the Secretary and the Attorney General deter-
mine to be appropriate. 
‘‘(2) GOALS.—The goals of the study author-
ized in paragraph (1) (which may be conducted in 
distinct sections, if there is overall coordination) 
are— 
‘‘(A) to identify gaps in the detection of, 
investigation of, and intervention in elder abuse, 
neglect, and exploitation; 
‘‘(B) to improve the response to elder 
abuse, neglect, and exploitation; and 
‘‘(C) to reduce elder victimization and its 
consequences by assessing and improving the 
systems created to address reports of elder 
abuse, neglect, and exploitation. 
‘‘(3) AUTHORIZED ACTIVITIES.—In conducting 
the study authorized in paragraph (1), the Director 
shall— 
‘‘(A) conduct an evaluation of— 
‘‘(i) how the social and protective 
service, advocacy, protection, judicial, and 
law enforcement entities and systems are 
operating; 
‘‘(ii) the interplay and allocation of re-
sponsibilities among those entities; 
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‘‘(iii) how that allocation differs from 
community to community and State to 
State; and 
‘‘(iv) how those differences impact the 
population intended to be protected by the 
entities and systems; 
‘‘(B) make recommendations on how to 
clarify the roles (at the Federal level) of entities 
such as State agencies with responsibility for 
adult protective services, the State Long-Term 
Care Ombudsmen, and other protection and ad-
vocacy entities to enhance efficiency, eliminate 
gaps in service, and identify conflicting man-
dates and duplication of efforts; and 
‘‘(C) evaluate how various communities de-
lineate the roles and responsibilities of the types 
of entities described in subparagraph (A) in 
order to identify and recommend effective mod-
els and methods to duplicate the delineation ef-
forts (such as duplication through memoranda 
of understanding). 
‘‘(4) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this subsection $2,000,000 for each of fiscal years 
2007 through 2013. 
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‘‘(b) FAMILY ELDER ABUSE, NEGLECT, AND EX-
PLOITATION STUDY.— 
‘‘(1) IN GENERAL.—The Director of the Cen-
ters for Disease Control and Prevention (in this sub-
section referred to as the ‘Director’), after consulta-
tion with the Director of the Office of Elder Justice 
in the Department of Health and Human Services 
and the Director of the Office of Elder Justice in 
the Department of Justice, shall conduct a study to 
determine the best method to address elder abuse, 
neglect, and exploitation from a public health per-
spective, including examining methods to reduce 
elder abuse, neglect, and exploitation committed by 
family members. 
‘‘(2) COLLABORATION.—The Director, in car-
rying out activities under this subsection, shall col-
laborate with the Director of the National Institute 
on Aging, the Director of the Office of Elder Justice 
in the Department of Health and Human Services, 
the Director of the Office of Elder Justice in the 
Department of Justice, the heads of State agencies 
with responsibility for adult protective services, and 
the heads of such other entities as the Director de-
termines appropriate. 
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‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this subsection— 
‘‘(A) $1,500,000 for fiscal year 2007; and 
‘‘(B) $2,000,000 for each of fiscal years 
2008 through 2013. 
‘‘SEC. 2224. FORENSIC MARKERS, METHODOLOGIES, AND 
TRAINING. 
‘‘(a) FORENSIC CENTERS.— 
‘‘(1) GRANTS.—The Secretary shall make 
grants to appropriate entities to establish and oper-
ate stationary and mobile forensic centers, to de-
velop forensic expertise regarding, and provide serv-
ices relating to, elder abuse, neglect, and exploi-
tation. 
‘‘(2) COORDINATION
AMONG
FORENSIC
CEN-
TERS AND CENTERS OF EXCELLENCE.—The entities 
establishing and operating the forensic centers shall 
coordinate activities on an ongoing basis with the 
Centers 
of 
Excellence 
described 
in 
section 
2222(b)(1). Such coordination shall include ongoing 
communication among the entities and the Centers 
of Excellence. The entities shall adhere to proce-
dures and mechanisms developed by the Secretary, 
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including procedures and mechanisms relating to the 
sharing of data. 
