Title: Elder Justice Reauthorization and Modernization Act of 2021
Policy area: Social Welfare

Summary:
Elder Justice Reauthorization and Modernization Act of 2021
This bill reauthorizes, provides funding through FY2025 for, and otherwise makes changes to programs for preventing, detecting, and treating abuse, neglect, and exploitation of older adults.
Specifically, the bill provides funding for states and localities to enhance adult protective services and long-term care ombudsman programs.
Additionally, the bill modifies an existing long-term care workforce grant program, including by requiring that grant recipients use funds to provide employees with wage subsidies, educational assistance, and access to affordable child care and transportation. Furthermore, the bill establishes new grant programs for states to (1) link health care and social services for older adults, including through medical-legal partnerships and legal services hotlines; and (2) prevent and address social isolation among older adults and individuals with disabilities.
The bill also provides funding for reporting by the Department of Health and Human Services on the effectiveness of various programs and activities in addressing abuse, neglect, and exploitation of older adults.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4969 Introduced in House (IH)]

<DOC>






117th CONGRESS
  1st Session
                                H. R. 4969

   To reauthorize funding for programs to prevent, investigate, and 
    prosecute elder abuse, neglect, and exploitation, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 6, 2021

Mr. Neal (for himself and Ms. Bonamici) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addition 
to the Committees on Energy and Commerce, Education and Labor, and the 
 Judiciary, 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 reauthorize funding for programs to prevent, investigate, and 
    prosecute elder abuse, neglect, and exploitation, and for other 
                               purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Elder Justice Reauthorization and 
Modernization Act of 2021''.

SEC. 2. REAUTHORIZATION OF FUNDING FOR PROGRAMS TO PREVENT, AND 
              INVESTIGATE ELDER ABUSE, NEGLECT, AND EXPLOITATION.

    (a) Nursing Home Worker Training Grants.--Section 2041 of the 
Social Security Act (42 U.S.C. 1397m) is amended to read as follows:

``SEC. 2041. NURSING HOME WORKER TRAINING GRANTS.

