[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 333 Reported in Senate (RS)]
Calendar No. 740
108th CONGRESS
2d Session
S. 333
To promote elder justice, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
February 10, 2003
Mr. Breaux (for himself, Mr. Hatch, Mr. Baucus, Mr. Bond, Mr. Burns,
Ms. Collins, Mr. Harkin, Mr. Kohl, Ms. Landrieu, Mrs. Lincoln, Mr.
Nelson of Florida, Mr. Rockefeller, Mr. Santorum, Mr. Smith, Mr.
Jeffords, Mr. Miller, Ms. Stabenow, Mr. Fitzgerald, Mr. Durbin, Mr.
Bingaman, Mr. Domenici, Mr. Schumer, Mr. Bunning, Mr. Hollings, Mrs.
Clinton, Ms. Mikulski, Mr. Chambliss, Mr. Voinovich, Mr. Pryor, Mrs.
Murray, Mr. Graham of South Carolina, Mrs. Boxer, Mr. Dayton, Mr.
Specter, Mr. Corzine, Mr. Sarbanes, Mr. Reed, Mr. Lautenberg, Mr.
Craig, Mr. DeWine, Mr. Warner, Mr. Bayh, Ms. Snowe, Mr. Wyden, and Ms.
Cantwell) introduced the following bill; which was read twice and
referred to the Committee on Finance
September 28, 2004
Reported by Mr. Grassley, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To promote elder justice, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE; TABLE OF CONTENTS.</DELETED>
<DELETED> (a) Short Title.--This Act may be cited as the ``Elder
Justice Act''.</DELETED>
<DELETED> (b) Table of Contents.--The table of contents of this Act
is as follows:</DELETED>
<DELETED>Sec. 1. Short title; table of contents.
<DELETED>Sec. 2. Findings.
<DELETED>Sec. 3. Purposes.
<DELETED>TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES
<DELETED>Sec. 101. Amendment to the social security act.
<DELETED>Sec. 102. Patient abuse prevention.
<DELETED>Sec. 103. Increasing the number of health care professionals
with geriatric training.
<DELETED>Sec. 104. Supporting the long-term care ombudsman program.
<DELETED>Sec. 105. Establishment of office of adult protective
services.
<DELETED>Sec. 106. Assuring safety of residents when nursing facilities
close.
<DELETED>TITLE II--DEPARTMENT OF JUSTICE
<DELETED>Sec. 201. Definitions; rule.
<DELETED>Sec. 202. Model State laws and practices.
<DELETED>Sec. 203. Office of elder justice of the department of
justice.
<DELETED>Sec. 204. Grants under the social security act.
<DELETED>Sec. 205. Victim advocacy grants.
<DELETED>Sec. 206. Supporting local prosecutors in elder justice
matters.
<DELETED>Sec. 207. Supporting State prosecutors in elder justice
matters.
<DELETED>Sec. 208. Supporting Federal cases involving elder justice.
<DELETED>Sec. 209. Community policing.
<DELETED>Sec. 210. Supporting law enforcement in elder justice matters.
<DELETED>Sec. 211. Evaluations.
<DELETED>Sec. 212. Authorization of appropriations.
<DELETED>Sec. 213. Cause of action for elder abuse and neglect.
<DELETED>Sec. 214. Civil actions for elder abuse and neglect.
<DELETED>TITLE III--TAX PROVISIONS
<DELETED>Sec. 301. Long-term care facility worker employment tax
credit.
<DELETED>SEC. 2. FINDINGS.</DELETED>
<DELETED> Congress finds the following:</DELETED>
<DELETED> (1) The proportion of the United States population
age 60 years or older will drastically increase in the next 30
years as 77,000,000 baby boomers approach retirement and old
age.</DELETED>
<DELETED> (2) Each year, anywhere between 500,000 and
5,000,000 elders in the United States are abused, neglected, or
exploited.</DELETED>
<DELETED> (3) Elder abuse, neglect, and exploitation have no
boundaries, and cross all racial, social class, gender, and
geographic lines.</DELETED>
<DELETED> (4) Victims of elder abuse, neglect, and
exploitation are not only subject to injury from mistreatment
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 exploitation.</DELETED>
<DELETED> (5) There is a general dearth of data as to the
nature and scope of elder abuse, neglect, and
exploitation.</DELETED>
<DELETED> (6) Despite the dearth of data in the field,
experts 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 difficult 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.</DELETED>
<DELETED> (7) For over 20 years, Congress has been presented
with facts and testimony calling for a coordinated Federal
effort to combat elder abuse, neglect, and
exploitation.</DELETED>
<DELETED> (8) The Federal Government has been slow to
respond to the needs of victims of elder abuse, neglect, and
exploitation or to undertake prevention efforts.</DELETED>
<DELETED> (9) No Federal law has been enacted that
adequately 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.</DELETED>
<DELETED> (10) Differences in State laws and practices in
the areas of elder abuse, neglect, and exploitation lead to
significant disparities in prevention, protective and social
services, treatment systems, and law enforcement, and lead to
other inequities.</DELETED>
<DELETED> (11) The Federal Government has played an
important role in promoting research, training, public safety,
data collection, the identification, development, and
dissemination of promising health care, social, and protective
services, and law enforcement practices, relating to child
abuse and neglect, domestic violence, and violence against
women. The Federal Government should promote similar efforts
and protections relating to elder abuse, neglect, and
exploitation.</DELETED>
<DELETED> (12) The Federal Government should provide
leadership and assist States and communities in their efforts
to protect elders in the United States by--</DELETED>
<DELETED> (A) promoting coordinated planning among
all levels of government;</DELETED>
<DELETED> (B) generating and sharing knowledge
relevant to protecting elders;</DELETED>
<DELETED> (C) providing leadership to combat the
abuse, neglect, and exploitation of the Nation's
elders; and</DELETED>
<DELETED> (D) providing resources to States and
communities to promote elder justice.</DELETED>
<DELETED> (13) The problem of elder abuse, neglect, and
exploitation requires a comprehensive approach that--</DELETED>
<DELETED> (A) integrates the work of health, legal,
and social service agencies and
organizations;</DELETED>
<DELETED> (B) emphasizes the need for prevention,
reporting, investigation, assessment, treatment, and
prosecution of elder abuse, neglect, and exploitation
at all levels of government;</DELETED>
<DELETED> (C) ensures that sufficient numbers of
properly trained personnel with specialized knowledge
are in place to treat, assess, and provide services
relating to elder abuse, neglect, and exploitation, and
carry out elder and vulnerable adult protection
duties;</DELETED>
<DELETED> (D) is sensitive to ethnic and cultural
diversity;</DELETED>
<DELETED> (E) recognizes the role of mental health,
disability, dementia, substance abuse, medication
mismanagement, and family dysfunction problems in
increasing and exacerbating elder abuse, neglect, and
exploitation; and</DELETED>
<DELETED> (F) balances adults' right to self-
determination with society's responsibility to protect
elders and vulnerable adults.</DELETED>
<DELETED> (14) The human, social, and economic cost of elder
abuse, neglect, and exploitation is high and includes
unnecessary expenditures of medicare and medicaid
funds.</DELETED>
<DELETED> (15) The failure to coordinate activities relating
to, and comprehensively prevent and treat, elder abuse,
neglect, and exploitation threatens the future and well-being
of millions of elders in the United States.</DELETED>
<DELETED> (16) All elements of society in the United States
have a shared responsibility in responding to a national
problem of elder abuse, neglect, and exploitation.</DELETED>
<DELETED>SEC. 3. PURPOSES.</DELETED>
<DELETED> The purposes of this Act are as follows:</DELETED>
<DELETED> (1) To bring a comprehensive approach to
preventing and combating elder abuse, neglect, and
exploitation, a long invisible problem that afflicts the most
vulnerable among the aging population of the United
States.</DELETED>
<DELETED> (2) To raise the issue of elder abuse, neglect,
and exploitation to national attention, and to create the
infrastructure at the Federal, State, and local levels, to
assure that individuals and organizations on the front lines,
who are fighting elder abuse, neglect, and exploitation with
scarce resources and fragmented systems, have the resources and
information needed to carry out their fight.</DELETED>
