabilitation. 

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

24 bodily injury shall be considered to have oc25 curred if the conduct causing the injury is conmstockstill on PROD1PC66 with BILLS

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1 duct described in section 2241 (relating to ag2 gravated sexual abuse) or 2242 (relating to sex3 ual abuse) of title 18, United States Code, or 

4 any similar offense under State law. 

5 ‘‘(20) SOCIAL.—The term ‘social’, when used 

6 with respect to a service, includes adult protective 

7 services. 

8 ‘‘(21) STATE LEGAL ASSISTANCE DEVEL9 OPER.—The term ‘State legal assistance developer’ 

10 means an individual described in section 731 of the 

11 Older Americans Act of 1965. 

12 ‘‘(22) STATE LONG-TERM CARE OMBUDSMAN.— 

13 The term ‘State Long-Term Care Ombudsman’ 

14 means the State Long-Term Care Ombudsman de15 scribed in section 712(a)(2) of the Older Americans 

16 Act of 1965. 

17 ‘‘SEC. 2012. GENERAL PROVISIONS. 

18 ‘‘(a) PROTECTION OF PRIVACY.—In pursuing activi19 ties under this subtitle, the Secretary shall ensure the pro20 tection of individual health privacy consistent with the reg21 ulations promulgated under section 264(c) of the Health 

22 Insurance Portability and Accountability Act of 1996 and 

23 applicable State and local privacy regulations. 

24 ‘‘(b) RULE OF CONSTRUCTION.—Nothing in this sub25 title shall be construed to interfere with or abridge an elmstockstill on PROD1PC66 with BILLS

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1 der’s right to practice his or her religion through reliance 

2 on prayer alone for healing when this choice— 

3 ‘‘(1) is contemporaneously expressed, either 

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

5 or injury which the elder has at the time of the deci6 sion by an elder who is competent at the time of the 

7 decision; 

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

9 health care proxy, or other advance directive docu10 ment that is validly executed and applied under 

11 State law; or 

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

13 elder’s life history. 

14 ‘‘PART A—NATIONAL COORDINATION OF ELDER 

15 JUSTICE ACTIVITIES AND RESEARCH 

16 ‘‘Subpart 1—Elder Justice Coordinating Council and 

17 Advisory Board on Elder Abuse, Neglect, and Ex18 ploitation 

19 ‘‘SEC. 2021. ELDER JUSTICE COORDINATING COUNCIL. 

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

21 the Office of the Secretary an Elder Justice Coordinating 

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

23 ‘‘(b) MEMBERSHIP.— 

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

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

2 designee). 

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

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

6 or agency or other governmental entity identi7 fied by the Chair referred to in subsection (d) 

8 as having responsibilities, or administering pro9 grams, relating to elder abuse, neglect, and ex10 ploitation. 

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

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

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

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

17 ‘‘(d) CHAIR.—The member described in subsection 

18 (b)(1)(A) shall be Chair of the Council. 

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

20 times per year, as determined by the Chair. 

21 ‘‘(f) DUTIES.— 

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

23 recommendations to the Secretary for the coordina24 tion of activities of the Department of Health and 

25 Human Services, the Department of Justice, and 

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1 other relevant Federal, State, local, and private 

2 agencies and entities, relating to elder abuse, ne3 glect, and exploitation and other crimes against el4 ders. 

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

6 2 years after the date of enactment of the Elder 

7 Justice Act and every 2 years thereafter, the Council 

8 shall submit to the Committee on Finance of the 

9 Senate and the Committee on Ways and Means and 

10 the Committee on Energy and Commerce of the 

11 House of Representatives a report that— 

12 ‘‘(A) describes the activities and accom13 plishments of, and challenges faced by— 

14 ‘‘(i) the Council; and 

15 ‘‘(ii) the entities represented on the 

16 Council; and 

17 ‘‘(B) makes such recommendations for leg18 islation, model laws, or other action as the 

19 Council determines to be appropriate. 

20 ‘‘(g) POWERS OF THE COUNCIL.— 

21 ‘‘(1) INFORMATION FROM FEDERAL AGEN22 CIES.—Subject to the requirements of section 

23 2012(a), the Council may secure directly from any 

24 Federal department or agency such information as 

25 the Council considers necessary to carry out this secmstockstill on PROD1PC66 with BILLS

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1 tion. Upon request of the Chair of the Council, the 

2 head of such department or agency shall furnish 

3 such information to the Council. 

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

5 the United States mails in the same manner and 

6 under the same conditions as other departments and 

7 agencies of the Federal Government. 

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

9 Council shall not receive compensation for the perform10 ance of services for the Council. The members shall be 

11 allowed travel expenses, including per diem in lieu of sub12 sistence, at rates authorized for employees of agencies 

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

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

15 business in the performance of services for the Council. 

16 Notwithstanding section 1342 of title 31, United States 

17 Code, the Secretary may accept the voluntary and uncom18 pensated services of the members of the Council. 

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

20 Federal Government employee may be detailed to the 

21 Council without reimbursement, and such detail shall be 

22 without interruption or loss of civil service status or privi23 lege. 

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1 ‘‘(j) STATUS AS PERMANENT COUNCIL.—Section 14 

2 of the Federal Advisory Committee Act (5 U.S.C. App.) 

3 shall not apply to the Council. 

4 ‘‘SEC. 2022. ADVISORY BOARD ON ELDER ABUSE, NEGLECT, 

5 AND EXPLOITATION. 

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

7 to be known as the ‘Advisory Board on Elder Abuse, Ne8 glect, and Exploitation’ (in this section referred to as the 

9 ‘Advisory Board’) to create short- and long-term multi10 disciplinary strategic plans for the development of the field 

11 of elder justice and to make recommendations to the Elder 

12 Justice Coordinating Council established under section 

13 2021. 

14 ‘‘(b) COMPOSITION.—The Advisory Board shall be 

15 composed of 27 members appointed by the Secretary from 

16 among members of the general public who are individuals 

17 with experience and expertise in elder abuse, neglect, and 

18 exploitation prevention, detection, treatment, intervention, 

19 or prosecution. 

20 ‘‘(c) SOLICITATION OF NOMINATIONS.—The Sec21 retary shall publish a notice in the Federal Register solic22 iting nominations for the appointment of members of the 

23 Advisory Board under subsection (b). 

24 ‘‘(d) TERMS.— 

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1 ‘‘(1) IN GENERAL.—Each member of the Advi2 sory Board shall be appointed for a term of 3 years, 

3 except that, of the members first appointed— 

4 ‘‘(A) 9 shall be appointed for a term of 3 

5 years; 

6 ‘‘(B) 9 shall be appointed for a term of 2 

7 years; and 

8 ‘‘(C) 9 shall be appointed for a term of 1 

9 year. 

10 ‘‘(2) VACANCIES.— 

11 ‘‘(A) IN GENERAL.—Any vacancy on the 

12 Advisory Board shall not affect its powers, but 

13 shall be filled in the same manner as the origi14 nal appointment was made. 

15 ‘‘(B) FILLING UNEXPIRED TERM.—An in16 dividual chosen to fill a vacancy shall be ap17 pointed for the unexpired term of the member 

18 replaced. 

19 ‘‘(3) EXPIRATION OF TERMS.—The term of any 

20 member shall not expire before the date on which 

21 the member’s successor takes office. 

