S.Amdt. 2640

SA 2640. Mr. GRASSLEY submitted an amendment intended to be proposed
by him to the bill S. 178, to condemn gross human rights violations of
ethnic Turkic Muslims in Xinjiang, and calling for an end to arbitrary
detention, torture, and harassment of these communities inside and
outside China; which was ordered to lie on the table; as follows:

At the appropriate place, insert the following:

SEC. __. EMERGENCY SUPPORT AND COVID-19 PROTECTIONS FOR
NURSING HOMES.

(a) Establishing COVID-19 Strike Teams for Nursing
Facilities.--
(1) In general.--The Secretary is authorized to establish
and support the operation of strike teams comprised of
individuals with relevant skills, qualifications, and
experience to respond to COVID-19-related crises in
participating providers during the COVID-19 public health
emergency period, based on data reported by such providers to
the Centers for Disease Control and Prevention.
(2) Mission and composition of strike teams.--
(A) In general.--Strike teams established by the Secretary
may include assessment, testing, and clinical teams, and a
mission for each such team may include performing medical
examinations, conducting COVID-19 testing, and assisting
participating providers with the implementation of infection
control practices (such as quarantine, isolation, or
disinfection procedures).
(B) Letter of authorization.--Strike teams and members of
such teams shall be subject to the Secretary's oversight and
direction and the Secretary may issue a letter of
authorization to team members describing--
(i) the individual's designation to serve on 1 or more
teams under an emergency proclamation by the Secretary;
(ii) the mission of the team;
(iii) the authority of the individual to perform the team
mission;
(iv) the individual's authority to access places, persons,
and materials necessary for the team member's performance of
the team's mission;
(v) the requirement that team members maintain the
confidentiality of patient information shared with such
individuals by a participating provider; and
(vi) the required security background checks that the
individual has passed.
(C) Secretarial oversight.--The Secretary may, at any time,
disband any strike team and rescind the letter of
authorization for any team member.
(D) Team and member authority.--A team and team member may
not use the letter of authorization described in subparagraph
(B) for any purpose except in connection with the team's
mission of acting in good faith to promote resident and
employee safety in participating providers in which COVID-19
is confirmed to be present.
(E) Administration.--The Secretary, in consultation with
the Director of the Centers for Disease Control and
Prevention, may establish protocols and procedures for
requesting the assistance of a strike team established under
this subsection and any other procedures deemed necessary for
the team's operation.
(F) Supplementation of other response efforts.--Strike
teams established by the Secretary under this subsection
shall supplement and not supplant response efforts carried
out by a State strike team or a technical assistance team
established by the Secretary during the COVID-19 public
health emergency period.
(b) Promoting COVID-19 Testing and Infection Control in
Nursing Facilities.--
(1) Nursing home protections.--The Secretary, in
consultation with the Elder Justice Coordinating Council
established under section 2021 of the Social Security Act (42
U.S.C. 1397k), is authorized during the COVID-19 public
health emergency period to enhance efforts by participating
providers to respond to COVID-19, including through--
(A) development of online training courses for personnel of
participating providers, survey agencies, the long-term care
ombudsman of each State, and other individuals to facilitate
the implementation of paragraph (2);
(B) enhanced diagnostic testing of visitors to, personnel
of, and residents of, participating providers in which
measures of COVID-19 in the community support more frequent
testing for COVID-19;
(C) development of training materials for personnel of
