(D) is sensitive to ethnic and cultural di-
versity; 
(E) recognizes the role of mental health, 
disability, dementia, substance abuse, medica-
tion mismanagement, and family dysfunction 
problems in increasing and exacerbating elder 
abuse, neglect, and exploitation; and 
(F) balances elders’ right to self-deter-
mination with society’s responsibility to protect 
elders. 
(14) The human, social, and economic cost of 
elder abuse, neglect, and exploitation is high and in-
cludes unnecessary expenditures of funds from many 
public programs. 
(15) The failure to coordinate activities relating 
to, and comprehensively prevent and treat, elder 
abuse, neglect, and exploitation threatens the future 
and well-being of millions of elders in the United 
States. 
(16) All elements of society in the United 
States have a shared responsibility in responding to 
a national problem of elder abuse, neglect, and ex-
ploitation. 
SEC. 3. PURPOSES. 
The purposes of this Act are as follows: 
VerDate Nov 24 2008 
22:17 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
(1) To enhance the social security of the Nation 
by ensuring adequate public-private infrastructure 
and resolving to prevent, detect, treat, understand, 
and intervene in, and where appropriate, aid in the 
prosecution of, elder abuse, neglect, and exploitation. 
(2) To bring a comprehensive approach to pre-
venting and combating elder abuse, neglect, and ex-
ploitation, a long invisible problem that afflicts the 
most vulnerable among the aging population of the 
United States. 
(3) To raise the issue of elder abuse, neglect, 
and exploitation to national attention, and to create 
the infrastructure at the Federal, State, and local 
levels, to ensure that individuals and organizations 
on the front lines, who are fighting elder abuse, ne-
glect, and exploitation with scarce resources and 
fragmented systems, have the resources and infor-
mation needed to carry out their fight. 
(4) To bring a comprehensive multidisciplinary 
approach to elder justice. 
(5) To set in motion research and data collec-
tion to fill gaps in knowledge about elder abuse, ne-
glect, and exploitation. 
(6) To supplement the activities of service pro-
viders and programs, to enhance training, and to le-
VerDate Nov 24 2008 
22:17 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
verage scarce resources efficiently, in order to ensure 
that elder justice receives the attention it deserves as 
the Nation’s population ages. 
(7) To recognize and address the role of mental 
health, disability, dementia, substance abuse, medi-
cation mismanagement, and family dysfunction prob-
lems in increasing and exacerbating elder abuse, ne-
glect, and exploitation. 
(8) To create short- and long-term strategic 
plans for the development and coordination of elder 
justice research, programs, studies, training, and 
other efforts nationwide. 
(9) To promote collaborative efforts and dimin-
ish overlap and gaps in efforts in developing the im-
portant field of elder justice. 
(10) To honor and respect the right of all indi-
viduals with diminished capacity to decisionmaking 
autonomy, self-determination, and dignity of choice. 
(11) To respect the wishes of individuals with 
diminished capacity and their family members in 
providing supportive services and care plans in-
tended to protect elders from abuse, neglect (includ-
ing self-neglect), and exploitation. 
VerDate Nov 24 2008 
22:17 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
TITLE I—DEPARTMENT OF 
HEALTH AND HUMAN SERVICES 
SEC. 101. DEFINITIONS. 
Except as otherwise specifically provided, any term 
that is defined in section 2011 of the Social Security Act 
(as added by section 102(a)) and is used in this title has 
the meaning given such term by such section. 
SEC. 102. ELDER JUSTICE. 
(a) ELDER JUSTICE.— 
(1) IN GENERAL.—Title XX of the Social Secu-
rity Act (42 U.S.C. 1397 et seq.) is amended— 
(A) in the title heading, by inserting 
‘‘AND ELDER JUSTICE’’ after ‘‘SO-
CIAL SERVICES’’; 
(B) by inserting before section 2001 the 
following: 
‘‘PART A—BLOCK GRANTS TO STATES FOR SOCIAL 
SERVICES’’; 
and 
(C) by adding at the end the following: 
‘‘PART B—ELDER JUSTICE 
‘‘SEC. 2011. DEFINITIONS. 
‘‘In this part: 
‘‘(1) ABUSE.—The term ‘abuse’ means the 
knowing infliction of physical or psychological harm 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
or the knowing deprivation of goods or services that 
are necessary to meet essential needs or to avoid 
physical or psychological harm. 
‘‘(2) ADULT PROTECTIVE SERVICES.—The term 
‘adult protective services’ means such services pro-
vided to adults as the Secretary may specify and in-
cludes services such as— 
‘‘(A) disseminating reports of adult abuse, 
neglect, or exploitation; 
‘‘(B) investigating the reports described in 
subparagraph (A); 
‘‘(C) case planning, monitoring, evaluation, 
and other case work and services; and 
‘‘(D) providing, arranging for, or facili-
tating the provision of medical, social service, 
economic, legal, housing, law enforcement, or 
other protective, emergency, or support services. 