22 ‘‘(e) ELECTION OF OFFICERS.—The Advisory Board 

23 shall elect a Chair and Vice Chair from among its mem24 bers. The Advisory Board shall elect its initial Chair and 

25 Vice Chair at its initial meeting. 

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1 ‘‘(f) DUTIES.— 

2 ‘‘(1) ENHANCE COMMUNICATION ON PRO3 MOTING QUALITY OF, AND PREVENTING ABUSE AND

4 NEGLECT IN, LONG-TERM CARE.—The Advisory 

5 Board shall develop collaborative and innovative ap6 proaches to improve the quality of, including pre7 venting abuse and neglect in, long-term care. 

8 ‘‘(2) COLLABORATIVE EFFORTS TO DEVELOP

9 CONSENSUS AROUND THE MANAGEMENT OF CER10 TAIN QUALITY-RELATED FACTORS.— 

11 ‘‘(A) IN GENERAL.—The Advisory Board 

12 shall establish multidisciplinary panels to ad13 dress, and develop consensus on, subjects relat14 ing to improving the quality of long-term care. 

15 At least 1 such panel shall address, and develop 

16 consensus on, methods for managing resident17 to-resident abuse in long-term care. 

18 ‘‘(B) ACTIVITIES CONDUCTED.—The multi19 disciplinary panels established under subpara20 graph (A) shall examine relevant research and 

21 data, identify best practices with respect to the 

22 subject of the panel, determine the best way to 

23 carry out those best practices in a practical and 

24 feasible manner, and determine an effective 

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1 manner of distributing information on such 

2 subject. 

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

4 18 months after the date of enactment of the Elder 

5 Justice Act, and annually thereafter, the Advisory 

6 Board shall prepare and submit to the Elder Justice 

7 Coordinating Council, the Committee on Finance of 

8 the Senate, and the Committee on Ways and Means 

9 and the Committee on Energy and Commerce of the 

10 House of Representatives a report containing— 

11 ‘‘(A) information on the status of Federal, 

12 State, and local public and private elder justice 

13 activities; 

14 ‘‘(B) recommendations (including rec15 ommended priorities) regarding— 

16 ‘‘(i) elder justice programs, research, 

17 training, services, practice, enforcement, 

18 and coordination; 

19 ‘‘(ii) coordination between entities 

20 pursuing elder justice efforts and those in21 volved in related areas that may inform or 

22 overlap with elder justice efforts, such as 

23 activities to combat violence against women 

24 and child abuse and neglect; and 

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1 ‘‘(iii) activities relating to adult fidu2 ciary systems, including guardianship and 

3 other fiduciary arrangements; 

4 ‘‘(C) recommendations for specific modi5 fications needed in Federal and State laws (in6 cluding regulations) or for programs, research, 

7 and training to enhance prevention, detection, 

8 and treatment (including diagnosis) of, inter9 vention in (including investigation of), and 

10 prosecution of elder abuse, neglect, and exploi11 tation; 

12 ‘‘(D) recommendations on methods for the 

13 most effective coordinated national data collec14 tion with respect to elder justice, and elder 

15 abuse, neglect, and exploitation; and 

16 ‘‘(E) recommendations for a multidisci17 plinary strategic plan to guide the effective and 

18 efficient development of the field of elder jus19 tice. 

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

21 ‘‘(1) INFORMATION FROM FEDERAL AGEN22 CIES.—Subject to the requirements of section 

23 2012(a), the Advisory Board may secure directly 

24 from any Federal department or agency such infor25 mation as the Advisory Board considers necessary to 

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1 carry out this section. Upon request of the Chair of 

2 the Advisory Board, the head of such department or 

3 agency shall furnish such information to the Advi4 sory Board. 

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

6 Advisory Board may request from any entity pur7 suing elder justice activities under the Elder Justice 

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

9 reports, or recommendations generated in connection 

10 with 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 ‘‘(h) TRAVEL EXPENSES.—The members of the Advi16 sory Board shall not receive compensation for the perform17 ance of services for the Advisory Board. The members 

18 shall be allowed travel expenses for up to 4 meetings per 

19 year, including per diem in lieu of subsistence, at rates 

20 authorized for employees of agencies under subchapter I 

21 of chapter 57 of title 5, United States Code, while away 

22 from their homes or regular places of business in the per23 formance of services for the Advisory Board. Notwith24 standing section 1342 of title 31, United States Code, the 

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1 Secretary may accept the voluntary and uncompensated 

2 services of the members of the Advisory Board. 

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

4 Federal Government employee may be detailed to the Ad5 visory Board without reimbursement, and such detail shall 

6 be without interruption or loss of civil service status or 

7 privilege. 

8 ‘‘(j) STATUS AS PERMANENT ADVISORY COM9 MITTEE.—Section 14 of the Federal Advisory Committee 

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

11 ‘‘SEC. 2023. RESEARCH PROTECTIONS. 

12 ‘‘(a) GUIDELINES.—The Secretary shall promulgate 

13 guidelines to assist researchers working in the area of 

14 elder abuse, neglect, and exploitation, with issues relating 

15 to human subject protections. 

16 ‘‘(b) DEFINITION OF LEGALLY AUTHORIZED REP17 RESENTATIVE FOR APPLICATION OF REGULATIONS.—For 

18 purposes of the application of subpart A of part 46 of title 

19 45, Code of Federal Regulations, to research conducted 

20 under this subpart, the term ‘legally authorized represent21 ative’ means, unless otherwise provided by law, the indi22 vidual or judicial or other body authorized under the appli23 cable law to consent to medical treatment on behalf of an24 other person. 

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1 ‘‘SEC. 2024. AUTHORIZATION OF APPROPRIATIONS. 

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

3 this subpart— 

4 ‘‘(1) for fiscal year 2008, $6,500,000; and 

5 ‘‘(2) for each of fiscal years 2009 through 

6 2011, $7,000,000. 

7 ‘‘Subpart 2—Elder Abuse, Neglect, and Exploitation 

8 Forensic Centers 

9 ‘‘SEC. 2031. ESTABLISHMENT AND SUPPORT OF ELDER 

10 ABUSE, NEGLECT, AND EXPLOITATION FO11 RENSIC CENTERS. 

12 ‘‘(a) IN GENERAL.—The Secretary, in consultation 

13 with the Attorney General, shall make grants to eligible 

14 entities to establish and operate stationary and mobile fo15 rensic centers, to develop forensic expertise regarding, and 

16 provide services relating to, elder abuse, neglect, and ex17 ploitation. 

18 ‘‘(b) STATIONARY FORENSIC CENTERS.—The Sec19 retary shall make 4 of the grants described in subsection 

20 (a) to institutions of higher education with demonstrated 

21 expertise in forensics or commitment to preventing or 

22 treating elder abuse, neglect, or exploitation, to establish 

23 and operate stationary forensic centers. 

24 ‘‘(c) MOBILE CENTERS.—The Secretary shall make 

25 6 of the grants described in subsection (a) to appropriate 

26 entities to establish and operate mobile forensic centers. 

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1 ‘‘(d) AUTHORIZED ACTIVITIES.— 

2 ‘‘(1) DEVELOPMENT OF FORENSIC MARKERS

3 AND METHODOLOGIES.—An eligible entity that re4 ceives a grant under this section shall use funds 

5 made available through the grant to assist in deter6 mining whether abuse, neglect, or exploitation oc7 curred and whether a crime was committed and to 

8 conduct research to describe and disseminate infor9 mation on— 

10 ‘‘(A) forensic markers that indicate a case 

11 in which elder abuse, neglect, or exploitation 

12 may have occurred; and 

13 ‘‘(B) methodologies for determining, in 

14 such a case, when and how health care, emer15 gency service, social and protective services, and 

16 legal service providers should intervene and 

17 when the providers should report the case to 

18 law enforcement authorities. 