<DELETED> (3) To bring a comprehensive multi-disciplinary
approach to elder justice.</DELETED>
<DELETED> (4) To set in motion research and data collection
to fill gaps in knowledge about elder abuse, neglect, and
exploitation.</DELETED>
<DELETED> (5) To supplement the activities of service
providers and programs, to enhance training, and to leverage
scarce resources efficiently to ensure that elder justice
receives the attention it deserves as the Nation's population
ages.</DELETED>
<DELETED> (6) To examine the many different laws and
practices relating to elder justice in different States and
jurisdictions to ascertain which among those laws and practices
are the most effective.</DELETED>
<DELETED> (7) To promote the development of an effective
adult fiduciary system, including an adult guardianship system,
that protects individuals with diminished capacity, maximizes
their autonomy, and develops effective resources and an elder
rights system.</DELETED>
<DELETED> (8) To recognize and address the role of mental
health, disability, dementia, substance abuse, medication
mismanagement, and family dysfunction problems in increasing
and exacerbating elder abuse, neglect and
exploitation.</DELETED>
<DELETED> (9) To create a short- and long-term strategic
plan for the development and coordination of elder justice
research, programs, studies, training, and other efforts
nationwide.</DELETED>
<DELETED> (10) To promote collaborative efforts and diminish
overlap and gaps in efforts in developing the important field
of elder justice.</DELETED>
<DELETED>TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES</DELETED>
<DELETED>SEC. 101. AMENDMENT TO THE SOCIAL SECURITY ACT.</DELETED>
<DELETED> The Social Security Act (42 U.S.C. 301 et seq.) is amended
by adding at the end the following:</DELETED>
<DELETED>``TITLE XXII--ELDER JUSTICE</DELETED>
<DELETED>``SEC. 2201. DEFINITIONS; RULE.</DELETED>
<DELETED> ``(a) Definitions.--In this title:</DELETED>
<DELETED> ``(1) Abuse.--The term `abuse' means the knowing
infliction of physical or psychological harm or the knowing
deprivation of goods or services that are necessary to meet
essential needs or to avoid physical or psychological
harm.</DELETED>
<DELETED> ``(2) Adult protective services.--The term `adult
protective services' means those services provided to elders
and to people age 18 and older with disabilities who are, or
who are in danger of being, abused, neglected, or exploited,
who are unable to protect themselves, or who have no one to
assist them adequately. The term includes services such as
disseminating reports of adult abuse, neglect or exploitation,
investigating those reports, case planning, monitoring,
evaluation, providing other case work and services, and
providing, arranging for, or facilitating the provision of
medical, social service, economic, legal, housing, law
enforcement, or other protective, emergency, or support
services.</DELETED>
<DELETED> ``(3) Caregiver.--The term `caregiver' means an
individual who has the responsibility for the care of an elder,
either voluntarily, by contract, by receipt of payment for
care, or as a result of the operation of law and means a family member
or other individual who provides (on behalf of such individual or of a
public or private agency, organization, or institution) compensated or
uncompensated care to an elder who needs supportive services in any
setting.</DELETED>
<DELETED> ``(4) Direct care.--The term `direct care' means
care by an employee or contractor who provides assistance or
long-term care services to a recipient.</DELETED>
<DELETED> ``(5) Elder.--The term `elder' means an individual
age 60 or older.</DELETED>
<DELETED> ``(6) Elder justice.--The term `elder justice'
means--</DELETED>
<DELETED> ``(A) from a societal perspective, efforts
to prevent, detect, treat, intervene in, and prosecute
elder abuse, neglect, and exploitation and to protect
elders with diminished capacity while maximizing their
autonomy; and</DELETED>
<DELETED> ``(B) from an individual perspective, the
recognition of an elder's rights, including the right
to be free of abuse, neglect, and
exploitation.</DELETED>
<DELETED> ``(7) Eligible entity.--The term `eligible entity'
means a State or local government agency, Indian tribe, or any
other public or private entity that is engaged in and has
expertise in issues relating to elder justice or in a field
necessary to promote elder justice efforts.</DELETED>
<DELETED> ``(8) Exploitation.--The term `exploitation' means
the fraudulent or otherwise illegal, unauthorized, or improper
act or process of an individual, including a caregiver or
fiduciary, that uses the resources of an elder for monetary or
personal benefit, profit, gain, or that results in depriving an
elder of rightful access to, or use of, benefits, resources,
belongings, or assets.</DELETED>
<DELETED> ``(9) Fiduciary.--The term `fiduciary'--</DELETED>
<DELETED> ``(A) means a person or entity with the
legal responsibility--</DELETED>
<DELETED> ``(i) to make decisions on behalf
of and for the benefit of another person;
and</DELETED>
<DELETED> ``(ii) to act in good faith and
with fairness; and</DELETED>
<DELETED> ``(B) includes a trustee, a guardian, a
conservator, an executor, an agent under a financial
power of attorney or health care power of attorney, or
a representative payee.</DELETED>
<DELETED> ``(10) Grant.--The term `grant' includes a
contract, cooperative agreement, or other mechanism for
providing financial assistance.</DELETED>
<DELETED> ``(11) Granting authority.--The term `granting
authority' means the Secretary of Health and Human Services,
the Attorney General, or the Secretary of Health and Human
Services and the Attorney General jointly, as
appropriate.</DELETED>
<DELETED> ``(12) Guardianship.--The term `guardianship'
means--</DELETED>
<DELETED> ``(A) the process by which a State court
determines that an adult individual lacks capacity to
make decisions about self-care and property, and
appoints another individual or entity known as a
guardian, as a conservator, or by a similar term, as
surrogate decisionmaker;</DELETED>
<DELETED> ``(B) the manner in which the court-
appointed surrogate carries out duties to the
individual and the court; or</DELETED>
<DELETED> ``(C) the manner in which the court
exercises oversight of the surrogate.</DELETED>
<DELETED> ``(13) Indian.--The term `Indian' means a person
who is a member of an Indian tribe.</DELETED>
<DELETED> ``(14) Indian tribe.--The term `Indian tribe'
means any Indian tribe, band, nation, or other organized group
or community, including any Alaska Native village or regional
corporation as defined in or established pursuant to the Alaska
Native Claims Settlement Act (43 U.S.C. 1601 et seq.), that is
recognized as eligible for the special programs and services
provided by the United States to Indians because of their
status as Indians.</DELETED>
<DELETED> ``(15) Knowingly.--The term `knowingly' has the
meaning given such term in section 3729(b) of title 31, United
States Code.</DELETED>
<DELETED> ``(16) Law enforcement.--The term `law
enforcement' means the full range of potential responders to
elder abuse, neglect, and exploitation including--</DELETED>
<DELETED> ``(A) police, sheriffs, detectives, public
safety officers, and corrections personnel;</DELETED>
<DELETED> ``(B) prosecutors;</DELETED>
<DELETED> ``(C) medical examiners;</DELETED>
<DELETED> ``(D) investigators; and</DELETED>
<DELETED> ``(E) coroners.</DELETED>
<DELETED> ``(17) Long-term care.--</DELETED>
<DELETED> ``(A) In general.--The term `long-term
care' means a wide range of supportive and health
services for individuals who need assistance because
the individuals have a loss of capacity for self-care
due to illness, disability, or vulnerability.</DELETED>
<DELETED> ``(B) Need for assistance.--For purposes
of subparagraph (A), a need for assistance is often
measured in terms of the capability to engage in
activities of daily living, including eating, dressing,
bathing, and management of one's financial
affairs.</DELETED>
<DELETED> ``(18) Long-term care facility.--The term `long-
term care facility' means a residential care provider that
arranges for, or directly provides, long-term care.</DELETED>