‘‘(3) CAREGIVER.—The term ‘caregiver’ means 
an individual who has the responsibility for the care 
of an elder, either voluntarily, by contract, by receipt 
of payment for care, or as a result of the operation 
of law, and means a family member or other indi-
vidual who provides (on behalf of such individual or 
of a public or private agency, organization, or insti-
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
tution) compensated or uncompensated care to an 
elder who needs supportive services in any setting. 
‘‘(4) DIRECT
CARE.—The term ‘direct care’ 
means care by an employee or contractor who pro-
vides assistance or long-term care services to a re-
cipient. 
‘‘(5) ELDER.—The term ‘elder’ means an indi-
vidual age 60 or older. 
‘‘(6) ELDER JUSTICE.—The term ‘elder justice’ 
means— 
‘‘(A) from a societal perspective, efforts 
to— 
‘‘(i) prevent, detect, treat, intervene 
in, and prosecute elder abuse, neglect, and 
exploitation; and 
‘‘(ii) protect elders with diminished 
capacity while maximizing their autonomy; 
and 
‘‘(B) from an individual perspective, the 
recognition of an elder’s rights, including the 
right to be free of abuse, neglect, and exploi-
tation. 
‘‘(7) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means a State or local government agency, In-
dian tribe or tribal organization, or any other public 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
or private entity that is engaged in and has expertise 
in issues relating to elder justice or in a field nec-
essary to promote elder justice efforts. 
‘‘(8) EXPLOITATION.—The term ‘exploitation’ 
means the fraudulent or otherwise illegal, unauthor-
ized, or improper act or process of an individual, in-
cluding a caregiver or fiduciary, that uses the re-
sources of an elder for monetary or personal benefit, 
profit, or gain, or that results in depriving an elder 
of rightful access to, or use of, benefits, resources, 
belongings, or assets. 
‘‘(9) FIDUCIARY.—The term ‘fiduciary’— 
‘‘(A) means a person or entity with the 
legal responsibility— 
‘‘(i) to make decisions on behalf of 
and for the benefit of another person; and 
‘‘(ii) to act in good faith and with 
fairness; and 
‘‘(B) includes a trustee, a guardian, a con-
servator, an executor, an agent under a finan-
cial power of attorney or health care power of 
attorney, or a representative payee. 
‘‘(10) GRANT.—The term ‘grant’ includes a 
contract, cooperative agreement, or other mechanism 
for providing financial assistance. 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
‘‘(11) GUARDIANSHIP.—The term ‘guardian-
ship’ means— 
‘‘(A) the process by which a State court 
determines that an adult individual lacks capac-
ity to make decisions about self-care and prop-
erty, and appoints another individual or entity 
known as a guardian, as a conservator, or by a 
similar term, as a surrogate decisionmaker; 
‘‘(B) the manner in which the court-ap-
pointed surrogate decisionmaker carries out du-
ties to the individual and the court; or 
‘‘(C) the manner in which the court exer-
cises oversight of the surrogate decisionmaker. 
‘‘(12) INDIAN TRIBE.— 
‘‘(A) IN
GENERAL.—The term ‘Indian 
tribe’ has the meaning given such term in sec-
tion 4 of the Indian Self-Determination and 
Education Assistance Act (25 U.S.C. 450b). 
‘‘(B) 
INCLUSION
OF
PUEBLO
AND 
RANCHERIA.—The term ‘Indian tribe’ includes 
any Pueblo or Rancheria. 
‘‘(13) LAW ENFORCEMENT.—The term ‘law en-
forcement’ means the full range of potential re-
sponders to elder abuse, neglect, and exploitation in-
cluding— 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
‘‘(A) police, sheriffs, detectives, public safe-
ty officers, and corrections personnel; 
‘‘(B) prosecutors; 
‘‘(C) medical examiners; 
‘‘(D) investigators; and 
‘‘(E) coroners. 
‘‘(14) LONG-TERM CARE.— 
‘‘(A) IN GENERAL.—The term ‘long-term 
care’ means supportive and health services spec-
ified by the Secretary for individuals who need 
assistance because the individuals have a loss of 
capacity for self-care due to illness, disability, 
or vulnerability. 
‘‘(B) LOSS
OF
CAPACITY
FOR
SELF- 
CARE.—For purposes of subparagraph (A), the 
term ‘loss of capacity for self-care’ means an in-
ability to engage in 1 or more activities of daily 
living, including eating, dressing, bathing, and 
management of one’s financial affairs. 
‘‘(15) LONG-TERM CARE FACILITY.—The term 
‘long-term care facility’ means a residential care pro-
vider that arranges for, or directly provides, long- 
term care. 