19 ‘‘(2) DEVELOPMENT OF FORENSIC EXPER20 TISE.—An eligible entity that receives a grant under 

21 this section shall use funds made available through 

22 the grant to develop forensic expertise regarding 

23 elder abuse, neglect, and exploitation in order to 

24 provide medical and forensic evaluation, therapeutic 

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1 intervention, victim support and advocacy, case re2 view, and case tracking. 

3 ‘‘(3) COLLECTION OF EVIDENCE.—The Sec4 retary, in coordination with the Attorney General, 

5 shall use data made available by grant recipients 

6 under this section to develop the capacity of geriatric 

7 health care professionals and law enforcement to col8 lect forensic evidence, including collecting forensic 

9 evidence relating to a potential determination of 

10 elder abuse, neglect, or exploitation. 

11 ‘‘(e) APPLICATION.—To be eligible to receive a grant 

12 under this section, an entity shall submit an application 

13 to the Secretary at such time, in such manner, and con14 taining such information as the Secretary may require. 

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

16 are authorized to be appropriated to carry out this sec17 tion— 

18 ‘‘(1) for fiscal year 2008, $4,000,000; 

19 ‘‘(2) for fiscal year 2009, $6,000,000; and 

20 ‘‘(3) for each of fiscal years 2010 and 2011, 

21 $8,000,000. 

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1 ‘‘PART B—PROGRAMS TO PROMOTE ELDER 

2 JUSTICE 

3 ‘‘SEC. 2041. ENHANCEMENT OF LONG-TERM CARE. 

4 ‘‘(a) GRANTS AND INCENTIVES FOR LONG-TERM

5 CARE STAFFING.— 

6 ‘‘(1) IN GENERAL.—The Secretary shall carry 

7 out activities, including activities described in para8 graphs (2) and (3), to provide incentives for individ9 uals to train for, seek, and maintain employment 

10 providing direct care in a long-term care facility. 

11 ‘‘(2) SPECIFIC PROGRAMS TO ENHANCE TRAIN12 ING, RECRUITMENT, AND RETENTION OF STAFF.— 

13 ‘‘(A) COORDINATION WITH SECRETARY OF

14 LABOR TO RECRUIT AND TRAIN LONG-TERM

15 CARE STAFF.—The Secretary shall coordinate 

16 activities under this subsection with the Sec17 retary of Labor in order to provide incentives 

18 for individuals to train for and seek employ19 ment providing direct care in a long-term care 

20 facility. 

21 ‘‘(B) CAREER LADDERS AND WAGE OR

22 BENEFIT INCREASES TO INCREASE STAFFING IN

23 LONG-TERM CARE FACILITIES.— 

24 ‘‘(i) IN GENERAL.—The Secretary 

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1 ties to carry out programs through which 

2 the facilities— 

3 ‘‘(I) offer, to employees who pro4 vide direct care to residents of a long5 term care facility, continuing training 

6 and varying levels of certification, 

7 based on observed clinical care prac8 tices and the amount of time the em9 ployees spend providing direct care; 

10 and 

11 ‘‘(II) provide, or make arrange12 ments to provide, bonuses or other in13 creased compensation or benefits to 

14 employees who achieve certification 

15 under such a program. 

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

17 receive a grant under this subparagraph, a 

18 long-term care facility shall submit an ap19 plication to the Secretary at such time, in 

20 such manner, and containing such infor21 mation as the Secretary may require 

22 (which may include evidence of consulta23 tion with the State in which the long-term 

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1 rying out activities funded under the 

2 grant). 

3 ‘‘(iii) AUTHORITY TO LIMIT NUMBER

4 OF APPLICANTS.—Nothing in this subpara5 graph shall be construed as prohibiting the 

6 Secretary from limiting the number of ap7 plicants for a grant under this subpara8 graph. 

9 ‘‘(3) SPECIFIC PROGRAMS TO IMPROVE MAN10 AGEMENT PRACTICES.— 

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

12 make grants to long-term care facilities to en13 able the facilities to provide training and tech14 nical assistance to eligible employees. 

15 ‘‘(B) AUTHORIZED ACTIVITIES.—A long16 term care facility that receives a grant under 

17 subparagraph (A) shall use funds made avail18 able through the grant to provide training and 

19 technical assistance to eligible employees re20 garding management practices using methods 

21 that are demonstrated to promote retention of 

22 individuals who provide direct care to residents 

23 of the long-term care facility, such as— 

24 ‘‘(i) the establishment of standard 

25 human resource policies that reward high 

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1 performance, including policies that pro2 vide for improved wages and benefits on 

3 the basis of job reviews; 

4 ‘‘(ii) the establishment of motivational 

5 and thoughtful work organization prac6 tices; 

7 ‘‘(iii) the creation of a workplace cul8 ture that respects and values caregivers 

9 and their needs; 

10 ‘‘(iv) the promotion of a workplace 

11 culture that respects the rights of residents 

12 of a long-term care facility and results in 

13 improved care for the residents; and 

14 ‘‘(v) the establishment of other pro15 grams that promote the provision of high 

16 quality care, such as a continuing edu17 cation program that provides additional 

18 hours of training, including on-the-job 

19 training, for employees who are certified 

20 nurse aides. 

21 ‘‘(C) APPLICATION.—To be eligible to re22 ceive a grant under this paragraph, a long-term 

23 care facility shall submit an application to the 

24 Secretary at such time, in such manner, and 

25 containing such information as the Secretary 

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1 may require (which may include evidence of 

2 consultation with the State in which the long3 term care facility is located with respect to car4 rying out activities funded under the grant). 

5 ‘‘(D) AUTHORITY TO LIMIT NUMBER OF

6 APPLICANTS.—Nothing in this paragraph shall 

7 be construed as prohibiting the Secretary from 

8 limiting the number of applicants for a grant 

9 under this paragraph. 

10 ‘‘(E) ELIGIBLE EMPLOYEE DEFINED.—In 

11 this paragraph, the term ‘eligible employee’ 

12 means an individual who establishes or imple13 ments management practices applicable with re14 spect to individuals who provide direct care to 

15 residents of a long-term care facility and in16 cludes administrators, directors of nursing, 

17 staff developers, and charge nurses. 

18 ‘‘(4) ACCOUNTABILITY MEASURES.—The Sec19 retary shall develop accountability measures to en20 sure that the activities conducted using funds made 

21 available under this subsection benefit eligible em22 ployees and increase the stability of the long-term 

23 care workforce. 

24 ‘‘(b) INFORMATICS SYSTEMS GRANT PROGRAM.— 

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

2 authorized to make grants to long-term care facili3 ties for the purpose of assisting such entities in off4 setting the costs related to purchasing, leasing, de5 veloping, and implementing standardized clinical 

6 health care informatics systems designed to improve 

7 patient safety and reduce adverse events and health 

8 care complications resulting from medication errors. 

9 ‘‘(2) USE OF GRANT FUNDS.—Funds provided 

10 under grants under this subsection may be used for 

11 any of the following: 

12 ‘‘(A) Purchasing, leasing, and installing 

13 computer software and hardware, including 

14 handheld computer technologies. 

15 ‘‘(B) Making improvements to existing 

16 computer software and hardware. 

17 ‘‘(C) Making upgrades and other improve18 ments to existing computer software and hard19 ware to enable e-prescribing. 

20 ‘‘(D) Providing education and training to 

21 eligible long-term care facility staff on the use 

22 of technology to implement the electronic trans23 mission of prescription and patient information. 

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

25 grant under this subsection, a long-term care facility 

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1 shall submit an application to the Secretary at such 

2 time, in such manner, and containing such informa3 tion as the Secretary may require (which may in4 clude evidence of consultation with the State in 

5 which the long-term care facility is located with re6 spect to carrying out activities funded under the 

7 grant). 

