I 
109TH CONGRESS 
2D SESSION 
H. R. 4993 
To amend the Social Security Act to enhance the Social Security of the 
Nation by ensuring adequate public-private infrastructure and to resolve 
to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, 
and exploitation, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 16, 2006 
Mr. KING of New York (for himself, Mr. EMANUEL, Mr. MCHUGH, Mr. LAN-
TOS, Mrs. MALONEY, Ms. SCHAKOWSKY, Mr. KIND, Ms. BALDWIN, Mrs. 
NAPOLITANO, Mr. STARK, Mr. VAN HOLLEN, Mr. WEINER, Mr. OBER-
STAR, Mr. OWENS, Mr. GRIJALVA, Mr. MORAN
of Virginia, Mr. 
DOGGETT, Mr. KENNEDY of Rhode Island, Mr. DELAHUNT, Mr. MCNUL-
TY, Mr. TOWNS, and Mr. RANGEL) introduced the following bill; which 
was referred to the Committee on Ways and Means, and in addition to 
the Committees on the Judiciary, Energy and Commerce, and Education 
and the Workforce, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To amend the Social Security Act to enhance the Social 
Security of the Nation by ensuring adequate public-pri-
vate infrastructure and to resolve to prevent, detect, 
treat, intervene in, and prosecute elder abuse, neglect, 
and exploitation, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Elder Justice Act’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
Sec. 3. Purposes. 
TITLE I—DEPARTMENT OF HEALTH AND HUMAN SERVICES 
Sec. 101. Amendment to the Social Security Act. 
Sec. 102. Supporting the long-term care ombudsman program. 
Sec. 103. Adult protective services functions and grant programs. 
Sec. 104. Assuring safety of residents when nursing facilities close. 
Sec. 105. National nurse aide registry. 
Sec. 106. Background checks on direct access employees of long-term care fa-
cilities or providers. 
TITLE II—DEPARTMENT OF JUSTICE 
Sec. 201. Model State laws and practices. 
Sec. 202. Office of Elder Justice of the Department of Justice. 
Sec. 203. Victim advocacy grants. 
Sec. 204. Supporting local prosecutors in elder justice matters. 
Sec. 205. Supporting state prosecutors in elder justice matters. 
Sec. 206. Increased support for federal cases involving elder justice. 
Sec. 207. Supporting law enforcement in elder justice matters. 
Sec. 208. Evaluations. 
TITLE III—TAX PROVISIONS 
Sec. 301. Long-term care facility worker employment tax credit. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) The proportion of the United States popu-
lation age 60 years or older will drastically increase 
in the next 30 years as 77,000,000 baby boomers 
approach retirement and old age. 
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(2) Each year, anywhere between 500,000 and 
5,000,000 elders in the United States are abused, 
neglected, or exploited. 
(3) Elder abuse, neglect, and exploitation have 
no boundaries, and cross all racial, social class, gen-
der, and geographic lines. 
(4) Victims of elder abuse, neglect, and exploi-
tation are not only subject to injury from mistreat-
ment and neglect, they are also 3.1 times more likely 
to die at an earlier age than expected than elders 
who were not victims of elder abuse, neglect, and ex-
ploitation. 
(5) There is a general dearth of data as to the 
nature and scope of elder abuse, neglect, and exploi-
tation. 
(6) Despite the dearth of data in the field, ex-
perts agree that most cases of elder abuse, neglect, 
and exploitation are never reported and that abuse 
and neglect shorten a victim’s life, often triggering 
a downward spiral of an otherwise productive, self- 
sufficient elder’s life. Programs addressing other dif-
ficult issues such as domestic violence and child 
abuse and neglect have demonstrated the need for a 
multi-faceted law combining public health, social 
service, and law enforcement approaches. 
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(7) For over 20 years, Congress has been pre-
sented with facts and testimony calling for a coordi-
nated Federal effort to combat elder abuse, neglect, 
and exploitation. 
(8) The Federal Government has been slow to 
respond to the needs of victims of elder abuse, ne-
glect, and exploitation or to undertake prevention ef-
forts. 
(9) No Federal law has been enacted that ade-
quately and comprehensively addresses the issues of 
elder abuse, neglect, and exploitation and there are 
very limited resources available to those in the field 
directly dealing with these issues. 
(10) Differences in State laws and practices in 
the areas of elder abuse, neglect, and exploitation 
lead to significant disparities in prevention, protec-
tive and social services, treatment systems, and law 
enforcement, and lead to other inequities. 
(11) The Federal Government has played an 
important role in promoting research, training, pub-
lic safety, data collection, the identification, develop-
ment, and dissemination of promising health care, 
social, and protective services, and law enforcement 
practices relating to child abuse and neglect, domes-
tic violence, and violence against women. The Fed-
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eral Government should promote similar efforts and 
protections relating to elder abuse, neglect, and ex-
ploitation. 
(12) The Federal Government should provide 
leadership and assist States and communities in 
their efforts to protect elders in the United States 
by— 
(A) promoting coordinated planning among 
all levels of government; 
(B) generating and sharing knowledge rel-
evant to protecting elders; 
(C) providing leadership to combat the 
abuse, neglect, and exploitation of the Nation’s 
elders; and 
(D) providing resources to States and com-
munities to promote elder justice. 
(13) The problem of elder abuse, neglect, and 
exploitation requires a comprehensive approach 
that— 
(A) integrates the work of health, legal, 
and social service agencies and organizations; 
(B) emphasizes the need for prevention, re-
porting, investigation, assessment, treatment, 
and prosecution of elder abuse, neglect, and ex-
ploitation at all levels of government; 
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