<DELETED> ``(19) Neglect.--The term `neglect' means--
</DELETED>
<DELETED> ``(A) the failure of a caregiver or
fiduciary to provide the goods or services that are
necessary to maintain the health or safety of an elder;
or</DELETED>
<DELETED> ``(B) self-neglect.</DELETED>
<DELETED> ``(20) Nursing facility.--The term `nursing
facility' has the meaning given such term under section
1919(a).</DELETED>
<DELETED> ``(21) Self-neglect.--The term `self-neglect'
means an adult's inability, due to physical or mental
impairment or diminished capacity, to perform essential self-
care tasks including--</DELETED>
<DELETED> (A) obtaining essential food, clothing,
shelter, and medical care;</DELETED>
<DELETED> (B) obtaining goods and services necessary
to maintain physical health, mental health, or general
safety; or</DELETED>
<DELETED> (C) managing one's own financial
affairs.</DELETED>
<DELETED> ``(22) Serious bodily injury.--</DELETED>
<DELETED> ``(A) In general.--The term `serious
bodily injury' means an injury--</DELETED>
<DELETED> ``(i) involving extreme physical
pain;</DELETED>
<DELETED> ``(ii) involving substantial risk
of death;</DELETED>
<DELETED> ``(iii) involving protracted loss
or impairment of the function of a bodily
member, organ, or mental faculty; or</DELETED>
<DELETED> ``(iv) requiring medical
intervention such as surgery, hospitalization,
or physical rehabilitation.</DELETED>
<DELETED> ``(B) Criminal sexual abuse.--Serious
bodily injury shall be considered to have occurred if
the conduct causing the injury is conduct constituting
aggravated sexual abuse under section 2241, or sexual
abuse under section 2242, of title 18, United States
Code, or any similar offense under State law.</DELETED>
<DELETED> ``(23) Social.--The term `social', when used with
respect to a service, includes adult protective
services.</DELETED>
<DELETED> ``(24) State.--The term `State' means any of the
several States, the District of Columbia, the Commonwealth of
Puerto Rico, and any other possession or territory of the
United States.</DELETED>
<DELETED> ``(25) State long-term care ombudsman.--The term
`State Long-Term Care Ombudsman' means the State Long-Term Care
Ombudsman described in section 712(a)(2) of the Older Americans
Act of 1965 (42 U.S.C. 3058g(a)(2)).</DELETED>
<DELETED> ``(26) Underserved population.--The term
`underserved population' means the population of an area
designated by the Secretary as an area with a shortage of elder
justice programs or a population group designated by the
Secretary as having a shortage of such programs. Such areas or
groups designated by the Secretary may include--</DELETED>
<DELETED> ``(A) areas or groups that are
geographically isolated (such as isolated in a rural
area);</DELETED>
<DELETED> ``(B) racial and ethnic minority
populations; and</DELETED>
<DELETED> ``(C) populations underserved because of
special needs (such as language barriers, disabilities,
alien status, or age).</DELETED>
<DELETED> ``(27) Vulnerable adult.--The term `vulnerable
adult' means an adult, age 18 or older, who needs protections
and programs that are the same as or similar to protections and
programs for elders, including an adult who, due to a
developmental, cognitive, psychological, physical, or other
type of disability, may be abused, neglected, or
exploited.</DELETED>
<DELETED> ``(b) Rule.--The Secretary may determine, in an
appropriate case, that a provision of this title that applies to elders
also applies to vulnerable adults.</DELETED>
<DELETED>``Subtitle A--Federal Elder Justice System</DELETED>
<DELETED>``SEC. 2211. OFFICE OF ELDER JUSTICE OF THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES.</DELETED>
<DELETED> ``(a) Establishment.--There is established within the
Department of Health and Human Services under the Assistant Secretary
for Aging an Office of Elder Justice.</DELETED>
<DELETED> ``(b) Director.--</DELETED>
<DELETED> ``(1) Appointment.--The President, with the advice
and consent of the Senate, shall appoint a Director of the
Office of Elder Justice, from among individuals with experience
and expertise in elder justice issues, to manage the Office of
Elder Justice established under this section.</DELETED>
<DELETED> ``(2) Duties.--The Director of the Office of Elder
Justice shall--</DELETED>
<DELETED> ``(A)(i) develop objectives, priorities,
policy, and a long-term plan for elder justice programs
and activities relating to prevention, detection,
training, treatment, evaluation, intervention,
research, and improvement of the elder justice system
in the United States;</DELETED>
<DELETED> ``(ii) implement the overall policy and a
strategy to carry out the plan described in clause (i);
and</DELETED>
<DELETED> ``(iii) hire personnel to assist the
director in carrying out the policy, program, and
administrative activities related to the duties under
clauses (i) and (ii);</DELETED>
<DELETED> ``(B) provide advice to the Secretary on
elder justice issues; and</DELETED>
<DELETED> ``(C) coordinate activities with the
Senior Advisor on Elder Justice.</DELETED>
<DELETED> ``(3) Reporting relationship.--The Director of the
Office of Elder Justice shall report to the Assistant Secretary
for Aging.</DELETED>
<DELETED> ``(4) Compensation.--The Director shall be
compensated at a rate that shall not exceed the rate
established for level I of the Executive Schedule under section
5312 of title 5, United States Code.</DELETED>
<DELETED> ``(c) Senior Advisor.--</DELETED>
<DELETED> ``(1) Appointment.--The Secretary shall appoint a
Senior Advisor on Elder Justice, from among individuals with
experience and expertise in elder justice issues.</DELETED>
<DELETED> ``(2) Duties.--The Senior Advisor on Elder Justice
shall--</DELETED>
<DELETED> ``(A) coordinate elder justice activities
among all relevant divisions, offices, and components
of the Department of Health and Human
Services;</DELETED>
<DELETED> ``(B) serve as the chairperson of the
Intra-Agency Elder Justice Steering Committee
established under section 2212; and</DELETED>
<DELETED> ``(C) provide advice to the Secretary on
elder justice issues.</DELETED>
<DELETED> ``(3) Location.--The Senior Advisor on Elder
Justice shall be located in the Office of the
Secretary.</DELETED>
<DELETED> ``(4) Position.--The position of the Senior
Advisor on Elder Justice shall be a Senior Executive Service
position, as defined in section 3132 of title 5, United States
Code.</DELETED>
<DELETED>``SEC. 2212. HEALTH AND HUMAN SERVICES INTRA-AGENCY ELDER
JUSTICE STEERING COMMITTEE.</DELETED>
<DELETED> ``(a) In General.--There is established within the
Department of Health and Human Services an Intra-Agency Elder Justice
Steering Committee (in this section referred to as the `steering
committee') to coordinate the elder justice programs and policy of the
Department of Health and Human Services.</DELETED>
<DELETED> ``(b) Membership.--The steering committee shall be
composed of representatives, appointed by the Secretary, from--
</DELETED>
<DELETED> ``(1) the Administration on Aging;</DELETED>
<DELETED> ``(2) the National Institute on Aging;</DELETED>
<DELETED> ``(3) the Centers for Medicare & Medicaid
Services;</DELETED>
<DELETED> ``(4) the Centers for Disease Control and
Prevention;</DELETED>
<DELETED> ``(5) the Agency for Healthcare Research and
Quality;</DELETED>
<DELETED> ``(6) the Administration for Children and
Families, including a representative who works in adult
protective services;</DELETED>
<DELETED> ``(7) the Office of the Assistant Secretary for
Planning and Evaluation;</DELETED>
<DELETED> ``(8) the Health Resources and Services
Administration;</DELETED>
<DELETED> ``(9) the Substance Abuse and Mental Health
Services Administration;</DELETED>
<DELETED> ``(10) the Indian Health Service; and</DELETED>
<DELETED> ``(11) such other offices or divisions within the
Department of Health and Human Services as the Secretary
determines appropriate.</DELETED>
<DELETED> ``(c) Duties.--The steering committee shall coordinate
elder justice matters for the Department of Health and Human Services
to enhance programs and collaborations and to avoid unnecessary
duplication of efforts.</DELETED>
<DELETED>``SEC. 2213. ELDER JUSTICE COORDINATING COUNCIL.</DELETED>
<DELETED> ``(a) Establishment.--There is established a committee to