‘‘(3) STATIONARY
FORENSIC
CENTERS.—The 
Secretary shall make 4 of the grants described in 
paragraph (1) to institutions of higher education 
with demonstrated expertise in forensics or commit-
ment to preventing or treating elder abuse, neglect, 
or exploitation, to establish and operate stationary 
forensic centers. The Secretary shall make at least 
2 of the 4 grants to an entity operating a Center of 
Excellence described in section 2222(b)(1) at an in-
stitution of higher education. 
‘‘(4) MOBILE
CENTERS.—The Secretary shall 
make 6 of the grants described in paragraph (1) to 
appropriate entities to establish and operate mobile 
forensic centers. 
‘‘(5) USE OF FUNDS.— 
‘‘(A) DEVELOPMENT OF FORENSIC MARK-
ERS AND METHODOLOGIES.—An entity that re-
ceives a grant under this subsection shall use 
funds made available through the grant to as-
sist in the determination of whether abuse or 
neglect occurred, or a crime was committed, 
and to conduct research to describe and dis-
seminate information on— 
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‘‘(i) forensic markers that indicate a 
case in which elder abuse, neglect, or ex-
ploitation may have occurred; and 
‘‘(ii) methodologies for determining, in 
such a case, when and how health care, 
emergency service, social and protective 
service, and legal service providers should 
intervene and when the providers should 
report the case to law enforcement authori-
ties. 
‘‘(B) APPLICATIONS.—An entity that re-
ceives a grant under this subsection shall use 
funds made available through the grant to de-
velop forensic expertise regarding elder abuse, 
neglect, and exploitation, in order to provide 
medical and forensic evaluation, therapeutic 
intervention, victim support and advocacy, case 
review, and case tracking. 
‘‘(C) COLLECTION OF EVIDENCE.—An en-
tity operating a Center of Excellence described 
in section 2222(b)(1) that receives a grant 
under this subsection shall use funds made 
available through the grant to develop the ca-
pacity to collect forensic evidence, including col-
lecting forensic evidence relating to a potential 
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determination of elder abuse, neglect, or exploi-
tation. 
‘‘(6) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this subsection— 
‘‘(A) $4,000,000 for fiscal year 2007; 
‘‘(B) $6,000,000 for fiscal year 2008; and 
‘‘(C) $8,000,000 for each of fiscal years 
2009 through 2013. 
‘‘(b) TRAINING TO DEVELOP EXPERTISE IN GERI-
ATRIC FORENSICS.— 
‘‘(1) FELLOWSHIP PROGRAMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
award fellowships to eligible individuals, to en-
able the individuals to obtain training through 
a standard forensic science training program. 
‘‘(B) ELIGIBLE INDIVIDUALS.—To be eligi-
ble to receive a fellowship under this paragraph, 
an individual shall be a physician who— 
‘‘(i) is board certified or board eligible 
in internal medicine or family practice; 
‘‘(ii) has completed a program in geri-
atrics that meets such criteria as the Sec-
retary may prescribe; and 
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‘‘(iii) has entered into an agreement 
with the Secretary to provide the team 
training described in subparagraph (C), 
after receiving the training described in 
subparagraph (A). 
‘‘(C) TEAM TRAINING.—An individual who 
receives a fellowship under this paragraph shall 
provide training in forensic geriatrics to inter-
disciplinary teams of health care professionals. 
‘‘(2) ADDITIONAL PROGRAMS.—In addition to 
the fellowships awarded under paragraph (1), the 
Secretary shall establish programs, and make grants 
to carry out such programs, that are designed to 
provide forensic training to experienced geriatricians. 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated to carry out 
this subsection $5,000,000 for each of fiscal years 
2007 through 2013. 
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‘‘Subtitle C—Increasing Security, 
Quality, and Consumer Informa-
tion for Long-Term Care 
‘‘CHAPTER 1—INCREASING SECURITY FOR 
LONG-TERM CARE 
‘‘SEC. 2231. REPORTING TO LAW ENFORCEMENT OF CRIMES 
OCCURRING IN FEDERALLY FUNDED LONG- 
TERM CARE FACILITIES. 
