I 
117TH CONGRESS 
1ST SESSION H. R. 5241 
To amend title XX of the Social Security Act to provide grants to States 
to support linkages to legal services and medical legal partnerships. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 10, 2021 
Ms. SPANBERGER (for herself and Mr. KATKO) introduced the following bill; 
which was referred to the Committee on Ways and Means 
A BILL 
To amend title XX of the Social Security Act to provide 
grants to States to support linkages to legal services 
and medical legal partnerships. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Linking Seniors to 
Needed Legal Services Act of 2021’’. 
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SEC. 2. INCENTIVES FOR DEVELOPING AND SUSTAINING 
STRUCTURAL COMPETENCY IN PROVIDING 
HEALTH AND HUMAN SERVICES. 
(a) IN GENERAL.—Part II of subtitle B of title XX 
of the Social Security Act (42 U.S.C. 1397m–5) is amend-
ed by adding at the end the following: 
‘‘SEC. 2047. INCENTIVES FOR DEVELOPING AND SUS-
TAINING STRUCTURAL COMPETENCY IN PRO-
VIDING HEALTH AND HUMAN SERVICES. 
‘‘(a) GRANTS TO STATES TO SUPPORT LINKAGES TO 
LEGAL
SERVICES
AND
MEDICAL
LEGAL
PARTNER-
SHIPS.— 
‘‘(1) IN GENERAL.—Within 2 years after the 
date of the enactment of this section, the Secretary 
shall establish and administer a program of grants 
to States to support the adoption of evidence-based 
approaches to establishing or improving and main-
taining real-time linkages between health and social 
services and supports for vulnerable elders or in con-
junction with authorized representatives of vulner-
able elders, including through the following: 
‘‘(A) MEDICAL-LEGAL
PARTNERSHIPS.— 
The establishment and support of medical-legal 
partnerships, the incorporation of the partner-
ships in the elder justice framework and health 
and human services safety net, and the imple-
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mentation and operation of such a partnership 
by an eligible grantee— 
‘‘(i) at the option of a State, in con-
junction with an area agency on aging; 
‘‘(ii) in a solo provider practice in a 
health professional shortage area (as de-
fined in section 332(a) of the Public 
Health Service Act), a medically under-
served community (as defined in section 
399V of such Act), or a rural area (as de-
fined in section 330J of such Act); 
‘‘(iii) in a minority-serving institution 
of higher learning with health, law, and so-
cial services professional programs; 
‘‘(iv) in a federally qualified health 
center, as described in section 330 of the 
Public Health Service Act, or look-alike, as 
described in section 1905(l)(2)(B) of this 
Act; or 
‘‘(v) in certain hospitals that are crit-
ical access hospitals, Medicare-dependent 
hospitals, sole community hospitals, rural 
emergency hospitals, or that serve a high 
proportion of Medicare or Medicaid pa-
tients. 
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‘‘(B) LEGAL HOTLINES DEVELOPMENT OR 
EXPANSION.—The provision of incentives to de-
velop, enhance, and integrate platforms, such as 
legal assistance hotlines, that help to facilitate 
the identification of older adults who could ben-
efit from linkages to available legal services 
such as those described in subparagraph (A). 
‘‘(2) STATE REPORTS.—Each State to which a 
grant is made under this subsection shall submit to 
the Secretary biannual reports on the activities car-
ried out by the State pursuant to this subsection, 
which shall include assessments of the effectiveness 
of the activities with respect to— 
‘‘(A) the number of unique individuals 
identified through the mechanism outlined in 
paragraph (1)(B) who are referred to services 
described in paragraph (1)(A), and the average 
time period associated with resolving issues; 
‘‘(B) the success rate for referrals to com-
munity-based resources; and 
‘‘(C) other factors determined relevant by 
the Secretary. 
‘‘(3) EVALUATION.—The Secretary shall, by 
grant, contract, or interagency agreement, evaluate 
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the activities conducted pursuant to this subsection, 
which shall include a comparison among the States. 
‘‘(4) REPORT
TO
THE
CONGRESS.—Every 4 
years, the Secretary shall submit to the Congress a 
written report on the activities conducted under this 
subsection. 
‘‘(5) APPROPRIATION.—Out of any money in 
the Treasury not otherwise appropriated, there are 
appropriated to the Secretary $125,000,000 for each 
of fiscal years 2022 through 2025 to carry out this 
subsection. 
‘‘(6) SUPPLEMENT
NOT
SUPPLANT.—Support 
provided to area agencies on aging, State units on 
aging, eligible entities, or other community-based or-
ganizations pursuant to this subsection shall be used 
to supplement and not supplant any other Federal, 
State, or local funds expended to provide the same 
or comparable services described in this subsection. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) AREA AGENCY ON AGING.—The term ‘area 
agency on aging’ means an area agency on aging 
designated under section 305 of the Older Ameri-
cans Act of 1965. 
‘‘(2) COMMUNITY-BASED ORGANIZATION.—The 
term ‘community-based organization’ includes, ex-
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cept as otherwise provided by the Secretary, a non-
profit community-based organization, a consortium 
of nonprofit community-based organizations, a na-
tional nonprofit organization acting as an inter-
mediary for a community-based organization, or a 
community-based organization that has a fiscal 
sponsor that allows the organization to function as 
an organization described in section 501(c)(3) of the 
Internal Revenue Code of 1986 and exempt from 
taxation under section 501(a) of such Code.’’. 
(b) CLARIFICATION THAT MEDICAL-LEGAL PART-
NERSHIPS ARE AUTHORIZED ADULT PROTECTIVE SERV-
ICES ACTIVITIES.—Section 2011 of such Act (42 U.S.C. 
1397j) is amended— 
(1) in paragraph (2)(D), by inserting ‘‘, includ-
ing through a medical-legal partnership’’ before the 
period; and 
(2) by redesignating paragraphs (16) through 
(22) as paragraphs (17) through (23), respectively, 
and inserting after paragraph (15) the following: 
‘‘(16) 
MEDICAL-LEGAL
PARTNERSHIP.—The 
term ‘medical-legal partnership’ means an arrange-
ment in a health care or social services setting which 
integrates lawyers and social workers to address the 
needs of an individual patient related to social deter-
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minants of health, and to help clinicians, case man-
agers, and social workers address structural prob-
lems at the root of many health inequities, including 
a multidisciplinary team integrated into such a set-
ting to address the needs and establish and maintain 
structural competence within clinicians, case man-
agers, and social workers to best address structural 
problems at the root of many health inequities.’’. 
Æ 
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