8 ‘‘(4) AUTHORITY TO LIMIT NUMBER OF APPLI9 CANTS.—Nothing in this subsection shall be con10 strued as prohibiting the Secretary from limiting the 

11 number of applicants for a grant under this sub12 section. 

13 ‘‘(5) ACCOUNTABILITY MEASURES.—The Sec14 retary shall develop accountability measures to en15 sure that the activities conducted using funds made 

16 available under this subsection help improve patient 

17 safety and reduce adverse events and health care 

18 complications resulting from medication errors. 

19 ‘‘(c) INCLUSION OF ADJUDICATED CRIMES ON NURS20 ING HOME COMPARE WEBSITE.—Not later than 1 year 

21 after the date of enactment of the Elder Justice Act, the 

22 Secretary shall ensure that the Department of Health and 

23 Human Services includes, as part of the information pro24 vided for comparison of nursing facilities on the official 

25 Internet website of the Federal Government for Medicare 

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1 beneficiaries (commonly referred to as the ‘Nursing Home 

2 Compare’ Medicare website), the number of adjudicated 

3 instances of criminal violations by a nursing facility or 

4 crimes committed by an employee of a nursing facility— 

5 ‘‘(1) that were committed inside of the facility; 

6 and 

7 ‘‘(2) with respect to such instances of violations 

8 or crimes committed outside of the facility, that 

9 were the violations or crimes of elder abuse, neglect, 

10 and exploitation, criminal sexual abuse of an elder, 

11 or other violations or crimes that resulted in the se12 rious bodily injury of an elder. 

13 ‘‘(d) DEVELOPMENT OF CONSUMER RIGHTS INFOR14 MATION PAGE ON NURSING HOME COMPARE WEBSITE.— 

15 Not later than 1 year after the date of enactment of the 

16 Elder Justice Act, the Secretary shall ensure that the De17 partment of Health and Human Services, as part of the 

18 information provided for comparison of nursing facilities 

19 on the Nursing Home Compare Medicare website develops 

20 and includes a consumer rights information page that con21 tains links to descriptions of, and information with respect 

22 to, the following: 

23 ‘‘(1) The documentation on nursing facilities 

24 that is available to the public. 

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1 ‘‘(2) General information and tips on choosing 

2 a nursing facility that meets the needs of the indi3 vidual. 

4 ‘‘(3) General information on consumer rights 

5 with respect to nursing facilities. 

6 ‘‘(4) The nursing facility survey process (on a 

7 national and State-specific basis). 

8 ‘‘(5) On a State-specific basis, the services 

9 available through the State long-term care ombuds10 man for such State. 

11 ‘‘(e) DEVELOPMENT AND ADOPTION OF STANDARDS

12 FOR TRANSACTIONS INVOLVING CLINICAL DATA BY

13 LONG-TERM CARE FACILITIES.— 

14 ‘‘(1) STANDARDS.—The Secretary shall develop 

15 and adopt uniform open electronic standards for 

16 transactions involving clinical data by long-term care 

17 facilities. Such standards shall include messaging 

18 and nomenclature standards. 

19 ‘‘(2) COMPATIBILITY WITH OTHER STAND20 ARDS.—The standards developed and adopted under 

21 paragraph (1) shall be compatible with standards es22 tablished under part C of title XI, standards estab23 lished under subsections (b)(2)(B)(i) and (e)(4) of 

24 section 1860D–4, and with general health informa25 tion technology standards. 

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1 ‘‘(3) ELECTRONIC SUBMISSION OF DATA TO

2 THE SECRETARY.— 

3 ‘‘(A) IN GENERAL.—Not later than 10 

4 years after the date of enactment of the Elder 

5 Justice Act, the Secretary shall have procedures 

6 in place to accept the optional electronic sub7 mission of clinical data by long-term care facili8 ties pursuant to the standards developed and 

9 adopted under paragraph (1). 

10 ‘‘(B) RULE OF CONSTRUCTION.—Nothing 

11 in this subsection shall be construed to require 

12 a long-term care facility to submit clinical data 

13 electronically to the Secretary. 

14 ‘‘(f) REGULATIONS.—The Secretary shall promulgate 

15 regulations to carry out subsections (c), (d), and (e) of 

16 this section. Such regulations shall require a State, as a 

17 condition of the receipt of funds under this part, to con18 duct such data collection and reporting as the Secretary 

19 determines are necessary to satisfy the requirements of 

20 such subsections. 

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

22 are authorized to be appropriated to carry out this sec23 tion— 

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

25 ‘‘(2) for fiscal year 2009, $17,500,000; and 

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1 ‘‘(3) for each of fiscal years 2010 and 2011, 

2 $15,000,000. 

3 ‘‘SEC. 2042. ADULT PROTECTIVE SERVICES FUNCTIONS AND 

4 GRANT PROGRAMS. 

5 ‘‘(a) SECRETARIAL RESPONSIBILITIES.— 

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

7 that the Department of Health and Human Serv8 ices— 

9 ‘‘(A) provides funding authorized by this 

10 part to State and local adult protective services 

11 offices that investigate reports of the abuse, ne12 glect, and exploitation of elders; 

13 ‘‘(B) collects and disseminates data annu14 ally relating to the abuse, exploitation, and ne15 glect of elders in coordination with the Depart16 ment of Justice; 

17 ‘‘(C) develops and disseminates informa18 tion on best practices regarding, and provides 

19 training on, carrying out adult protective serv20 ices; 

21 ‘‘(D) conducts research related to the pro22 vision of adult protective services; and 

23 ‘‘(E) provides technical assistance to 

24 States and other entities that provide or fund 

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1 cluding through grants made under subsections 

2 (b) and (c). 

3 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

4 There are authorized to be appropriated to carry out 

5 this subsection, $3,000,000 for fiscal year 2008 and 

6 $4,000,000 for each of fiscal years 2009 through 

7 2011. 

8 ‘‘(b) GRANTS TO ENHANCE THE PROVISION OF

9 ADULT PROTECTIVE SERVICES.— 

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

11 adult protective services grant program under which 

12 the Secretary shall annually award grants to States 

13 in the amounts calculated under paragraph (2) for 

14 the purposes of enhancing adult protective services 

15 provided by States and local units of government. 

16 ‘‘(2) AMOUNT OF PAYMENT.— 

17 ‘‘(A) IN GENERAL.—Subject to the avail18 ability of appropriations and subparagraphs (B) 

19 and (C), the amount paid to a State for a fiscal 

20 year under the program under this subsection 

21 shall equal the amount appropriated for that 

22 year to carry out this subsection multiplied by 

23 the percentage of the total number of elders 

24 who reside in the United States who reside in 

25 that State. 

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1 ‘‘(B) GUARANTEED MINIMUM PAYMENT

2 AMOUNT.— 

3 ‘‘(i) 50 STATES.—Subject to clause 

4 (ii), if the amount determined under sub5 paragraph (A) for a State for a fiscal year 

6 is less than 0.75 percent of the amount ap7 propriated for such year, the Secretary 

8 shall increase such determined amount so 

9 that the total amount paid under this sub10 section to the State for the year is equal 

11 to 0.75 percent of the amount so appro12 priated. 

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

14 State other than 1 of the 50 States, clause 

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

16 ‘0.75’ were a reference to ‘0.1’. 

17 ‘‘(C) PRO RATA REDUCTIONS.—The Sec18 retary shall make such pro rata reductions to 

19 the amounts described in subparagraph (A) as 

20 are necessary to comply with the requirements 

21 of subparagraph (B). 