‘‘(a) REPORTING REQUIREMENT.— 
‘‘(1) IN GENERAL.—Each individual who is an 
owner, operator, employee, manager, agent, or con-
tractor of a long-term care facility that is described 
in subsection (b)(1) shall report to 1 or more law en-
forcement entities for the jurisdiction in which the 
facility is located any reasonable suspicion of a crime 
(as defined by the law of the applicable political sub-
division) against any person who is a resident of or 
receiving care from the facility. 
‘‘(2) TIMING.—If the events that cause the sus-
picion— 
‘‘(A) result in serious bodily injury, the in-
dividual shall report the suspicion immediately; 
and 
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‘‘(B) do not result in serious bodily injury, 
the individual shall report the suspicion not 
later than 24 hours after forming the suspicion. 
‘‘(b) LONG-TERM CARE FACILITY DESCRIBED.— 
‘‘(1) LONG-TERM CARE FACILITY.—A long-term 
care facility is described in this paragraph if such 
facility will receive at least $10,000 in Federal funds 
during a year. 
‘‘(2) NOTIFICATION.—In the case of a long- 
term facility described in paragraph (1), the owner 
or operator shall annually notify each individual de-
scribed in subsection (a)(1) of the obligation to com-
ply with subsection(a). 
‘‘(c) PENALTY.— 
‘‘(1) IN GENERAL.—If an individual described 
in subsection (a)(1) violates subsection (a)— 
‘‘(A) the individual shall be fined not more 
than $200,000 or subject to a civil money pen-
alty of not more than $200,000; or 
‘‘(B) the Secretary shall classify the indi-
vidual as an excluded individual for a period of 
not more than 3 years. 
‘‘(2) INCREASED HARM.—If an individual de-
scribed in subsection (a)(1) violates subsection (a), 
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and the violation exacerbates the harm to the victim 
of the crime or results in harm to another person— 
‘‘(A) the individual shall be fined not more 
than $300,000 or subject to a civil money pen-
alty of not more than $300,000; and 
‘‘(B) the Secretary shall classify the indi-
vidual as an excluded individual for a period of 
not more than 3 years. 
‘‘(3) EXCLUDED INDIVIDUAL.—During any pe-
riod for which an individual is classified as an ex-
cluded individual under this paragraph, an entity 
that employs the individual shall be ineligible to re-
ceive Federal funds. 
‘‘(4) 
EXTENUATING
CIRCUMSTANCES.—The 
Secretary may take into account the financial bur-
den on providers with underserved populations in de-
termining the penalty. 
‘‘(d) REGULATIONS.—The Secretary, after consulting 
with the Attorney General, shall issue regulations to carry 
out this section. 
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‘‘CHAPTER 2—IMPROVING THE QUALITY 
OF LONG-TERM CARE 
‘‘SEC. 2241. GRANTS AND INCENTIVES TO ENHANCE LONG- 
TERM CARE STAFFING. 
‘‘(a) GENERAL AUTHORITY.—The Administrator of 
the Centers for Medicare & Medicaid Services (in this sec-
tion referred to as the ‘Administrator’) shall carry out ac-
tivities, including activities described in subsections (b) 
and (c), to provide incentives for individuals to train for, 
seek, and maintain employment providing direct care in 
a long-term care facility. 
‘‘(b) SPECIFIC PROGRAMS TO ENHANCE TRAINING, 
RECRUITMENT, AND RETENTION OF STAFF.— 
‘‘(1) COORDINATION
WITH
OTHER
PROGRAMS 
TO RECRUIT AND TRAIN LONG-TERM CARE STAFF.— 
The Administrator shall coordinate activities with 
the Secretary of Labor and the Assistant Secretary 
for the Administration for Children and Families, in 
order to provide incentives to participants in pro-
grams carried out under section 403(a)(5) and part 
A of title IV to train for and seek employment pro-
viding direct care in a long-term care facility. 
‘‘(2) CAREER LADDERS AND WAGE OR BENEFIT 
INCREASES TO INCREASE STAFFING IN LONG-TERM 
CARE FACILITIES.— 
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