be known as the Elder Justice Coordinating Council (in this section
referred to as the `Council').</DELETED>
<DELETED> ``(b) Membership.--The Council shall be composed of the
following:</DELETED>
<DELETED> ``(1) The Secretary (or the Secretary's
designee).</DELETED>
<DELETED> ``(2) The Attorney General (or the Attorney
General's designee).</DELETED>
<DELETED> ``(3) A representative, appointed by the head of
the Federal department or agency, or other entity, involved
from--</DELETED>
<DELETED> ``(A) the Department of Housing and Urban
Development;</DELETED>
<DELETED> ``(B) the Department of
Education;</DELETED>
<DELETED> ``(C) the Department of Labor;</DELETED>
<DELETED> ``(D) the Department of
Transportation;</DELETED>
<DELETED> ``(E) the Department of the
Treasury;</DELETED>
<DELETED> ``(F) the Office of Management and
Budget;</DELETED>
<DELETED> ``(G) the Office of the Surgeon
General;</DELETED>
<DELETED> ``(H) the Social Security
Administration;</DELETED>
<DELETED> ``(I) the Food and Drug
Administration;</DELETED>
<DELETED> ``(J) the Federal Trade
Commission;</DELETED>
<DELETED> ``(K) the Department of
Commerce;</DELETED>
<DELETED> ``(L) the Pension Benefit Guaranty
Corporation;</DELETED>
<DELETED> ``(M) the Securities and Exchange
Commission;</DELETED>
<DELETED> ``(N) the Commodity Futures Trading
Commission;</DELETED>
<DELETED> ``(O) the Board of Governors of the
Federal Reserve System;</DELETED>
<DELETED> ``(P) the Office of the Comptroller of the
Currency;</DELETED>
<DELETED> ``(Q) the Federal Deposit Insurance
Corporation;</DELETED>
<DELETED> ``(R) the Federal Bureau of
Investigation;</DELETED>
<DELETED> ``(S) the Centers for Disease Control and
Prevention;</DELETED>
<DELETED> ``(T) the Secret Service;</DELETED>
<DELETED> ``(U) the National Institute on
Aging;</DELETED>
<DELETED> ``(V) the Internal Revenue Service;
and</DELETED>
<DELETED> ``(W) the United States Postal
Service.</DELETED>
<DELETED> ``(4) A representative appointed by the Board of
Directors of the Legal Services Corporation from the Legal
Services Corporation.</DELETED>
<DELETED> ``(5) A representative appointed by the President
from--</DELETED>
<DELETED> ``(A) the State Justice
Institute;</DELETED>
<DELETED> ``(B) the National Research Council of the
National Academy of Sciences; and</DELETED>
<DELETED> ``(C) the Institute of Medicine of the
National Academy of Sciences.</DELETED>
<DELETED> ``(6) Representatives from other Federal agencies,
appointed by the heads of the Federal agencies with
responsibilities or programs relating to elder abuse, neglect,
and exploitation as determined appropriate by the Secretary and
the Attorney General.</DELETED>
<DELETED> ``(7) One representative from each State,
representing State and local governments, appointed by the
President from among persons designated by the Governor of such
State due to expertise in, and active work in, the area of
elder justice.</DELETED>
<DELETED> ``(8) The members of the advisory board
established under section 2214.</DELETED>
<DELETED> ``(c) Period of Appointment; Vacancies.--Members shall be
appointed for terms of 3 years. Any vacancy in the Council shall not
affect its powers, but shall be filled in the same manner as the
original appointment was made.</DELETED>
<DELETED> ``(d) Co-Chairpersons.--The Council shall be co-chaired by
the Secretary and the Attorney General (or their designees).</DELETED>
<DELETED> ``(e) Meetings.--</DELETED>
<DELETED> ``(1) In general.--The Council shall meet at least
2 times per year as determined by the co-
chairpersons.</DELETED>
<DELETED> ``(2) Elder justice summit.--</DELETED>
<DELETED> ``(A) In general.--One of the meetings
described in paragraph (1) shall be an Elder Justice
Summit to review the state of elder justice, including--</DELETED>
<DELETED> ``(i) a summary presentation
directly to the Secretary and the Attorney
General regarding--</DELETED>
<DELETED> ``(I) the nature and
dimension of the problems of elder
abuse, neglect, and
exploitation;</DELETED>
<DELETED> ``(II) Federal, State,
local, and private efforts in elder
justice;</DELETED>
<DELETED> ``(III) challenges to be
faced in elder justice;</DELETED>
<DELETED> ``(IV) promising practices
in elder justice; and</DELETED>
<DELETED> ``(V) plans and priorities
for the future in elder
justice;</DELETED>
<DELETED> ``(ii) additional presentations to
address in greater detail those topics
described in clause (i); and</DELETED>
<DELETED> ``(iii) presentations on such
other topics as the Council determines
appropriate.</DELETED>
<DELETED> ``(B) Participants.--Additional
participants, in addition to the members of the
Council, to be invited to the Elder Justice Summit
shall include--</DELETED>
<DELETED> ``(i) experts in the fields of
elder abuse, neglect, and exploitation,
selected by the co-chairpersons;</DELETED>
<DELETED> ``(ii) the chairman and ranking
member of the Special Committee on Aging of the
Senate;</DELETED>
<DELETED> ``(iii) designees of the Speaker
of the House of Representatives and the
minority leader of the House of
Representatives; and</DELETED>
<DELETED> ``(iv) governmental
representatives invited jointly by the co-
chairpersons, including--</DELETED>
<DELETED> ``(I) 1 representative
from the Federal Government;</DELETED>
<DELETED> ``(II) 1 representative
from a State government; and</DELETED>
<DELETED> ``(III) 1 representative
from a local government.</DELETED>
<DELETED> ``(C) Additional observers.--Additional
observers of the Elder Justice Summit may include
representatives of Federal, State, and local public and
private entities, as well as experts and members of the
public designated by the Council to be
observers.</DELETED>
<DELETED> ``(3) Other meetings.--In addition to the meeting
described in paragraph (2), the Council shall have at least 1
additional meeting per year in order to--</DELETED>
<DELETED> ``(A) conduct an in-depth analysis of the
numerous phenomena that make up elder abuse, neglect,
and exploitation;</DELETED>
<DELETED> ``(B) permit participants to highlight
promising practices, exchange information about
addressing challenges, and identify needs and
priorities; and</DELETED>
<DELETED> ``(C) determine a procedure for examining
and eliciting national elder justice issues and
priorities in order to guide the Council.</DELETED>
<DELETED> ``(f) Duties.--</DELETED>
<DELETED> ``(1) In general.--The Council shall make
recommendations for the coordination of activities, relating to
elder abuse, neglect, and exploitation and other crimes against
elders, to the Department of Health and Human Services, the
Department of Justice, and other relevant Federal, State,
local, and private agencies and entities.</DELETED>
<DELETED> ``(2) Report.--Not later than 2 years after the
date of enactment of the Elder Justice Act and every 2 years
thereafter, the Council shall provide to Congress a report
that--</DELETED>
<DELETED> ``(A) describes the activities of,
accomplishments of, and challenges faced by--</DELETED>
<DELETED> ``(i) the Council; and</DELETED>
<DELETED> ``(ii) the entities represented on
the Council; and</DELETED>
<DELETED> ``(B) makes recommendations for
legislation, model laws, or other appropriate
action.</DELETED>
<DELETED> ``(g) Powers of the Council.--</DELETED>
<DELETED> ``(1) Hearings.--The Council may hold such
hearings, sit and act at such times and places, take such
testimony, and receive such evidence as the Council considers
advisable to carry out this section.</DELETED>
<DELETED> ``(2) Information from federal agencies.--The
Council may secure directly from any Federal department or
agency such information as the Council considers necessary to
carry out this section. Upon request of the co-chairpersons of
the Council, the head of such department or agency shall
furnish such information to the Council.</DELETED>
<DELETED> ``(3) Postal services.--The Council may use the
United States mails in the same manner and under the same
conditions as other departments and agencies of the Federal
Government.</DELETED>
<DELETED> ``(h) Travel Expenses.--The members of the Council, and
the participants in and observers of the Elder Justice Summit shall not
receive compensation for the performance of services for the council.