22 ‘‘(3) AUTHORIZED ACTIVITIES.— 

23 ‘‘(A) ADULT PROTECTIVE SERVICES.— 

24 Funds made available pursuant to this sub25 section may only be used by States and local 

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1 units of government to provide adult protective 

2 services and may not be used for any other pur3 pose. 

4 ‘‘(B) USE BY AGENCY.—Each State receiv5 ing funds pursuant to this subsection shall pro6 vide such funds to the agency or unit of State 

7 government having legal responsibility for pro8 viding adult protective services within the State. 

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

10 State or local unit of government shall use 

11 funds made available pursuant to this sub12 section to supplement and not supplant other 

13 Federal, State, and local public funds expended 

14 to provide adult protective services in the State. 

15 ‘‘(4) STATE REPORTS.—Each State receiving 

16 funds under this subsection shall submit to the Sec17 retary, at such time and in such manner as the Sec18 retary may require, a report on the number of elders 

19 served by the grants awarded under this subsection. 

20 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

21 There are authorized to be appropriated to carry out 

22 this subsection, $100,000,000 for each of fiscal 

23 years 2008 through 2011. 

24 ‘‘(c) STATE DEMONSTRATION PROGRAMS.— 

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1 ‘‘(1) ESTABLISHMENT.—The Secretary shall 

2 award grants to States for the purposes of con3 ducting demonstration programs in accordance with 

4 paragraph (2). 

5 ‘‘(2) DEMONSTRATION PROGRAMS.—Funds 

6 made available pursuant to this subsection may be 

7 used by States and local units of government to con8 duct demonstration programs that test— 

9 ‘‘(A) training modules developed for the 

10 purpose of detecting or preventing elder abuse; 

11 ‘‘(B) methods to detect or prevent financial 

12 exploitation of elders; 

13 ‘‘(C) methods to detect elder abuse; 

14 ‘‘(D) whether training on elder abuse 

15 forensics enhances the detection of elder abuse 

16 by employees of the State or local unit of gov17 ernment; or 

18 ‘‘(E) other matters relating to the detec19 tion or prevention of elder abuse. 

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

21 grant under this subsection, a State shall submit an 

22 application to the Secretary at such time, in such 

23 manner, and containing such information as the Sec24 retary may require. 

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1 ‘‘(4) STATE REPORTS.—Each State that re2 ceives funds under this subsection shall submit a re3 port to the Secretary at such time, in such manner, 

4 and containing such information as the Secretary 

5 may require on the results of the demonstration pro6 gram conducted by the State using funds made 

7 available under this subsection. 

8 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

9 There are authorized to be appropriated to carry out 

10 this subsection, $25,000,000 for each of fiscal years 

11 2008 through 2011. 

12 ‘‘SEC. 2043. LONG-TERM CARE OMBUDSMAN PROGRAM 

13 GRANTS AND TRAINING. 

14 ‘‘(a) GRANTS TO SUPPORT THE LONG-TERM CARE

15 OMBUDSMAN PROGRAM.— 

16 ‘‘(1) IN GENERAL.—The Secretary shall make 

17 grants to eligible entities with relevant expertise and 

18 experience in abuse and neglect in long-term care fa19 cilities or long-term care ombudsman programs and 

20 responsibilities, for the purpose of— 

21 ‘‘(A) improving the capacity of State long22 term care ombudsman programs to respond to 

23 and resolve complaints about abuse and neglect; 

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1 ‘‘(B) conducting pilot programs with State 

2 long-term care ombudsman offices or local om3 budsman entities; and 

4 ‘‘(C) providing support for such State 

5 long-term care ombudsman programs and such 

6 pilot programs (such as through the establish7 ment of a national long-term care ombudsman 

8 resource center). 

9 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

10 There are authorized to be appropriated to carry out 

11 this subsection— 

12 ‘‘(A) for fiscal year 2008, $5,000,000; 

13 ‘‘(B) for fiscal year 2009, $7,500,000; and 

14 ‘‘(C) for each of fiscal years 2010 and 

15 2011, $10,000,000. 

16 ‘‘(b) OMBUDSMAN TRAINING PROGRAMS.— 

17 ‘‘(1) IN GENERAL.—The Secretary shall estab18 lish programs to provide and improve ombudsman 

19 training with respect to elder abuse, neglect, and ex20 ploitation for national organizations and State long21 term care ombudsman programs. 

22 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

23 There are authorized to be appropriated to carry out 

24 this subsection, for each of fiscal years 2008 

25 through 2011, $10,000,000. 

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1 ‘‘SEC. 2044. PROVISION OF INFORMATION REGARDING, AND 

2 EVALUATIONS OF, ELDER JUSTICE PRO3 GRAMS. 

4 ‘‘(a) PROVISION OF INFORMATION.—To be eligible to 

5 receive a grant under this part, an applicant shall agree— 

6 ‘‘(1) except as provided in paragraph (2), to 

7 provide the eligible entity conducting an evaluation 

8 under subsection (b) of the activities funded through 

9 the grant with such information as the eligible entity 

10 may require in order to conduct such evaluation; or 

11 ‘‘(2) in the case of an applicant for a grant 

12 under section 2041(b), to provide the Secretary with 

13 such information as the Secretary may require to 

14 conduct an evaluation or audit under subsection (c). 

15 ‘‘(b) USE OF ELIGIBLE ENTITIES TO CONDUCT

16 EVALUATIONS.— 

17 ‘‘(1) EVALUATIONS REQUIRED.—Except as pro18 vided in paragraph (2), the Secretary shall— 

19 ‘‘(A) reserve a portion (not less than 2 per20 cent) of the funds appropriated with respect to 

21 each program carried out under this part; and 

22 ‘‘(B) use the funds reserved under sub23 paragraph (A) to provide assistance to eligible 

24 entities to conduct evaluations of the activities 

25 funded under each program carried out under 

26 this part. 

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1 ‘‘(2) INFORMATICS SYSTEMS GRANT PROGRAM

2 NOT INCLUDED.—The provisions of this subsection 

3 shall not apply to the informatics systems grant pro4 gram under section 2041(b). 

5 ‘‘(3) AUTHORIZED ACTIVITIES.—A recipient of 

6 assistance described in paragraph (1)(B) shall use 

7 the funds made available through the assistance to 

8 conduct a validated evaluation of the effectiveness of 

9 the activities funded under a program carried out 

10 under this part. 

11 ‘‘(4) APPLICATIONS.—To be eligible to receive 

12 assistance under paragraph (1)(B), an entity shall 

13 submit an application to the Secretary at such time, 

14 in such manner, and containing such information as 

15 the Secretary may require, including a proposal for 

16 the evaluation. 

17 ‘‘(5) REPORTS.—Not later than a date specified 

18 by the Secretary, an eligible entity receiving assist19 ance under paragraph (1)(B) shall submit to the 

20 Secretary, the Committee on Ways and Means and 

21 the Committee on Energy and Commerce of the 

22 House of Representatives, and the Committee on Fi23 nance of the Senate a report containing the results 

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1 gether with such recommendations as the entity de2 termines to be appropriate. 

3 ‘‘(c) EVALUATIONS AND AUDITS OF INFORMATICS

4 SYSTEMS GRANT PROGRAM BY THE SECRETARY.— 

5 ‘‘(1) EVALUATIONS.—The Secretary shall con6 duct an evaluation of the activities funded under the 

7 informatics systems grant program under section 

8 2041(b). Such evaluation shall include an evaluation 

9 of whether the funding provided under the grant is 

10 expended only for the purposes for which it is made. 

11 ‘‘(2) AUDITS.—The Secretary shall conduct ap12 propriate audits of grants made under section 

13 2041(b). 