participating providers, the long-term care ombudsman of each
State, and representatives and family members of residents;
and
(D) providing support to participating providers in areas
deemed by the Secretary to require additional assistance due
to the presence COVID-19 infections.
(2) Training on best practices in infection control and
prevention.--
(A) In general.--The Secretary shall develop training
courses on infection control and prevention, including
cohorting, strategies and use of telehealth to mitigate the
transmission of COVID-19 in participating providers during
the COVID-19 public health emergency period.
(B) Development.--To the extent practicable, the training
programs developed by the Secretary under this subsection
shall use best practices in infection control and prevention.
(C) Coordination with other federal entities.--The
Secretary shall seek input as appropriate on the training
courses developed under this subsection from the Elder
Justice Coordinating Council and the Director of the Centers
for Disease Control and Prevention.
(D) Interactive website.--The Secretary is authorized to
create an interactive website to disseminate training
materials and related information in the areas of infection
control and prevention, for purposes of carrying out this
subsection during the COVID-19 public health emergency
period.
(c) Promoting Transparency in COVID-19 Reporting by Nursing
Facilities and Long-term Care Facilities.--
(1) Collection and reporting of staffing data by nursing
facilities during covid-19 emergency period.--The Secretary
shall develop a plan for ensuring that participating
providers resume compliance with the requirement, under
section 1128I(g) of the Social Security Act (42 U.S.C. 1320a-
7j(g)), to electronically submit direct care staffing
information based on payroll and other auditable data
(including measures to ensure that the submitted data
includes direct care staffing information for the entire
duration of the COVID-19 emergency period).
(2) Collection and reporting of data related to covid-19 by
nursing facilities during covid-19 emergency period.--The
Secretary shall ensure that participating providers and long-
term care facilities report all suspected and confirmed cases
of COVID-19 among personnel and residents of the provider or
facility, all COVID-19-related fatalities among personnel and
residents of the provider or facility, and all fatalities
among personnel and residents of the provider or facility,
whether related to COVID-19 or unrelated to COVID-19, for the
period beginning on January 1, 2020, to the Secretary.
(3) Reporting of nursing facility data related to covid-19
by the secretary.--Not later than 10 days after the date of
enactment of this Act, and at least weekly thereafter during
the COVID-19 public health emergency period, the Secretary
shall provide the Governor of each State with a list of all
participating providers in the State with respect to which
the reported cases of COVID-19 in visitors to, personnel of,
and residents of, such providers increased during the
previous week (or, in the case of the first such list, during
the 10-day period beginning on the date of enactment of this
Act).
(4) Confidentiality.--Any information reported under this
subsection that is made available to the public shall be made
so available in a manner that protects the identity of
residents of participating providers and long-term care
facilities.
(d) Extending Elder Justice Act Protections During the
COVID-19 Emergency Period.--
(1) Long-term care ombudsman program grants and training.--
Section 2043 of the Social Security Act (42 U.S.C. 1397m-2)
is amended--
(A) in subsection (a)--
(i) in paragraph (1)(A), by inserting ``(including during
the emergency period described in section 1135(g)(1)(B), from
amounts made available with respect to such period in
accordance with paragraph (2)(D))'' before the semicolon; and
(ii) in paragraph (2)--
(iii) in subparagraph (B), by striking ``and'' after the
semicolon;
(iv) in subparagraph (C), by striking the period at the end
and inserting a semicolon; and
(v) by adding at the end the following:

[[Page S5335]]

``(D) for the emergency period described in section
1135(g)(1)(B), $12,000,000.'';
(B) in subsection (b)--
(i) in paragraph (1), by inserting ``(including during the
emergency period described in section 1135(g)(1)(B), from
amounts made available with respect to such period in
accordance with paragraph (2))'' before the period; and
(ii) in paragraph (2), by inserting before the period the
following: ``, and for the emergency period described in
section 1135(g)(1)(B), $12,000,000''.
(2) Elder justice coordinating council.--
(A) Membership.--Section 2021(b)(1) of the Social Security
Act (42 U.S.C. 1397k(b)(1)) is amended--
(i) by redesignating subparagraph (C) as subparagraph (D);
and
(ii) by inserting after subparagraph (B), the following:
``(C) The Administrator of the Federal Emergency Management
Agency.''.
(B) Duties.--Section 2021(f)(1) of such Act (42 U.S.C.
1397k(f)(1)) is amended by inserting ``the Federal Emergency
Management Agency,'' after ``Justice,''.
(3) Adult protective services functions and grant
programs.--Section 2042 of the Social Security Act (42 U.S.C.
1397m-1) is amended--
(A) in subsection (a)(2), by inserting ``, and $5,000,000
for the emergency period described in section 1135(g)(1)(B)''
after ``2014'';
(B) in subsection (b)(5), by inserting ``, and $150,000,000
for the emergency period described in section 1135(g)(1)(B)''
after ``2014''; and
(C) in subsection (c)(6), by inserting ``, and $30,000,000
for the emergency period described in section 1135(g)(1)(B)''
after ``2014''.
(4) 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''.
(e) Addressing Racial and Ethnic Coronavirus Disparities in
Long-term Care Facilities.--
(1) Task force.--The Secretary shall establish a task
force, to be known as the ``Racial and Ethnic Coronavirus
Disparities in Long-Term Care Facilities Task Force''
(referred to in this section as the ``task force''), to
gather data and information on racial and ethnic disparities
in long-term care facilities, during the public health
emergency, and to provide recommendations to Federal, State,
local, and Tribal policymakers on ways to eliminate health
disparities and to improve the health of racial and ethnic
minority populations residing in long-term care facilities.
(2) Membership.--The task force shall be composed of the
Surgeon General, other Federal, State, and local government
officials, and individuals appointed by the Surgeon General
with firsthand knowledge of, or expertise relating to,
disparities in access to quality care for residents of long-
term care facilities who are members of racial or ethnic
minority groups. In appointing such individuals, the Surgeon
General, in consultation with the Director of the U.S.
Department of Health and Human Services Office of Minority
Health, shall ensure the individuals appointed provide ample
representation with respect to the demographics of residents
and caregivers of all long-term care facilities, during the
COVID-19 public health emergency period particularly with
respect to residents and caregivers of such facilities who
are members of racial or ethnic minority groups, communities
of color, and communities with preexisting health challenges
or difficulties in accessing care.
(3) Administration.--
(A) Chairperson and vice chairperson.--The Surgeon General
shall serve as the chairperson of the task force. The
Director of the Department's Office of Minority Health shall
serve as the vice chairperson.
(B) Staff.--The task force shall have at least 2 full-time
staff members, with diverse and relevant experience,
including, but not limited to academic, community,
governmental, or vocational work. The staff members, in
coordination with the Chairperson and Vice Chairperson shall
appoint at least two representatives from the aging community
to serve on the task force in addition to at least four
representatives providing ample representation with respect
to the demographics of residents and caregivers of all long-
term care facilities, particularly with respect to members of
racial or ethnic minority groups and communities of color,
and communities with preexisting health challenges or
difficulties in accessing care.
(C) Meetings.--The task force shall convene at least
monthly, with the first meeting to occur within 60 days after
the enactment of this Act.
(4) Reporting and recommendations.--
(A) Monthly reports.--Not later than 45 days after the 1st
meeting of the task force, and monthly thereafter, the task
force shall submit to Congress, the Centers for Medicare and
Medicaid, and the Centers for Disease Control and Prevention
a report that includes--
(i) recommended methodologies for improving Federal data
collection, including transparent publication of such data
and information on resident outcomes in long-term care
facilities with disproportionately high rates of admission of
individuals who are members of racial or ethnic minority
groups;
(ii) the identification of long-term care facilities
evidencing racial or ethnic disparities in COVID-19 cases and
fatalities, psychotropic drug usage, infection prevention and
control deficiencies, hospitalization rates, infectious
disease rates, injury rates, abuse rates, neglect rates,
fatality rates, and any additional areas, as determined by