    ``(a) In General.--
            ``(1) State entitlement.--
                    ``(A) In general.--Each State shall be entitled to 
                receive from the Secretary for each fiscal year 
                specified in subsection (e)(1) a grant in an amount 
                equal to the amount allotted to the State under 
                subparagraph (B).
                    ``(B) State allotments.--
                            ``(i) In general.--Subject to clauses (ii) 
                        and (iii), the amount allotted to a State under 
                        this subparagraph for a fiscal year shall be--
                                    ``(I) the number of State residents 
                                who have attained 65 years of age or 
                                are under a disability (as defined in 
                                section 216(i)(1)), as determined by 
                                the Secretary using the most recent 
                                version of the American Community 
                                Survey published by the Bureau of the 
                                Census or a successor data set; divided 
                                by
                                    ``(II) the total number of such 
                                residents of all States.
                            ``(ii) Limitation.--The amount allotted to 
                        a State under this subparagraph for a fiscal 
                        year shall be not less than 0.25 percent of the 
                        available amount for the fiscal year.
                            ``(iii) Adjustment of state allotments.--
                        Subject to clause (ii), the Secretary shall 
                        proportionately increase or decrease the 
                        amounts allotted under this subparagraph for a 
                        fiscal year as necessary to ensure that the 
                        available amount for the fiscal year is 
                        allotted among the States.
                            ``(iv) Redeterminations.--
                                    ``(I) Frequency.--The Secretary 
                                shall make the determination referred 
                                to in clause (i)(I) every 5 years.
                                    ``(II) Limitation.--Subject to 
                                clause (ii), the amount allotted to a 
                                State under this subparagraph, on the 
                                basis of such a determination, for a 
                                fiscal year after fiscal year 2026 
                                shall be--
                                            ``(aa) not less than 90 
                                        percent of the amount of the 
                                        grant made to the State under 
                                        this subparagraph for the then 
                                        preceding fiscal year; and
                                            ``(bb) not more than 110 
                                        percent of the amount referred 
                                        to in item (aa).
            ``(2) Grants to indian tribes and tribal organizations.--
                    ``(A) In general.--The Secretary, in consultation 
                with the Secretary of the Interior, shall make grants 
                in accordance with this section to Indian tribes and 
                tribal organizations who operate at least 1 eligible 
                setting.
                    ``(B) Grant formula.--The Secretary, in 
                consultation with the Secretary of the Interior, shall 
                devise a formula for distributing among Indian tribes 
                and tribal organizations the amount required to be 
                reserved by subsection (e)(1) for each fiscal year.
            ``(3) Sub-grants.--A State, Indian tribe, or tribal 
        organization to which an amount is paid under this section may 
        use the amount to make sub-grants to local organizations, 
        including community organizations, local non-profits, elder 
        rights and justice groups, and workforce development boards for 
        any purpose described in paragraph (1) or (2) of subsection 
        (b).
    ``(b) Use of Funds.--
            ``(1) Required uses.--A State to which an amount is paid 
        under this section shall use the amount to--
                    ``(A) provide wage subsidies to eligible 
                individuals;
                    ``(B) provide student loan repayment or tuition 
                assistance to eligible individuals for a degree or 
                certification in a field relevant to their position 
                referred to in subsection (f)(1)(A);
                    ``(C) guarantee affordable and accessible child 
                care for eligible individuals, including help with 
                referrals, co-pays, or other direct assistance; and
                    ``(D) provide assistance where necessary with 
                obtaining appropriate transportation, including public 
                transportation if available, or gas money if public 
                transportation is unavailable or impractical based on 
                work hours or location.
            ``(2) Authorized uses.--A State to which an amount is paid 
        under this section may use the amount to--
                    ``(A) establish a reserve fund for financial 
                assistance to eligible individuals in emergency 
                situations;
                    ``(B) provide in-kind resource donations, such as 
                interview clothing and conference attendance fees;
                    ``(C) provide assistance with programs and 
                activities, including legal assistance, deemed 
                necessary to address arrest or conviction records that 
                are an employment barrier;
                    ``(D) support employers operating an eligible 
                setting in the State in providing employees with not 
                less than 2 weeks of paid leave per year; or
                    ``(E) provide other support services the Secretary 
                deems necessary to allow for successful recruitment and 
                retention of workers.
            ``(3) Provision of funds only for the benefit of eligible 
        individuals in eligible settings.--A State to which an amount 
        is paid under this section may provide the amount to only an 
        eligible individual or a partner organization serving an 
        eligible individual.
            ``(4) Nonsupplantation.--A State to which an amount is paid 
        under this section shall not use the amount to supplant the 
        expenditure of any State funds for recruiting or retaining 