14 ‘‘SEC. 2045. REPORT. 

15 ‘‘Not later than October 1, 2011, the Secretary shall 

16 submit to the Elder Justice Coordinating Council, the 

17 Committee on Ways and Means and the Committee on En18 ergy and Commerce of the House of Representatives, and 

19 the Committee on Finance of the Senate a report— 

20 ‘‘(1) compiling, summarizing, and analyzing the 

21 information contained in the State reports submitted 

22 under subsections (b)(4) and (c)(4) of section 2042; 

23 and 

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1 ‘‘(2) containing such recommendations for legis2 lative or administrative action as the Secretary de3 termines to be appropriate.’’. 

4 (2) OPTION FOR STATE PLAN UNDER PROGRAM

5 FOR TEMPORARY ASSISTANCE FOR NEEDY FAMI6 LIES.— 

7 (A) IN GENERAL.—Section 402(a)(1)(B) of 

8 the Social Security Act (42 U.S.C. 

9 602(a)(1)(B)) is amended by adding at the end 

10 the following new clause: 

11 ‘‘(v) The document shall indicate 

12 whether the State intends to assist individ13 uals to train for, seek, and maintain em14 ployment— 

15 ‘‘(I) providing direct care in a 

16 long-term care facility (as such terms 

17 are defined under section 2011); or 

18 ‘‘(II) in other occupations related 

19 to elder care determined appropriate 

20 by the State for which the State iden21 tifies an unmet need for service per22 sonnel, 

23 and, if so, shall include an overview of such 

24 assistance.’’. 

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1 (B) EFFECTIVE DATE.—The amendment 

2 made by subparagraph (A) shall take effect on 

3 October 1, 2008. 

4 (b) PROTECTING RESIDENTS OF LONG-TERM CARE

5 FACILITIES.— 

6 (1) NATIONAL TRAINING INSTITUTE FOR SUR7 VEYORS.— 

8 (A) IN GENERAL.—The Secretary of 

9 Health and Human Services shall enter into a 

10 contract with an entity for the purpose of estab11 lishing and operating a National Training Insti12 tute for Federal and State surveyors. Such In13 stitute shall provide and improve the training of 

14 surveyors with respect to investigating allega15 tions of abuse, neglect, and misappropriation of 

16 property in programs and long-term care facili17 ties that receive payments under title XVIII or 

18 XIX of the Social Security Act. 

19 (B) ACTIVITIES CARRIED OUT BY THE IN20 STITUTE.—The contract entered into under 

21 subparagraph (A) shall require the Institute es22 tablished and operated under such contract to 

23 carry out the following activities: 

24 (i) Assess the extent to which State 

25 agencies use specialized surveyors for the 

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1 investigation of reported allegations of 

2 abuse, neglect, and misappropriation of 

3 property in such programs and long-term 

4 care facilities. 

5 (ii) Evaluate how the competencies of 

6 surveyors may be improved to more effec7 tively investigate reported allegations of 

8 such abuse, neglect, and misappropriation 

9 of property, and provide feedback to Fed10 eral and State agencies on the evaluations 

11 conducted. 

12 (iii) Provide a national program of 

13 training, tools, and technical assistance to 

14 Federal and State surveyors on inves15 tigating reports of such abuse, neglect, and 

16 misappropriation of property. 

17 (iv) Develop and disseminate informa18 tion on best practices for the investigation 

19 of such abuse, neglect, and misappropria20 tion of property. 

21 (v) Assess the performance of State 

22 complaint intake systems, in order to en23 sure that the intake of complaints occurs 

24 24 hours per day, 7 days a week (including 

25 holidays). 

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1 (vi) To the extent approved by the 

2 Secretary of Health and Human Services, 

3 provide a national 24 hours per day, 7 

4 days a week (including holidays), back-up 

5 system to State complaint intake systems 

6 in order to ensure optimum national re7 sponsiveness to complaints of such abuse, 

8 neglect, and misappropriation of property. 

9 (vii) Analyze and report annually on 

10 the following: 

11 (I) The total number and sources 

12 of complaints of such abuse, neglect, 

13 and misappropriation of property. 

14 (II) The extent to which such 

15 complaints are referred to law en16 forcement agencies. 

17 (III) General results of Federal 

18 and State investigations of such com19 plaints. 

20 (viii) Conduct a national study of the 

21 cost to State agencies of conducting com22 plaint investigations of skilled nursing fa23 cilities and nursing facilities under sections 

24 1819 and 1919, respectively, of the Social 

25 Security Act (42 U.S.C. 1395i–3; 1396r), 

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1 and making recommendations to the Sec2 retary of Health and Human Services with 

3 respect to options to increase the efficiency 

4 and cost-effectiveness of such investiga5 tions. 

6 (C) AUTHORIZATION.—There are author7 ized to be appropriated to carry out this para8 graph, for the period of fiscal years 2008 

9 through 2011, $12,000,000. 

10 (2) GRANTS TO STATE SURVEY AGENCIES.— 

11 (A) IN GENERAL.—The Secretary of 

12 Health and Human Services shall make grants 

13 to State agencies that perform surveys of 

14 skilled nursing facilities or nursing facilities 

15 under sections 1819 or 1919, respectively, of 

16 the Social Security Act (42 U.S.C. 1395i–3; 

17 1395r). 

18 (B) USE OF FUNDS.—A grant awarded 

19 under subparagraph (A) shall be used for the 

20 purpose of designing and implementing com21 plaint investigations systems that— 

22 (i) promptly prioritize complaints in 

23 order to ensure a rapid response to the 

24 most serious and urgent complaints; 

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1 (ii) respond to complaints with opti2 mum effectiveness and timeliness; and 

3 (iii) optimize the collaboration be4 tween local authorities, consumers, and 

5 providers, including— 

6 (I) such State agency; 

7 (II) the State Long-Term Care 

8 Ombudsman; 

9 (III) local law enforcement agen10 cies; 

11 (IV) advocacy and consumer or12 ganizations; 

13 (V) State aging units; 

14 (VI) Area Agencies on Aging; 

15 and 

16 (VII) other appropriate entities. 

17 (C) AUTHORIZATION.—There are author18 ized to be appropriated to carry out this para19 graph, for each of fiscal years 2008 through 

20 2011, $5,000,000. 

21 (3) REPORTING OF CRIMES AND ENSURING

22 SAFETY OF RESIDENTS WHEN FEDERALLY FUNDED

23 LONG-TERM CARE FACILITIES CLOSE.—Part A of 

24 title XI of the Social Security Act (42 U.S.C. 1301 

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1 et seq.) is amended by adding at the end the fol2 lowing new sections: 

3 ‘‘REPORTING TO LAW ENFORCEMENT OF CRIMES OCCUR4 RING IN FEDERALLY FUNDED LONG-TERM CARE FA5 CILITIES

6 ‘‘SEC. 1150A. (a) DETERMINATION AND NOTIFICA7 TION.— 

8 ‘‘(1) DETERMINATION.—The owner or operator 

9 of each long-term care facility that receives Federal 

10 funds under this Act shall annually determine 

11 whether the facility received at least $10,000 in such 

12 Federal funds during the preceding year. 

13 ‘‘(2) NOTIFICATION.—If the owner or operator 

14 determines under paragraph (1) that the facility re15 ceived at least $10,000 in such Federal funds during 

16 the preceding year, such owner or operator shall an17 nually notify each covered individual (as defined in 

18 paragraph (3)) of that individual’s obligation to 

19 comply with the reporting requirements described in 

20 subsection (b). 