The members shall be allowed, and the participants may be allowed,
travel expenses, including per diem in lieu of subsistence, at rates
authorized for employees of agencies under subchapter I of chapter 57
of title 5, United States Code, while away from their homes or regular
places of business in the performance of services for the Council.
Notwithstanding section 1342 of title 31, United States Code, the
Secretary and the Attorney General may accept the voluntary and
uncompensated services of the members and the participants.</DELETED>
<DELETED> ``(i) Detail of Government Employees.--Any Federal
Government employee may be detailed to the Council without
reimbursement, and such detail shall be without interruption or loss of
civil service status or privilege.</DELETED>
<DELETED> ``(j) Effective Date.--Section 14 of the Federal Advisory
Committee Act (5 U.S.C. App.) shall not apply to the Council.</DELETED>
<DELETED>``SEC. 2214. ADVISORY BOARD ON ELDER ABUSE, NEGLECT, AND
EXPLOITATION.</DELETED>
<DELETED> ``(a) Establishment.--There is established a board to be
known as the `Advisory Board on Elder Abuse, Neglect, and Exploitation'
(in this section referred to as the `advisory board') to create a
short- and long-term multidisciplinary strategic plan for the
development of the field of elder justice, and to make recommendations
to the Secretary, the Attorney General, the Elder Justice Coordinating
Council established under section 2213, and the appropriate committees
of Congress.</DELETED>
<DELETED> ``(b) Solicitation of Nominations.--The Secretary and the
Attorney General shall jointly publish a notice in the Federal Register
soliciting nominations for the appointment of members of the advisory
board under subsection (c).</DELETED>
<DELETED> ``(c) Composition.--The advisory board shall be composed
of members appointed jointly by the Secretary and the Attorney General,
from the general public who are individuals with experience and
expertise in elder abuse, neglect, and exploitation prevention,
intervention, treatment, law enforcement, or research, with due
consideration to representation of ethnic or racial minorities and
diverse geographic areas, including individuals who represent--
</DELETED>
<DELETED> ``(1) social service providers (including State
and local agencies with the statutory responsibility for adult
protective services);</DELETED>
<DELETED> ``(2) health care providers (including geriatrics,
emergency medicine, and nursing and mental health
professionals);</DELETED>
<DELETED> ``(3) legal professionals (including law
enforcement and the judiciary);</DELETED>
<DELETED> ``(4) gerontologists;</DELETED>
<DELETED> ``(5) psychologists;</DELETED>
<DELETED> ``(6) State and local government;</DELETED>
<DELETED> ``(7) organizations providing services to elders
and disabled persons;</DELETED>
<DELETED> ``(8) volunteer groups;</DELETED>
<DELETED> ``(9) elder rights advocates;</DELETED>
<DELETED> ``(10) family groups;</DELETED>
<DELETED> ``(11) experts in adult fiduciary relationships,
and those serving as or monitoring fiduciaries, including
guardians; and</DELETED>
<DELETED> ``(12) individuals in forensics-related positions
(including coroners and forensic pathologists).</DELETED>
<DELETED> ``(d) Vacancies.--Members shall be appointed for terms of
3 years. Any vacancy in the advisory board shall not affect its powers,
but shall be filled in the same manner as the original appointment was
made.</DELETED>
<DELETED> ``(e) Election of Officers.--The advisory board shall
elect a chairperson and vice chairperson from among the members of the
advisory board. The advisory board shall elect its initial chairperson
and vice chairperson at its initial meeting.</DELETED>
<DELETED> ``(f) Duties.--Not later than 18 months after the
establishment of the advisory board under subsection (a), and annually
thereafter, the advisory board shall prepare and submit to the
Secretary, the Attorney General, and the appropriate committees of
Congress a report containing--</DELETED>
<DELETED> ``(1) information on the status of Federal, State,
and local public and private elder justice
activities;</DELETED>
<DELETED> ``(2) recommendations (including recommended
priorities) regarding--</DELETED>
<DELETED> ``(A) elder justice programs, research,
training, services, practice, enforcement, and
coordination;</DELETED>
<DELETED> ``(B) coordination between entities
pursuing elder justice efforts and those involved in
related areas that may inform or overlap with elder
justice efforts, such as activities to combat violence
against women and child abuse and neglect;
and</DELETED>
<DELETED> ``(C) activities relating to adult
fiduciary systems, including guardianship and other
fiduciary arrangements;</DELETED>
<DELETED> ``(3) recommendations for specific modifications
needed in Federal and State laws (including regulations) or for
programs, research, and training to enhance prevention,
detection, diagnosis, treatment, intervention in,
investigation, and prosecution of elder abuse, neglect, and
exploitation;</DELETED>
<DELETED> ``(4) recommendations for the most effective
coordinated national data collection with respect to elder
justice, and elder abuse, neglect, and exploitation;
and</DELETED>
<DELETED> ``(5) recommendations for a multidisciplinary
strategic plan to guide the effective and efficient development
of the elder justice area.</DELETED>
<DELETED> ``(g) Powers of the Advisory Board.--</DELETED>
<DELETED> ``(1) Hearings.--The advisory board may hold such
hearings, sit and act at such times and places, take such
testimony, and receive such evidence as the advisory board
considers advisable to carry out this section.</DELETED>
<DELETED> ``(2) Information from federal agencies.--The
advisory board may secure directly from any Federal department
or agency such information as the advisory board considers
necessary to carry out this section. Upon request of the co-
chairpersons of the advisory board, the head of such department
or agency shall furnish such information to the advisory
board.</DELETED>
<DELETED> ``(3) Sharing of data and reports.--The advisory
board may secure from any entity pursuing elder justice
activities under the Elder Justice Act or an amendment made by
that Act, any data, reports, or recommendations generated in
connection with such activities.</DELETED>
<DELETED> ``(4) Postal services.--The advisory board may
use the United States mails in the same manner and under the
same conditions as other departments and agencies of the
Federal Government.</DELETED>
<DELETED> ``(h) Travel Expenses.--The members of the advisory board
shall not receive compensation for the performance of services for the
advisory board, but shall be allowed travel expenses, including per
diem in lieu of subsistence, at rates authorized for employees of
agencies under subchapter I of chapter 57 of title 5, United States
Code, while away from their homes or regular places of business in the
performance of services for the advisory board. Notwithstanding section
1342 of title 31, United States Code, the Secretary and the Attorney
General may accept the voluntary and uncompensated services of the
members of the advisory board.</DELETED>
<DELETED> ``(i) Detail of Government Employees.--Any Federal
Government employee may be detailed to the advisory board without
reimbursement, and such detail shall be without interruption or loss of
civil service status or privilege.</DELETED>
<DELETED> ``(j) Effective Date.--Section 14 of the Federal Advisory
Committee Act (5 U.S.C. App.) shall not apply to the advisory
board.</DELETED>
<DELETED>``Subtitle B--Activities to Promote Elder Justice</DELETED>
<DELETED>``SEC. 2221. DATA COLLECTION AND DISSEMINATION.</DELETED>
<DELETED> ``(a) Elder Justice Resource Center.--</DELETED>
<DELETED> ``(1) Establishment.--The Secretary, after
consultation with the Attorney General, shall establish within
the Office of Elder Justice (established under this title), an
Elder Justice Resource Center (in this section referred to as
the `Center') to be the central repository for information
regarding elder abuse, neglect, and exploitation.</DELETED>
<DELETED> ``(2) Duties.--The Center shall--</DELETED>
<DELETED> ``(A) develop the capacity and procedures
to collect, maintain, and disseminate information
relevant to consumers, families, providers, clinicians,
advocates, regulators, law enforcement, policymakers,
researchers, fiduciaries including guardians, judges,
and lawyers, relevant to the prevention, detection,
assessment, identification, and treatment of,
intervention in, and prosecution of, elder abuse,
neglect, and exploitation;</DELETED>