        employees in an eligible setting.
            ``(5) Obligation deadline.--A State, Indian tribe, or 
        tribal organization shall remit to the Secretary for 
        reallotment under this section any amount paid under this 
        section for a fiscal year that is not obligated within 2 years 
        after the end of the fiscal year.
    ``(c) Administration.--A State to which a grant is made under this 
section shall reserve not more than 10 percent of the grant to--
            ``(1) administer subgrants in accordance with this section;
            ``(2) provide technical assistance and support for applying 
        for and accessing such a subgrant opportunity;
            ``(3) publicize the availability of the subgrants;
            ``(4) carry out activities to increase the supply of 
        eligible individuals; and
            ``(5) provide technical assistance to help subgrantees find 
        and train individuals to provide the services for which they 
        are contracted.
    ``(d) Reports.--
            ``(1) State reports.--Not less frequently than annually, 
        each State to which a grant has been made under this section 
        shall transmit to the Secretary a written report describing the 
        activities undertaken by the State pursuant to this section 
        during the period covered by the report, which shall include--
                    ``(A) the total amount expended in the State for 
                each type of use described in paragraph (1) or (2) of 
                subsection (b);
                    ``(B) the total number of non-State organizations 
                in the State to which grant funds were provided, and 
                the amount so provided to each such organization;
                    ``(C) the change in the number of individuals 
                working in each job category described in subsection 
                (f)(1)(A) in an eligible setting in the State;
                    ``(D) the average duration of employment for each 
                such job category;
                    ``(E) the average annual wage of workers in each 
                job category described in subsection (f)(1)(A) in an 
                eligible setting in the State;
                    ``(F) the average amount of paid time off to which 
                a worker in each job category described in subsection 
                (f)(1)(A) in an eligible setting in the State is 
                entitled by their contract; and
                    ``(G) such other data elements as the Secretary 
                deems relevant.
            ``(2) Report to the congress.--Not later than 3 years after 
        the date of the enactment of this section, and every 4 years 
        thereafter, the Secretary shall submit to the Congress a 
        written report outlining how the States have used the grants 
        made under this section during the period covered by the 
        report, which shall include--
                    ``(A) the total amount expended in each State for 
                each type of use described in paragraph (1) or (2) of 
                subsection (b);
                    ``(B) the total number of non-State organizations 
                in each State to which grant funds were provided, and 
                the amount so provided to each such organization;
                    ``(C) the change in the number of individuals 
                working in each job category described in subsection 
                (f)(1)(A) in an eligible setting;
                    ``(D) the average duration of employment for each 
                such job category, by State;
                    ``(E) the average annual wage of workers in each 
                job category described in subsection (f)(1)(A) in an 
                eligible setting;
                    ``(F) the average amount of paid time off to which 
                a worker in each job category described in subsection 
                (f)(1)(A) in an eligible setting is entitled by their 
                contract; and
                    ``(G) such other data elements as the Secretary 
                deems relevant.
    ``(e) Appropriation.--Out of any funds in the Treasury not 
otherwise appropriated, there is appropriated to the Secretary 
$400,000,000 for each of fiscal years 2022 through 2025 to carry out 
this section, of which 2 percent shall be reserved for grants to Indian 
tribes and tribal organizations.
    ``(f) Definitions.--In this section:
            ``(1) Available amount.--The term `available amount' means, 
        with respect to a fiscal year, the amount specified in 
        subsection (e) that remains after the reservation required by 
        such subsection for the fiscal year, plus all amounts remitted 
        to the Secretary under subsection (b)(5) that have not been 
        reallotted under subsection (a)(1)(B)(iii).
            ``(2) Eligible individual.--The term `eligible individual' 
        means an individual who--
                    ``(A)(i) is a qualified home health aide, as 
                defined in section 484.80(a) of title 42, Code of 
                Federal Regulations;
                    ``(ii) is a nurse aide approved by the State as 
                meeting the requirements of sections 483.150 through 
                483.154 of such title, and is listed in good standing 
                on the State nurse aide registry;
                    ``(iii) is a personal care aide approved by the 
                State, and furnishes personal care services, as defined 
                in section 440.167 of such title;
                    ``(iv) is a qualified hospice aide, as defined in 
                section 418.76 of such title;
                    ``(v) is a licensed practical nurse or a licensed 
                or certified social worker; or
                    ``(vi) is receiving training to be certified or 
                licensed as such an aide, nurse, or social worker; and
                    ``(B) provides (or, in the case of a trainee, 
                intends to provide) services as such an aide, nurse, or 
                social worker in an eligible setting.
            ``(3) Eligible setting.--The term `eligible setting' 
        means--
                    ``(A) a skilled nursing facility, as defined in 
                section 1819;
                    ``(B) a nursing facility, as defined in section 
                1919;
                    ``(C) a home health agency, as defined in section 
                1891;
                    ``(D) a facility approved to deliver home or 
                community-based services authorized under State options 
                described in subsection (c) or (i) of section 1915 or, 
                as relevant, demonstration projects authorized under 
                section 1115;
                    ``(E) a hospice, as defined in section 1814; or
                    ``(F) a tribal assisted living facility.