‘‘(16) NEGLECT.—The term ‘neglect’ means— 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
‘‘(A) the failure of a caregiver or fiduciary 
to provide the goods or services that are nec-
essary to maintain the health or safety of an 
elder; or 
‘‘(B) self-neglect. 
‘‘(17) NURSING FACILITY.— 
‘‘(A) IN GENERAL.—The term ‘nursing fa-
cility’ has the meaning given such term under 
section 1919(a). 
‘‘(B) INCLUSION OF SKILLED NURSING FA-
CILITY.—The term ‘nursing facility’ includes a 
skilled nursing facility (as defined in section 
1819(a)). 
‘‘(18) SELF-NEGLECT.—The term ‘self-neglect’ 
means an adult’s inability, due to physical or mental 
impairment or diminished capacity, to perform es-
sential self-care tasks including— 
‘‘(A) obtaining essential food, clothing, 
shelter, and medical care; 
‘‘(B) obtaining goods and services nec-
essary to maintain physical health, mental 
health, or general safety; or 
‘‘(C) managing one’s own financial affairs. 
‘‘(19) SERIOUS BODILY INJURY.— 
VerDate Nov 24 2008 
21:54 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
‘‘(A) IN
GENERAL.—The term ‘serious 
bodily injury’ means an injury— 
‘‘(i) involving extreme physical pain; 
‘‘(ii) involving substantial risk of 
death; 
‘‘(iii) involving protracted loss or im-
pairment of the function of a bodily mem-
ber, organ, or mental faculty; or 
‘‘(iv) requiring medical intervention 
such as surgery, hospitalization, or phys-
ical rehabilitation. 
‘‘(B) CRIMINAL SEXUAL ABUSE.—Serious 
bodily injury shall be considered to have oc-
curred if the conduct causing the injury is con-
duct described in section 2241 (relating to ag-
gravated sexual abuse) or 2242 (relating to sex-
ual abuse) of title 18, United States Code, or 
any similar offense under State law. 
‘‘(20) SOCIAL.—The term ‘social’, when used 
with respect to a service, includes adult protective 
services. 
‘‘(21) 
STATE
LEGAL
ASSISTANCE
DEVEL-
OPER.—The term ‘State legal assistance developer’ 
means an individual described in section 731 of the 
Older Americans Act of 1965. 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
‘‘(22) STATE LONG-TERM CARE OMBUDSMAN.— 
The term ‘State Long-Term Care Ombudsman’ 
means the State Long-Term Care Ombudsman de-
scribed in section 712(a)(2) of the Older Americans 
Act of 1965. 
‘‘SEC. 2012. GENERAL PROVISIONS. 
‘‘(a) PROTECTION OF PRIVACY.—In pursuing activi-
ties under this part, the Secretary shall ensure the protec-
tion of individual health privacy consistent with the regu-
lations promulgated under section 264(c) of the Health 
Insurance Portability and Accountability Act of 1996 and 
applicable State and local privacy regulations. 
‘‘(b) RULE OF CONSTRUCTION.—Nothing in this part 
shall be construed to interfere with or abridge an elder’s 
right to practice his or her religion through reliance on 
prayer alone for healing when this choice— 
‘‘(1) is contemporaneously expressed, either 
orally or in writing, with respect to a specific illness 
or injury which the elder has at the time of the deci-
sion by an elder who is competent at the time of the 
decision; 
‘‘(2) is previously set forth in a living will, 
health care proxy, or other advance directive docu-
ment that is validly executed and applied under 
State law; or 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00018
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
‘‘(3) may be unambiguously deduced from the 
elder’s life history. 
‘‘SUBPART 1—NATIONAL COORDINATION OF ELDER 
JUSTICE ACTIVITIES AND RESEARCH 
‘‘CHAPTER I—ELDER JUSTICE COORDINATING 
COUNCIL AND ADVISORY BOARD ON ELDER 
ABUSE, NEGLECT, AND EXPLOITATION 
‘‘SEC. 2021. ELDER JUSTICE COORDINATING COUNCIL. 
‘‘(a) ESTABLISHMENT.—There is established within 
the Office of the Secretary an Elder Justice Coordinating 
Council (in this section referred to as the ‘Council’). 
‘‘(b) MEMBERSHIP.— 
‘‘(1) IN GENERAL.—The Council shall be com-
posed of the following members: 
‘‘(A) The Secretary (or the Secretary’s 
designee). 
‘‘(B) The Attorney General (or the Attor-
ney General’s designee). 
‘‘(C) The head of each Federal department 
or agency or other governmental entity identi-
fied by the Chair referred to in subsection (d) 
as having responsibilities, or administering pro-
grams, relating to elder abuse, neglect, and ex-
ploitation. 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00019
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
‘‘(2) REQUIREMENT.—Each member of the 
Council shall be an officer or employee of the Fed-
eral Government. 