the task force based on available public health data (or, if
no such data are available, on the basis of such other
publicly available data or information as the task force may
determine);
(iii) the identification of factors, including Federal and
State policies, that have contributed to health disparities
in resident outcomes in long-term care facilities, and
actions Congress (and if appropriate, other entities) can
take to address these factors; and
(iv) recommendations for best practices to eliminate health
disparities and to improve the health of racial and ethnic
minority populations in long-term care facilities, especially
such facilities evidencing racial or ethnic disparities in
COVID-19 cases and fatalities, psychotropic drug usage,
infection prevention and control deficiencies,
hospitalization rates, infectious disease rates, injury
rates, abuse and neglect rates, fatality rates, or any
additional areas determined by the task force.
(B) Consultation with indian tribes.--In submitting reports
and recommendations under this subsection, the task force
shall consult with Indian Tribes and Tribal organizations.
(C) Sunset.--The task force shall terminate on December 31,
2022.
(f) Achieving Savings in Health Care Programs by Reducing
Improper Prescribing of Controlled Substances.--
(1) In general.--Within 120 days of enactment of this Act
and annually thereafter, the Secretary shall report all
Medicare revocation actions or preclusion list placements to
the Drug Enforcement Administration that are based totally or
in part on the improper prescribing, administering, or
dispensing of controlled substances.
(2) Definitions.--The terms used in this subsection shall
have the meaning given such terms in section 102 of the
Controlled Substances Act (42 U.S.C. 802). For purposes of
paragraph (1), the ``improper prescribing, administering, or
dispensing of controlled substances'' includes doing so in
any of the following respects:
(A) In excessive quantities.
(B) For other than a legitimate medical purpose or outside
the usual course of professional practice.
(C) Beyond the scope of the practitioner's DEA
registration.
(D) In any other manner not permitted by the Controlled
Substances Act (21 U.S.C. 801 et. seq.).
(3) Access to evidence.--When making the reports required
under paragraph (1), the Secretary shall provide the Drug
Enforcement Administration with any relevant records or other
evidence that Drug Enforcement Administration requests for
purposes of carrying out its functions under the Controlled
Substances Act. The Drug Enforcement Administration may use
any such information or other evidence provided by the
Secretary for the purposes of any criminal, civil, or
administrative proceeding arising out the Controlled
Substances Act.
(g) Funding.--
(1) CARES act.---The Secretary may use amounts appropriated
for COVID-19 response and related activities pursuant to the
CARES Act (Public Law 116-136) and subsequently enacted
legislation to carry out this section and the amendments made
by this section.
(2) Prevention and public health fund.--The Secretary may
use amounts in the Prevention and Public Health Fund,
established under section 4002 of the Patient Protection and
Affordable Care Act of 2010, to carry out this section and
the amendments made by this section, including by providing
financial assistance to participating providers as
appropriate for implementation of the requirements of this
section and the amendments made by this section.
(h) Definitions.--In this section:
(1) COVID-19.--The term ``COVID-19'' means the 2019 Novel
Coronavirus or 2019-nCoV.
(2) COVID-19 public health emergency period.--The term
``COVID-19 public health emergency period'' means the period
beginning on the first day of the emergency period defined in
paragraph (1)(B) of section 1135(g) of the Social Security
Act (42 U.S.C. 1320b-5(g)) and ending on the last day of the
calendar quarter in which the last day of such emergency
period occurs.
(3) Long-term care facility.--The term ``long-term care
facility'' has the meaning given that term in section
2011(15) of the Social Security Act (42 U.S.C. 1397j(15)).
(4) Nursing facility.--The term ``nursing facility'' has
the meaning given that term in section 1919(a) of the Social
Security Act (42 U.S.C. 1396r(a)).
(5) Participating provider.--The term ``participating
provider'' means a skilled nursing facility or a nursing
facility that has been assigned a national provider
identifier number by the Secretary and has executed an
agreement to participate in the Medicare program established
under title XVIII of the Social Security Act (42 U.S.C. 1395
et seq.) or the Medicaid program established under title XIX
of such Act (42 U.S.C. 1396 et seq.).
(6) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(7) Skilled nursing facility.--The term ``skilled nursing
facility'' has the meaning given that term in section 1819(a)
of the Social Security Act (42 U.S.C. 1395i-3(a)).

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(8) State.--Except as otherwise provided, the term
``State'' has the meaning given such term for purposes of
title XIX of the Social Security Act (42 U.S.C. 1396 et
seq.).
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