<DELETED> ``(B) provide, in a user-friendly manner,
information on--</DELETED>
<DELETED> ``(i) ways to promote autonomy in
the face of aging or diminishing capacity and
mobility;</DELETED>
<DELETED> ``(ii) how to avoid becoming a
victim of elder abuse, neglect, or
exploitation; and</DELETED>
<DELETED> ``(iii) advance planning and how
to avoid the need for a fiduciary;</DELETED>
<DELETED> ``(C) provide links and references to
other sources of information;</DELETED>
<DELETED> ``(D) compile, analyze, and publish a
summary of research conducted on elder abuse, neglect,
and exploitation and information on how to obtain the
original research materials;</DELETED>
<DELETED> ``(E) solicit public comment and comment
from the advisory board established under section 2214
on the activities of the Center;</DELETED>
<DELETED> ``(F) establish a toll-free number for
information and referrals;</DELETED>
<DELETED> ``(G) coordinate activities with resource
centers and clearinghouses on elder justice topics;
and</DELETED>
<DELETED> ``(H) provide funding to public and
private agencies and entities to develop or continue
the efforts of specialized elder justice-related
clearinghouses and information repositories, to be
linked to the Center, that address topics such as those
enumerated in subparagraphs (A) and (B) and that
provide effective services.</DELETED>
<DELETED> ``(3) Coordination of available resources.--In
establishing the Center under this subsection the Secretary,
after consultation with the Attorney General, shall--</DELETED>
<DELETED> ``(A) consult with other Federal agencies
that operate similar resource centers;</DELETED>
<DELETED> ``(B) consult with private entities that
operate resource centers or clearinghouses on elder
justice related topics;</DELETED>
<DELETED> ``(C) consult with the head of each agency
participating in the Elder Justice Coordinating Council
established under section 2213, as well as other
agencies with clearinghouses comparable to the Center,
such as clearinghouses relating to child abuse and
neglect, to determine the most efficient and effective
manner for collecting, maintaining, and disseminating
information on elder abuse, neglect, and exploitation;
and</DELETED>
<DELETED> ``(D) solicit public comment on the
components of such Center.</DELETED>
<DELETED> ``(4) National elder justice library.--</DELETED>
<DELETED> ``(A) Establishment.--The Secretary shall
establish within the Center, a National Elder Justice
Library (in this paragraph referred to as the
`Library') to serve as a centralized repository for all
types of appropriate materials concerning training,
technical assistance, and promising practices relating
to elder justice including--</DELETED>
<DELETED> ``(i) brochures and
pamphlets;</DELETED>
<DELETED> ``(ii) video and computer-based
resources;</DELETED>
<DELETED> ``(iii) books; and</DELETED>
<DELETED> ``(iv) training
materials.</DELETED>
<DELETED> ``(B) Index.--The Library shall create and
maintain an up-to-date index of the materials described
in subparagraph (A) by title, author, date, subject,
and type of material, and a brief description of such
materials. Such index shall be available on the
Internet as well as in printed form in order to be
easily accessible to the general public.</DELETED>
<DELETED> ``(C) Availability.--The materials held by
the Library shall be available for copying by
individuals and entities nationwide and shall be
disseminated at a nominal or no fee. The materials
shall be copied and disseminated in accordance with the
applicable provisions of title 17, United States
Code.</DELETED>
<DELETED> ``(D) Duties.--</DELETED>
<DELETED> ``(i) Additional materials.--The
Library shall--</DELETED>
<DELETED> ``(I) collect data on
materials that would be appropriate for
such library;</DELETED>
<DELETED> ``(II) make efforts to
identify and obtain appropriate
materials; and</DELETED>
<DELETED> ``(III) identify and
obtain materials relating to effective
methods of conducting training and
providing technical assistance relating
to elder justice, including conducting
the training and providing the
assistance for underserved populations.</DELETED>
<DELETED> ``(ii) Information packets.--After
evaluating the materials described in this
paragraph, the Library shall compile and
develop information packets for use by groups
in various settings including groups who are
underserved or have other special needs. Such
information packets shall include information
and materials on training, technical
assistance, and promising practices targeted at
specific topics, groups, and
settings.</DELETED>
<DELETED> ``(b) Collection of Uniform National Data on Elder Abuse,
Neglect, and Exploitation.--</DELETED>
<DELETED> ``(1) Purpose.--The purpose of this subsection is
to improve, streamline, and promote uniform collection,
maintenance, and dissemination of national data relating to
elder abuse, neglect, and exploitation.</DELETED>
<DELETED> ``(2) Phase i.--</DELETED>
<DELETED> ``(A) In general.--Not later than 1 year
after the date of enactment of the Elder Justice Act,
the Director of the Centers for Disease Control and
Prevention (in this subsection referred to as the
`Director'), after consultation with the Attorney
General and working with experts in relevant
disciplines, shall--</DELETED>
<DELETED> ``(i) develop a method for
collecting national data regarding elder abuse,
neglect, and exploitation; and</DELETED>
<DELETED> ``(ii) develop uniform national
data reporting forms adapted to each relevant
entity or discipline (such as health, public
safety, social and protective services, and
law) reflecting--</DELETED>
<DELETED> ``(I) the distinct manner
in which each discipline receives and
maintains information; and</DELETED>
<DELETED> ``(II) the sequence and
history of reports to or involvement of
different disciplines, independently,
or the sequence and history of reports
from one discipline to another over
time.</DELETED>
<DELETED> ``(B) Forms.--The national data reporting
forms described in subparagraph (A)(ii) shall
incorporate the definitions of this title, for use in
determining what is considered a reportable
event.</DELETED>
<DELETED> ``(3) Phase ii.--</DELETED>
<DELETED> ``(A) In general.--Not later than 1 year
after the completion of the activities described in
paragraph (2), the Director shall ensure that the
national data reporting forms and data collection
methods developed in accordance with such paragraph are
pilot tested in 6 States determined by the
Director.</DELETED>
<DELETED> ``(B) Adjustments to the form and
methods.--The Director, after considering the results
of the pilot testing described in subparagraph (A), and
after consultation with the Attorney General and
relevant experts shall adjust the national data
reporting forms and data collection methods as
necessary.</DELETED>
<DELETED> ``(4) Phase iii.--</DELETED>
<DELETED> ``(A) Distribution of national data
reporting forms.--After completion of the adjustment to
the national data reporting forms under paragraph
(3)(B), the Director shall submit the national data
reporting forms along with instructions to--</DELETED>
<DELETED> ``(i) the heads of the relevant
components of the Department of Health and
Human Services, the Department of Justice, and
the Department of the Treasury, and such other
Federal entities as may be appropriate;
and</DELETED>
<DELETED> ``(ii) the Governor's office of
each State for collection from all relevant
State entities of data, including health care,
social services, and law enforcement
data.</DELETED>
<DELETED> ``(B) Data collection grants.--</DELETED>
<DELETED> ``(i) Authorization.--The Director
is authorized to award grants to States to
improve data collection activities relating to
elder abuse, neglect, and
exploitation.</DELETED>
<DELETED> ``(ii) Amount.--The amount of
funds provided under each grant awarded to a
State under this subsection shall not exceed
$200,000, to be distributed in accordance with
clause (v).</DELETED>
<DELETED> ``(iii) Application.--Each State
desiring a grant under this subparagraph shall
submit to the Director an application at such
time, in such manner, and containing such
information as the Director may
require.</DELETED>
<DELETED> ``(iv) Requirements.--Each State
receiving a grant under this subparagraph for a
fiscal year is required to report data for the
calendar year that begins during that fiscal
year, using the national data reporting forms
described in subparagraph (A).</DELETED>
<DELETED> ``(v) Funding.--</DELETED>
<DELETED> ``(I) First year.--For the
first fiscal year in which a State
receives grant funds under this
subsection the Director shall initially
distribute 50 percent of such funds.