‘‘(c) VACANCIES.—Any vacancy in the Council shall 
not affect its powers, but shall be filled in the same man-
ner as the original appointment was made. 
‘‘(d) CHAIR.—The member described in subsection 
(b)(1)(A) shall be Chair of the Council. 
‘‘(e) MEETINGS.—The Council shall meet at least 2 
times per year, as determined by the Chair. 
‘‘(f) DUTIES.— 
‘‘(1) IN
GENERAL.—The Council shall make 
recommendations to the Secretary for the coordina-
tion of activities of the Department of Health and 
Human Services, the Department of Justice, and 
other relevant Federal, State, local, and private 
agencies and entities, relating to elder abuse, ne-
glect, and exploitation and other crimes against el-
ders. 
‘‘(2) REPORT.—Not later than the date that is 
2 years after the date of enactment of the Elder 
Justice Act and every 2 years thereafter, the Council 
shall submit to the Committee on Finance of the 
Senate and the Committee on Ways and Means and 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00020
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
the Committee on Energy and Commerce of the 
House of Representatives a report that— 
‘‘(A) describes the activities and accom-
plishments of, and challenges faced by— 
‘‘(i) the Council; and 
‘‘(ii) the entities represented on the 
Council; and 
‘‘(B) makes such recommendations for leg-
islation, model laws, or other action as the 
Council determines to be appropriate. 
‘‘(g) POWERS OF THE COUNCIL.— 
‘‘(1) INFORMATION
FROM
FEDERAL
AGEN-
CIES.—Subject to the requirements of section 
2012(a), the Council may secure directly from any 
Federal department or agency such information as 
the Council considers necessary to carry out this sec-
tion. Upon request of the Chair of the Council, the 
head of such department or agency shall furnish 
such information to the Council. 
‘‘(2) POSTAL SERVICES.—The Council may use 
the United States mails in the same manner and 
under the same conditions as other departments and 
agencies of the Federal Government. 
‘‘(h) TRAVEL EXPENSES.—The members of the 
Council shall not receive compensation for the perform-
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00021
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
ance of services for the Council. The members shall be 
allowed travel expenses, including per diem in lieu of sub-
sistence, at rates authorized for employees of agencies 
under subchapter I of chapter 57 of title 5, United States 
Code, while away from their homes or regular places of 
business in the performance of services for the Council. 
Notwithstanding section 1342 of title 31, United States 
Code, the Secretary may accept the voluntary and uncom-
pensated services of the members of the Council. 
‘‘(i) DETAIL OF GOVERNMENT EMPLOYEES.—Any 
Federal Government employee may be detailed to the 
Council without reimbursement, and such detail shall be 
without interruption or loss of civil service status or privi-
lege. 
‘‘(j) STATUS AS PERMANENT COUNCIL.—Section 14 
of the Federal Advisory Committee Act (5 U.S.C. App.) 
shall not apply to the Council. 
‘‘SEC. 2022. ADVISORY BOARD ON ELDER ABUSE, NEGLECT, 
AND EXPLOITATION. 
‘‘(a) ESTABLISHMENT.—There is established a board 
to be known as the ‘Advisory Board on Elder Abuse, Ne-
glect, and Exploitation’ (in this section referred to as the 
‘Advisory Board’) to create short- and long-term multi-
disciplinary strategic plans for the development of the field 
of elder justice and to make recommendations to the Elder 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00022
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS
Justice Coordinating Council established under section 
2021. 
‘‘(b) COMPOSITION.—The Advisory Board shall be 
composed of 27 members appointed by the Secretary from 
among members of the general public who are individuals 
with experience and expertise in elder abuse, neglect, and 
exploitation prevention, detection, treatment, intervention, 
or prosecution. 
‘‘(c) SOLICITATION
OF NOMINATIONS.—The Sec-
retary shall publish a notice in the Federal Register solic-
iting nominations for the appointment of members of the 
Advisory Board under subsection (b). 
‘‘(d) TERMS.— 
‘‘(1) IN GENERAL.—Each member of the Advi-
sory Board shall be appointed for a term of 3 years, 
except that, of the members first appointed— 
‘‘(A) 9 shall be appointed for a term of 3 
years; 
‘‘(B) 9 shall be appointed for a term of 2 
years; and 
‘‘(C) 9 shall be appointed for a term of 1 
year. 
‘‘(2) VACANCIES.— 
‘‘(A) IN GENERAL.—Any vacancy on the 
Advisory Board shall not affect its powers, but 
VerDate Nov 24 2008 
03:07 Apr 23, 2009
Jkt 079200
PO 00000
Frm 00023
Fmt 6652
Sfmt 6201
E:\BILLS\H2006.IH
H2006
jbell on PROD1PC69 with BILLS