21 ‘‘(3) COVERED INDIVIDUAL DEFINED.—In this 

22 section, the term ‘covered individual’ means each in23 dividual who is an owner, operator, employee, man24 ager, agent, or contractor of a long-term care facility 

25 that is the subject of a determination described in 

26 paragraph (1). 

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1 ‘‘(b) REPORTING REQUIREMENTS.— 

2 ‘‘(1) IN GENERAL.—Each covered individual 

3 shall report to the Secretary and 1 or more law en4 forcement entities for the political subdivision in 

5 which the facility is located any reasonable suspicion 

6 of a crime (as defined by the law of the applicable 

7 political subdivision) against any individual who is a 

8 resident of, or is receiving care from, the facility. 

9 ‘‘(2) TIMING.—If the events that cause the sus10 picion— 

11 ‘‘(A) result in serious bodily injury, the in12 dividual shall report the suspicion immediately, 

13 but not later than 2 hours after forming the 

14 suspicion; and 

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

16 the individual shall report the suspicion not 

17 later than 24 hours after forming the suspicion. 

18 ‘‘(c) PENALTIES.— 

19 ‘‘(1) IN GENERAL.—If a covered individual vio20 lates subsection (b)— 

21 ‘‘(A) the covered individual shall be subject 

22 to a civil money penalty of not more than 

23 $200,000; or 

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1 ‘‘(B) the Secretary shall classify the cov2 ered individual as an excluded individual, for a 

3 period of not more than 3 years. 

4 ‘‘(2) INCREASED HARM.—If a covered indi5 vidual violates subsection (b) and the violation exac6 erbates the harm to the victim of the crime or re7 sults in harm to another individual— 

8 ‘‘(A) the covered individual shall be subject 

9 to a civil money penalty of not more than 

10 $300,000; and 

11 ‘‘(B) the Secretary shall classify the cov12 ered individual as an excluded individual, for a 

13 period of not more than 3 years. 

14 ‘‘(3) EXCLUDED INDIVIDUAL.—During any pe15 riod for which a covered individual is classified as an 

16 excluded individual under paragraph (1)(B) or 

17 (2)(B), a long-term care facility that employs such 

18 individual shall be ineligible to receive Federal funds 

19 under this Act. 

20 ‘‘(4) EXTENUATING CIRCUMSTANCES.— 

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

22 take into account the financial burden on pro23 viders with underserved populations in deter24 mining any penalty to be imposed under this 

25 subsection. 

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1 ‘‘(B) UNDERSERVED POPULATION DE2 FINED.—In this paragraph, the term ‘under3 served population’ means the population of an 

4 area designated by the Secretary as an area 

5 with a shortage of elder justice programs or a 

6 population group designated by the Secretary 

7 as having a shortage of such programs. Such 

8 areas or groups designated by the Secretary 

9 may include— 

10 ‘‘(i) areas or groups that are geo11 graphically isolated (such as isolated in a 

12 rural area); 

13 ‘‘(ii) racial and ethnic minority popu14 lations; and 

15 ‘‘(iii) populations underserved because 

16 of special needs (such as language barriers, 

17 disabilities, alien status, or age). 

18 ‘‘(d) ADDITIONAL PENALTIES FOR RETALIATION.— 

19 ‘‘(1) IN GENERAL.—A long-term care facility 

20 may not— 

21 ‘‘(A) discharge, demote, suspend, threaten, 

22 harass, or deny a promotion or other employ23 ment-related benefit to an employee, or in any 

24 other manner discriminate against an employee 

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1 in the terms and conditions of employment be2 cause of lawful acts done by the employee; or 

3 ‘‘(B) file a complaint or a report against a 

4 nurse or other employee with the appropriate 

5 State professional disciplinary agency because 

6 of lawful acts done by the nurse or employee, 

7 for making a report, causing a report to be made, 

8 or for taking steps in furtherance of making a report 

9 pursuant to subsection (b)(1). 

10 ‘‘(2) PENALTIES FOR RETALIATION.—If a long11 term care facility violates subparagraph (A) or (B) 

12 of paragraph (1) the facility shall be subject to a 

13 civil money penalty of not more than $200,000 or 

14 the Secretary may classify the entity as an excluded 

15 entity for a period of 2 years pursuant to section 

16 1128(b), or both. 

17 ‘‘(3) REQUIREMENT TO POST NOTICE.—Each 

18 long-term care facility shall post conspicuously in an 

19 appropriate location a sign (in a form specified by 

20 the Secretary) specifying the rights of employees 

21 under this section. Such sign shall include a state22 ment that an employee may file a complaint with the 

23 Secretary against a long-term care facility that vio24 lates the provisions of this subsection and informamstockstill on PROD1PC66 with BILLS

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1 tion with respect to the manner of filing such a com2 plaint. 

3 ‘‘(e) PROCEDURE.—The provisions of section 1128A 

4 (other than subsections (a) and (b) and the second sen5 tence of subsection (f)) shall apply to a civil money penalty 

6 under this section in the same manner as such provisions 

7 apply to a penalty or proceeding under section 1128A(a). 

8 ‘‘(f) DEFINITIONS.—In this section, the terms ‘elder 

9 justice’, ‘long-term care facility’, and ‘law enforcement’ 

10 have the meanings given those terms in section 2011. 

11 ‘‘ENSURING SAFETY OF RESIDENTS WHEN FEDERALLY

12 FUNDED LONG-TERM CARE FACILITIES CLOSE

13 ‘‘SEC. 1150B. (a) IN GENERAL.— 

14 ‘‘(1) NOTIFICATION OF FACILITY CLOSURE.— 

15 Subject to paragraph (2), if the owner or operator 

16 determines under section 1150A(a)(1) that a long17 term care facility received at least $10,000 in Fed18 eral funds under this Act during the preceding year, 

19 the owner or operator of the facility shall— 

20 ‘‘(A) submit to the Secretary and the ap21 propriate State regulatory agency written notifi22 cation of an impending closure not later than 

23 the date that is 60 days prior to the date of 

24 such closure; 

25 ‘‘(B) include in the notice a plan for the 

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1 dents of the facility prior to closure, including 

2 assurances that the residents will be transferred 

3 to the most appropriate facility in terms of 

4 quality, services, and location; and 

5 ‘‘(C) not later than 10 days after the facil6 ity closure, submit to the Secretary and the ap7 propriate State agency information identifying 

8 where residents of the closed facility were trans9 ferred and on what date. 

10 ‘‘(2) EXCEPTION WHERE THE SECRETARY HAS

11 ISSUED A TERMINATION NOTICE.—In the case of a 

12 long-term care facility described in paragraph (1) for 

13 which the Secretary has issued a termination notice 

14 for the facility to close by not later than 15 days 

15 after the issuance of such notice, the Secretary shall 

16 establish requirements for the notification, transfer, 

17 and adequate relocation of residents within an ap18 propriate timeframe. 

19 ‘‘(b) SANCTIONS.—Any person owning or operating 

20 a long-term care facility that fails to comply with the re21 quirements of subsection (a) shall be subject to— 

22 ‘‘(1) a civil monetary penalty of up to 

23 $1,000,000; 

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1 ‘‘(2) exclusion from participation in the pro2 grams under this Act (in accordance with the proce3 dures of section 1128); and 

4 ‘‘(3) any other applicable civil monetary pen5 alties and assessments. 

6 ‘‘(c) PROCEDURE.—The provisions of section 1128A 

7 (other than subsections (a) and (b) and the second sen8 tence of subsection (f)) shall apply to a civil money penalty 

9 or assessment under this section in the same manner as 

10 such provisions apply to a penalty or proceeding under 

11 section 1128A(a). 