The Director shall distribute the
remaining funds at the end of the
calendar year that begins during that
fiscal year, if the Director determines
that the State has properly reported
data required under this subsection for
the calendar year.</DELETED>
<DELETED> ``(II) Subsequent years.--
Except as provided in subclause (I),
the Director shall distribute grant
funds to a State under this subsection
for a fiscal year if the Director
determines that the State properly
reported data required under this
subsection for the calendar year that
ends during that fiscal year.</DELETED>
<DELETED> ``(C) Required information.--Each report
submitted under this paragraph shall receive an
identifier beginning with a 2-letter State code, and a
2-letter year code, and such numbers as the Director
determines to be appropriate. Each individual report
shall be assigned a new identifier, even if a victim
described in the report is reported to have been
victimized more than once. If the State submits a
report for more than one discipline, the State shall
submit a combined report to avoid double counting. The
State shall note in each report whether an event was
ongoing or occurred in distinct separate
episodes.</DELETED>
<DELETED> ``(5) Report.--Not later than 1 year after the
date of enactment of the Elder Justice Act and annually
thereafter, the Director shall prepare and submit to the
appropriate committees of Congress, including to the Special
Committee on Aging of the Senate, a report regarding activities
conducted under this subsection.</DELETED>
<DELETED> ``(6) Regulations.--The Secretary shall promulgate
such regulations as are necessary to carry out this
subsection.</DELETED>
<DELETED>``SEC. 2222. ENHANCING RESEARCH AND TRAINING AND STRENGTHENING
SERVICES, SYSTEMS, AND PREVENTION.</DELETED>
<DELETED> ``(a) Grants.--The Secretary may award grants to eligible
entities for the prevention, detection, assessment, and treatment of,
intervention in, investigation of, and prosecution of elder abuse,
neglect, and exploitation including--</DELETED>
<DELETED> ``(1) physical, psychological, and emotional abuse
and neglect by family and other in-home caregivers;</DELETED>
<DELETED> ``(2) physical, psychological, and emotional abuse
and neglect of residents in institutional and other residential
care facilities;</DELETED>
<DELETED> ``(3) elder sexual abuse;</DELETED>
<DELETED> ``(4) domestic violence in later life;</DELETED>
<DELETED> ``(5) financial fraud and exploitation;
and</DELETED>
<DELETED> ``(6) self-neglect.</DELETED>
<DELETED> ``(b) Centers of Excellence.--</DELETED>
<DELETED> ``(1) Grants authorized.--The Secretary, through
the Director of the National Institute on Aging, and after
consultation with the Director of the Centers for Disease
Control and Prevention, 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, and the members of the advisory board established
under section 2214, may award grants to institutions of higher
education and other appropriate entities to establish 5 Centers
of Excellence nationwide that shall specialize in research,
clinical practice, and training relating to elder abuse,
neglect, and exploitation.</DELETED>
<DELETED> ``(2) Authorized activities.--The Centers of
Excellence established with funds provided under paragraph (1)
shall conduct the following activities:</DELETED>
<DELETED> ``(A) Examine potential issues relating to
the protection of elders who are the subjects of
research on elder abuse, neglect, and exploitation and
provide guidance to other elder abuse, neglect, or
exploitation researchers regarding human subjects,
protections, and the institutional or peer review
boards at research institutions.</DELETED>
<DELETED> ``(B) After consultation with the Director
of the National Institute on Aging, and the Director of
the Office of Human Research Protections, develop and
recommend to the Secretary guidelines to assist the
institutional or peer review boards in the review of
research under this title.</DELETED>
<DELETED> ``(C) Coordinate activities, to the extent
feasible, among the Centers and with other researchers
of elder abuse, neglect, and exploitation and related
areas, and designate 1 such Center to lead such
coordination.</DELETED>
<DELETED> ``(3) Additional activities.--The Centers of
Excellence established under paragraph (1) may conduct
activities including the following:</DELETED>
<DELETED> ``(A) Carrying out a study to determine
the national incidence and prevalence of elder abuse,
neglect, and exploitation in all settings.</DELETED>
<DELETED> ``(B) Developing uniform, validated
screening tools to assist individuals, families,
practitioners, institutions, and communities in
detecting ongoing or potential elder abuse, neglect,
and exploitation. The tools that may be developed
include--</DELETED>
<DELETED> ``(i) a screening tool to
determine whether a particular elder is at risk
for becoming, or is, a victim;</DELETED>
<DELETED> ``(ii) a screening tool to measure
whether caregivers are at risk of committing
elder abuse, neglect, or
exploitation;</DELETED>
<DELETED> ``(iii) a screening tool to
measure whether families are at risk for elder
abuse, neglect, and exploitation; and</DELETED>
<DELETED> ``(iv) a screening tool to assess
communities, evaluating how each individual
agency or system relating to elder abuse,
neglect, or exploitation operates in such a
community and how all of such agencies or
systems communicate and operate in relationship
to each other within such community.</DELETED>
<DELETED> ``(C) Carrying out various types of
intervention research.</DELETED>
<DELETED> ``(D) Identifying steps that can be taken
(and replicated) to make homes, neighborhoods,
communities, and facilities safer for elders, and to
enhance their sense of security in all kinds of
environments.</DELETED>
<DELETED> ``(E) Researching successful fiduciary
practices and systems to enhance the well-being of
persons with diminished capacity.</DELETED>
<DELETED> ``(4) Collaboration and access to records.--In
awarding a grant under this subsection the Secretary shall--
</DELETED>
<DELETED> ``(A) consider the potential for
collaboration among researchers and other relevant
entities, such as State agencies with statutory
responsibility for adult protective services and State
Long-Term Care Ombudsmen, that receive reports of elder
abuse, neglect, and exploitation, but that may be
restricted from participating in research as a result
of State law, confidentiality requirements, or other
provisions; and</DELETED>
<DELETED> ``(B) require that each institution of
higher education desiring a grant under this subsection
ensure that the researchers working at such institution
will have access to records necessary to conduct
research in accordance with this subsection.</DELETED>
<DELETED> ``(5) Excellence advisory committee.--</DELETED>
<DELETED> ``(A) Committee established.--There is
established in the Department of Health and Human
Services an Excellence Advisory Committee (in this
subsection referred to as the `Committee').</DELETED>
<DELETED> ``(B) Membership.--The Committee shall be
composed of individuals appointed by the Secretary with
a demonstrated interest and expertise in research,
education, and clinical activities related to elder
abuse, neglect, and exploitation, or individuals with
related experience in essential fields such as
epidemiology or forensic pathology, including--
</DELETED>
<DELETED> ``(i) representatives from private
entities; and</DELETED>
<DELETED> ``(ii) representatives from
Federal and State agencies, including--
</DELETED>
<DELETED> ``(I)
researchers;</DELETED>
<DELETED> ``(II) health care
practitioners;</DELETED>
<DELETED> ``(III) policy experts;
and</DELETED>
<DELETED> ``(IV) other individuals
appropriate to promote useful research,
training, and clinical
practice.</DELETED>