            ``(4) Tribal organization.--The term `tribal organization' 
        has the meaning given the term in section 4 of the Indian Self-
        Determination and Education Assistance Act.''.
    (b) Adult Protective Services Functions and Grant Programs.--
            (1) Direct funding; state entitlement.--Section 2042 of the 
        Social Security Act (42 U.S.C. 1397m-1) is amended--
                    (A) in subsection (a), by striking paragraph (2) 
                and inserting the following:
            ``(2) Appropriation.--Out of any money in the Treasury not 
        otherwise appropriated, there are appropriated to the Secretary 
        $8,000,000 for each of fiscal years 2023 through 2025 to carry 
        out this section.'';
                    (B) in subsection (b)--
                            (i) in paragraph (2), by striking ``the 
                        availability of appropriations and''; and
                            (ii) by striking paragraph (5) and 
                        inserting the following:
            ``(5) Appropriation.--Out of any money in the Treasury not 
        otherwise appropriated, there are appropriated to the Secretary 
        $400,000,000 for each of fiscal years 2023 through 2025 to 
        carry out this section.''; and
                    (C) in subsection (c), by striking paragraph (6) 
                and inserting the following:
            ``(6) Appropriation.--Out of any money in the Treasury not 
        otherwise appropriated, there are appropriated to the Secretary 
        $75,000,000 for each of fiscal years 2023 through 2025 to carry 
        out this section.''.
            (2) State entitlement; grants to indian tribes and tribal 
        organizations.--Section 2042 of such Act (42 U.S.C. 1397m-1) is 
        amended--
                    (A) in subsection (a)(1)(A), by striking ``State 
                and local'' and inserting ``State, local, and tribal'';
                    (B) in subsection (b)(1), by striking ``the 
                Secretary shall annually award grants to States in the 
                amounts calculated under paragraph (2)'' and inserting 
                ``each State shall be entitled to annually receive from 
                the Secretary in the amounts calculated under paragraph 
                (2), and the Secretary may annually award to each 
                Indian tribe and tribal organization in accordance with 
                paragraph (3), grants'';
                    (C) in subsection (b)(2)--
                            (i) in the paragraph heading, by inserting 
                        ``for a state'' after ``payment'';
                            (ii) by inserting ``that remains after the 
                        reservation under paragraph (3)(B)'' before 
                        ``multiplied''; and
                            (iii) in subparagraph (B)(i)--
                                    (I) by inserting ``that so 
                                remains'' after ``such year''; and
                                    (II) by inserting ``amount so 
                                appropriated'' and inserting 
                                ``remaining amount''; and
                    (D) in subsection (b), by redesignating paragraphs 
                (3) through (5) as paragraphs (4) through (6), 
                respectively, and inserting after paragraph (2) the 
                following:
            ``(3) Amount of payment to indian tribe or tribal 
        organization.--
                    ``(A) In general.--The Secretary, in consultation 
                with Indian tribes and tribal organizations, shall 
                determine the amount of any grant to be made to each 
                Indian tribe and tribal organization from the amount 
                reserved under subparagraph (B) of this paragraph. 
                Paragraphs (4) and (5) shall apply to grantees under 
                this paragraph in the same manner in which the 
                paragraphs apply to States.
                    ``(B) Reservation of funds.--The Secretary shall 
                reserve 2 percent of the amount made available by 
                subsection (b)(6) for each fiscal year for grants under 
                this paragraph.'';
            (3) in subsection (c)--
                    (A) in paragraph (1), by striking ``to States'' and 
                inserting ``to States, Indian tribes, and tribal 
                organizations'';
                    (B) in paragraph (2)--
                            (i) in the matter preceding subparagraph 
                        (A), by inserting ``and Indian tribes and 
                        tribal organizations'' after ``government''; 
                        and
                            (ii) in subparagraph (D), by inserting ``or 
                        Indian tribe or tribal organization, as the 
                        case may be'' after ``government'';
                    (C) in paragraph (4), by inserting ``or Indian 
                tribe or tribal organization'' after ``a State'' the 
                first place it appears; and
                    (D) in paragraph (5)--
                            (i) by inserting ``or Indian tribe or 
                        tribal organization'' after ``Each State''; and
                            (ii) by inserting ``or Indian tribe or 
                        tribal organization, as the case may be'' after 
                        ``the State''; and
            (4) by adding at the end the following:
    ``(d) Definitions of Indian Tribe and Tribal Organization.--In this 
section, the terms `Indian tribe' and `tribal organization' have the 
meanings given the terms in section 419.''.
    (c) Long-Term Care Ombudsman Program Grants and Training.--Section 
2043 of the Social Security Act (42 U.S.C. 1397m-2) is amended--
            (1) in subsection (a), by striking paragraph (2) and 
        inserting the following:
            ``(2) Appropriation.--Out of any money in the Treasury not 
        otherwise appropriated, there are appropriated to the Secretary 
        to carry out this subsection--
                    ``(A) $22,500,000 for fiscal year 2023; and
                    ``(B) $30,000,000 for each of fiscal years 2024 and 
                2025.''; and
            (2) in subsection (b), by striking paragraph (2) and 
        inserting the following:
            ``(2) Appropriation.--Out of any money in the Treasury not 
        otherwise appropriated, there are appropriated to the Secretary 
        $30,000,000 for each of fiscal years 2023 through 2025 to carry 
        out this subsection.''.
    (d) Incentives for Developing and Sustaining Structural Competency 
in Providing Health and Human Services.--
            (1) In general.--Part II of subtitle B of title XX of the 
        Social Security Act (42 U.S.C. 397m-5) is amended by adding at 
        the end the following:

``SEC. 2047. INCENTIVES FOR DEVELOPING AND SUSTAINING STRUCTURAL 
              COMPETENCY IN PROVIDING HEALTH AND HUMAN SERVICES.

    ``(a) Grants to States To Support Linkages to Legal Services and 
Medical Legal Partnerships.--
            ``(1) In general.--Within __ 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 maintaining real-time linkages between health and 
        social services and supports for vulnerable elders or in 
        conjunction with authorized representatives of vulnerable 
        elders, including through the following:
                    ``(A) Medical-legal partnerships.--The 
                establishment and support of medical-legal 
                partnerships, the incorporation of the partnerships in 
                the elder justice framework and health and human 
                services safety net, and the implementation and 
                operation of such a partnership by an eligible 
                grantee--
                            ``(i) at the option of a State, in 
                        conjunction with an area agency on aging;
                            ``(ii) in a solo provider practice in a 
                        health professional shortage area (as defined 
                        in section 332(a) of the Public Health Service 
                        Act), a medically underserved community (as 
                        defined in section 399V of such Act), or a 
                        rural area (as defined in section 330J of such 
                        Act);
                            ``(iii) in a minority-serving institution 
                        of higher learning with health, law, and social 
                        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 
                        critical access hospitals, Medicare-dependent 
                        hospitals, sole community hospitals, rural 
                        emergency hospitals, or that serve a high 
                        proportion of Medicare or Medicaid patients.
                    ``(B) Legal hotlines development or expansion.--The 
                provision of incentives to develop, enhance, and 
                integrate platforms, such as legal assistance hotlines, 
                that help to facilitate the identification of older 
                adults who could benefit 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 carried 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 community-
                based resources; and
                    ``(C) other factors determined relevant by the 
                Secretary.
            ``(3) Evaluation.--The Secretary shall, by grant, contract, 
        or interagency agreement, evaluate 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 organizations 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) Grants and Training To Support Area Agencies on Aging or 
Other Community-Based Organizations To Address Social Isolation Among 
Vulnerable Alder Adults and People With Disabilities.--
            ``(1) Grants.--The Secretary shall make grants to eligible 
        area agencies on aging or other community-based organizations 
        for the purpose of--
                    ``(A) conducting outreach to individuals at risk 
                for, or already experiencing, social isolation or 
                loneliness, through established screening tools or 
                other methods identified by the Secretary;
                    ``(B) developing community-based interventions for 
                the purposes of mitigating loneliness or social 
                isolation (including evidence-based programs, as 
                defined by the Secretary, developed with multi-
                stakeholder input for the purposes of promoting social 
                connection, mitigating social isolation or loneliness, 
                or preventing social isolation or loneliness) among at-
                risk individuals;
                    ``(C) connecting at-risk individuals with community 
                social and clinical supports; and
                    ``(D) evaluating the effect of programs developed 
                and implemented under subparagraphs (B) and (C).
            ``(2) Training.--
                    ``(A) In general.--The Secretary shall establish 
                programs to provide and improve training for area 
                agencies on aging or community-based organizations with 
                respect to addressing and preventing social isolation 
                and loneliness among older adults and people with 
                disabilities.
                    ``(B) Prioritization authority.--For purposes of 
                connecting at-risk individuals with existing community 
                social and clinical supports, the Secretary may, in 
                carrying out subparagraph (A), prioritize models that 
                incorporate training and service delivery in 
                coordination with medical-legal partnerships.
            ``(3) Evaluation.--Not later than 3 years after the date of 
        the enactment of this section and every 3 years thereafter, the 
        Secretary shall submit to the Congress a written report which 
        assesses the extent to which the programs established under 
        this subsection address social isolation and loneliness among 
        older adults and people with disabilities.
            ``(4) Appropriation.--Out of any money in the Treasury not 
        otherwise appropriated, there are appropriated to the Secretary 
        $62,500,000 for each of fiscal years 2022 through 2025 to carry 
        out this subsection.
            ``(5) Coordination.--The Secretary shall coordinate with 
        resource centers, grant programs, or other funding mechanisms 
        established under section 411(a)(18) of the Older Americans Act 
        (42 U.S.C. 3032(a)(18)), section 417(a)(1) of such Act (42 
        U.S.C. 3032F(a)(1)), or other programs as determined by the 
        Secretary.
    ``(c) 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 Americans Act of 1965.
            ``(2) Social isolation.--The term `social isolation' means 
        objectively being alone, or having few relationships or 
        infrequent social contact.
            ``(3) Loneliness.--The term `loneliness' means subjectively 
        feeling alone, or the discrepancy between one's desired level 
        of social connection and one's actual level of social 
        connection.
            ``(4) Social connection.--The term `social connection' 
        means the variety of ways one can connect to others socially, 
        through physical, behavioral, social-cognitive, and emotional 
        channels.
            ``(5) Community-based organization.--The term `community-
        based organization' includes, except as otherwise provided by 
        the Secretary, a nonprofit community-based organization, a 
        consortium of nonprofit community-based organizations, a 
        national nonprofit organization acting as an intermediary 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.''.
            (2) Clarification that medical-legal partnerships are 
        authorized adult protective services activities.--Section 2011 
        of such Act (42 U.S.C. 1397j) is amended--
                    (A) in paragraph (2)(D), by inserting ``, including 
                through a medical-legal partnership'' before the 
                period; and
                    (B) 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 arrangement 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 
        determinants of health, and to help clinicians, case managers, 
        and social workers address structural problems at the root of 
        many health inequities, including a multidisciplinary team 
        integrated into such a setting to address the needs and 
        establish and maintain structural competence within clinicians, 
        case managers, and social workers to best address structural 
        problems at the root of many health inequities.''.
    (e) Technical Amendment.--Section 2011(12)(A) of the Social 
Security Act (42 U.S.C. 1397j(12)(A)) is amended by striking ``450b'' 
and inserting ``5304''.