12 ‘‘(d) DEFINITION.—In this section, the term ‘long13 term care facility’ has the meaning given that term in sec14 tion 2011.’’. 

15 (4) REPORT TO CONGRESS ON PILOT PROGRAM

16 FOR NATIONAL AND STATE BACKGROUND CHECKS

17 ON DIRECT PATIENT ACCESS EMPLOYEES OF LONG18 TERM CARE FACILITIES OR PROVIDERS.—Not later 

19 than the date that is 6 months after the completion 

20 of the pilot program for national and State back21 ground checks on direct patient access employees of 

22 long-term care facilities or providers established 

23 under section 307 of the Medicare Prescription 

24 Drug, Improvement, and Modernization Act of 2003 

25 (42 U.S.C. 1395aa note), the Secretary shall submit 

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1 to the Committee on Finance of the Senate and the 

2 Committee on Ways and Means and the Committee 

3 on Energy and Commerce of the House of Rep4 resentatives a report containing the results of the 

5 evaluation required under subsection (e) of such sec6 tion of such Act, together with recommendations for 

7 such legislation and administrative action as the 

8 Secretary determines appropriate. 

9 (c) NATIONAL NURSE AIDE REGISTRY.— 

10 (1) DEFINITION OF NURSE AIDE.—In this sub11 section, the term ‘‘nurse aide’’ has the meaning 

12 given that term in sections 1819(b)(5)(F) and 

13 1919(b)(5)(F) of the Social Security Act (42 U.S.C. 

14 1395i–3(b)(5)(F); 1396r(b)(5)(F)). 

15 (2) STUDY AND REPORT.— 

16 (A) IN GENERAL.—The Secretary, in con17 sultation with appropriate government agencies 

18 and private sector organizations, shall conduct 

19 a study on establishing a national nurse aide 

20 registry. 

21 (B) AREAS EVALUATED.—The study con22 ducted under this subsection shall include an 

23 evaluation of— 

24 (i) who should be included in the reg25 istry; 

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1 (ii) how such a registry would comply 

2 with Federal and State privacy laws and 

3 regulations; 

4 (iii) how data would be collected for 

5 the registry; 

6 (iv) what entities and individuals 

7 would have access to the data collected; 

8 (v) how the registry would provide ap9 propriate information regarding violations 

10 of Federal and State law by individuals in11 cluded in the registry; 

12 (vi) how the functions of a national 

13 nurse aide registry would be coordinated 

14 with the pilot program for national and 

15 State background checks on direct patient 

16 access employees of long-term care facili17 ties or providers established under section 

18 307 of the Medicare Prescription Drug, 

19 Improvement, and Modernization Act of 

20 2003 (Public Law 108–173); and 

21 (vii) how the information included in 

22 State nurse aide registries developed and 

23 maintained under sections 1819(e)(2) and 

24 1919(e)(2) of the Social Security Act (42 

25 U.S.C. 1395i–3(e)(2); 1396r(e)(2)(2)) 

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1 would be provided as part of a national 

2 nurse aide registry. 

3 (C) CONSIDERATIONS.—In conducting the 

4 study and preparing the report required under 

5 this subsection, the Secretary shall take into 

6 consideration the findings and conclusions of 

7 relevant reports and other relevant resources, 

8 including the following: 

9 (i) The Department of Health and 

10 Human Services Office of Inspector Gen11 eral Report, Nurse Aide Registries: State 

12 Compliance and Practices (February 

13 2005). 

14 (ii) The General Accounting Office 

15 (now known as the Government Account16 ability Office) Report, Nursing Homes: 

17 More Can Be Done to Protect Residents 

18 from Abuse (March 2002). 

19 (iii) The Department of Health and 

20 Human Services Office of the Inspector 

21 General Report, Nurse Aide Registries: 

22 Long-Term Care Facility Compliance and 

23 Practices (July 2005). 

24 (iv) The Department of Health and 

25 Human Services Health Resources and 

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1 Services Administration Report, Nursing 

2 Aides, Home Health Aides, and Related 

3 Health Care Occupations—National and 

4 Local Workforce Shortages and Associated 

5 Data Needs (2004)(in particular with re6 spect to chapter 7 and appendix F). 

7 (v) The 2001 Report to CMS from 

8 the School of Rural Public Health, Texas 

9 A&M University, Preventing Abuse and 

10 Neglect in Nursing Homes: The Role of 

11 Nurse Aide Registries. 

12 (vi) Information included in State 

13 nurse aide registries developed and main14 tained under sections 1819(e)(2) and 

15 1919(e)(2) of the Social Security Act (42 

16 U.S.C. 1395i–3(e)(2); 1396r(e)(2)(2)). 

17 (D) REPORT.—Not later than 18 months 

18 after the date of enactment of this Act, the Sec19 retary shall submit a report to the Elder Jus20 tice Coordinating Council, the Committee on 

21 Finance of the Senate, and the Committee on 

22 Ways and Means and the Committee on Energy 

23 and Commerce of the House of Representatives 

24 containing the findings and recommendations of 

25 the study conducted under this paragraph. 

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1 (E) FUNDING LIMITATION.—Funding for 

2 the study conducted under this subsection shall 

3 not exceed $500,000. 

4 (3) CONGRESSIONAL ACTION.—After receiving 

5 the report submitted by the Secretary under para6 graph (2)(D), the Committee on Finance of the Sen7 ate and the Committee on Ways and Means and the 

8 Committee on Energy and Commerce of the House 

9 of Representatives shall, as they deem appropriate, 

10 take action based on the recommendations contained 

11 in the report. 

12 (4) AUTHORIZATION OF APPROPRIATIONS.— 

13 There are authorized to be appropriated such sums 

14 as are necessary for the purpose of carrying out this 

15 subsection. 

16 (d) CONFORMING AMENDMENTS.— 

17 (1) TITLE XX.—Title XX of the Social Security 

18 Act (42 U.S.C. 1397 et seq.), as amended by section 

19 5(a), is amended— 

20 (A) in the heading of section 2001, by 

21 striking ‘‘TITLE’’ and inserting ‘‘SUBTITLE’’; 

22 and 

23 (B) in subtitle 1, by striking ‘‘this title’’ 

24 each place it appears and inserting ‘‘this sub25 title’’. 

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1 (2) TITLE IV.—Title IV of the Social Security 

2 Act (42 U.S.C. 601 et seq.) is amended— 

3 (A) in section 404(d)— 

4 (i) in paragraphs (1)(A), (2)(A), and 

5 (3)(B), by inserting ‘‘subtitle 1 of’’ before 

6 ‘‘title XX’’ each place it appears; 

7 (ii) in the heading of paragraph (2), 

8 by inserting ‘‘SUBTITLE 1 OF’’ before 

9 ‘‘TITLE XX’’; and 

10 (iii) in the heading of paragraph 

11 (3)(B), by inserting ‘‘SUBTITLE 1 OF’’ be12 fore ‘‘TITLE XX’’; and 

13 (B) in sections 422(b), 471(a)(4), 

14 472(h)(1), and 473(b)(2), by inserting ‘‘subtitle 

15 1 of’’ before ‘‘title XX’’ each place it appears. 

16 (3) TITLE XI.—Title XI of the Social Security 

17 Act (42 U.S.C. 1301 et seq.) is amended— 

18 (A) in section 1128(h)(3)— 

19 (i) by inserting ‘‘subtitle 1 of’’ before 

20 ‘‘title XX’’; and 

21 (ii) by striking ‘‘such title’’ and in22 serting ‘‘such subtitle’’; and 

23 (B) in section 1128A(i)(1), by inserting 

24 ‘‘subtitle 1 of’’ before ‘‘title XX’’. 

Æ 

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