SEC. 3. ASSESSMENT REPORTS.

    (a) In General.--Not later than 2 years after the date of enactment 
of this Act, and not less frequently than once every 2 years 
thereafter, the Secretary of Health and Human Services shall submit a 
report to the Committee on Ways and Means of the House of 
Representatives and the Committee on Finance of the Senate on the 
programs, coordinating bodies, registries, and activities established 
or authorized under subtitle B of title XX of the Social Security Act 
(42 U.S.C. 1397l et seq.) or section 6703(b) of the Patient Protection 
and Affordable Care Act (42 U.S.C. 1395i-3a(b)). Each such report shall 
assess the extent to which such programs, coordinating bodies, 
registries, and activities have improved access to, and the quality of, 
resources available to aging Americans and their caregivers to 
ultimately prevent, detect, and treat abuse, neglect, and exploitation, 
and shall include, as appropriate, recommendations to Congress on 
funding levels and policy changes to help these programs, coordinating 
bodies, registries, and activities better prevent, detect, and treat 
abuse, neglect, and exploitation of aging Americans.
    (b) Appropriation.--Out of any money in the Treasury not otherwise 
appropriated, there are appropriated to the Secretary of Health and 
Human Services $5,000,000 for each of fiscal years 2022 through 2025 to 
carry out this section.
                                 <all>