<DELETED> ``(C) Period of appointment; vacancies.--
Members shall be appointed for terms of 3 years. Any
vacancy in the Committee shall not affect its powers,
but shall be filled in the same manner as the original
appointment was made.</DELETED>
<DELETED> ``(D) Duties.--The Committee shall
coordinate with the Advisory Board established under
section 2214 and shall make recommendations to the
Secretary, the Attorney General, the Elder Justice
Coordinating Council established under section 2213, and the Centers of
Excellence established under this subsection concerning--</DELETED>
<DELETED> ``(i) facilitating the
coordination of the activities of the Centers
of Excellence established under this
subsection;</DELETED>
<DELETED> ``(ii) developing procedures and
mechanisms for data sharing between such
Centers of Excellence; and</DELETED>
<DELETED> ``(iii) ensuring that such Centers
of Excellence have similar systems and research
and reporting procedures in order to facilitate
the sharing of data.</DELETED>
<DELETED> ``(E) Travel expenses.--The members of the
Committee shall not receive compensation for the
performance of services for the committee, but shall be
allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of
agencies under subchapter I of chapter 57 of title 5,
United States Code, while away from their homes or
regular places of business in the performance of
services for the Committee. Notwithstanding section
1342 of title 31, United States Code, the Secretary may
accept the voluntary and uncompensated services of
members of the Committee.</DELETED>
<DELETED> ``(F) Detail of government employees.--Any
Federal Government employee may be detailed to the
Committee without reimbursement, and such detail shall
be without interruption or loss of civil service status
or privilege.</DELETED>
<DELETED> ``(G) Termination.--Section 14 of the
Federal Advisory Committee Act (5 U.S.C. App.) shall
not apply to the Committee.</DELETED>
<DELETED> ``(c) Safe Haven and Legal Advocacy Grants.--</DELETED>
<DELETED> ``(1) Safe haven grants.--</DELETED>
<DELETED> ``(A) Grants authorized.--The Secretary
may award grants to 6 diverse communities to examine
various types of elder shelters (in this paragraph
referred to as `safe havens') and to test various
models for establishing safe havens at home or
elsewhere.</DELETED>
<DELETED> ``(B) Authorized activities.--Grant funds
awarded pursuant to subparagraph (A) shall be used to
establish safe havens that--</DELETED>
<DELETED> ``(i) provide a comprehensive,
culturally sensitive, and multidisciplinary
team response to allegations of elder abuse,
neglect, or exploitation;</DELETED>
<DELETED> ``(ii) provide a dedicated, elder-
friendly setting;</DELETED>
<DELETED> ``(iii) have the capacity to meet
the needs of elders for care; and</DELETED>
<DELETED> ``(iv) provide various services
including--</DELETED>
<DELETED> ``(I) nursing and forensic
evaluation;</DELETED>
<DELETED> ``(II) therapeutic
intervention;</DELETED>
<DELETED> ``(III) victim support and
advocacy; and</DELETED>
<DELETED> ``(IV) case review and
assistance to make the elder safer at
home or to find appropriate placement
in safer environments, including
shelters, and, in some circumstances
long-term care facilities, other
residential care facilities, and
hospitals.</DELETED>
<DELETED> ``(2) Legal advocacy grants.--</DELETED>
<DELETED> ``(A) Grants authorized.--The Secretary,
after consultation with the Attorney General, may award
grants--</DELETED>
<DELETED> ``(i) to study the need for
community resources in order to provide
assistance for legal and related services for
victims of elder abuse, neglect, or
exploitation; and</DELETED>
<DELETED> ``(ii) to provide assistance for
such services by awarding grants for
demonstration projects in diverse
communities.</DELETED>
<DELETED> ``(B) Authorized activities.--Grant funds
awarded pursuant to subparagraph (A) shall be used to
provide--</DELETED>
<DELETED> ``(i) court-appointed
advocates;</DELETED>
<DELETED> ``(ii) authorized fiduciaries,
including public guardians;</DELETED>
<DELETED> ``(iii) monitoring and oversight
of fiduciaries;</DELETED>
<DELETED> ``(iv) legal services;
and</DELETED>
<DELETED> ``(v) such other services as the
Secretary, after consultation with the Attorney
General, determines appropriate.</DELETED>
<DELETED> ``(d) Grants To Enhance Volunteer Services.--The
Secretary, after consultation with the Attorney General, may award
grants to nonprofit organizations and faith-based organizations to
encourage such organizations to establish or continue volunteer
programs that focus on the issues of elder abuse, neglect, and
exploitation, or that provide related services.</DELETED>
<DELETED> ``(e) Multidisciplinary Efforts.--</DELETED>
<DELETED> ``(1) Grants.--The Secretary may award grants to
fund various multidisciplinary elder justice activities,
including the following:</DELETED>
<DELETED> ``(A) Supporting and studying team
approaches for bringing a coordinated multidisciplinary
or interdisciplinary response to elder abuse, neglect,
and exploitation, including a response from individuals
in social service, health care, public safety, and
legal disciplines.</DELETED>
<DELETED> ``(B) Establishing State coordinating
councils modeled after the national Elder Justice
Coordinating Council established under section 2213.
Such State coordinating councils shall identify the
individual States' needs and provide the national Elder
Justice Coordinating Council with information and
recommendations relating to State efforts to combat
elder abuse, neglect, and exploitation.</DELETED>
<DELETED> ``(C) Providing training, technical
assistance, and other methods of support to
groups carrying out multidisciplinary efforts at the State level
(referred to in some States as `State Working Groups').</DELETED>
<DELETED> ``(D) Broadening and studying various
models for elder fatality and serious injury review
teams, to make recommendations about their composition,
protocols, functions, timing, roles, and
responsibilities, with a goal of producing models and
information that will allow for replication based on
the needs of other States and communities.</DELETED>
<DELETED> ``(E) Carrying out other interdisciplinary
or multidisciplinary efforts as determined by the
Secretary to be appropriate.</DELETED>
<DELETED> ``(2) Intradisciplinary review.--</DELETED>
<DELETED> ``(A) In general.--The Director of the
Centers for Disease Control and Prevention, after
consultation 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 an intensive
intradisciplinary review of entities that conduct elder
justice activities in several different communities,
examining how the entities address elder abuse,
neglect, and exploitation issues (such as an assessment
of various types of health care and social service
providers, public safety agencies, law enforcement
agencies, prosecutor offices, and the
judiciary).</DELETED>
<DELETED> ``(B) Goal.--The goals of the study
described in subparagraph (A) include--</DELETED>
<DELETED> ``(i) making an assessment of the
functioning and effectiveness of each entity in
a community that conducts elder justice
activities, and the interdisciplinary
communications and collaborations among such
entities; and</DELETED>
<DELETED> ``(ii) developing a procedure for
communities to conduct a self-assessment to
assist them in identifying the manner in which
the entities described in clause (i) in such
communities respond to elder justice issues,
the needs of such communities relating to elder
justice issues, and ways to improve the
response systems of such communities for elder
abuse, neglect, and exploitation.</DELETED>
<DELETED> ``(f) Training Grants.--</DELETED>
<DELETED> ``(1) Grants authorized.--The Secretary may award
grants to groups representing the targeted disciplines
described in paragraph (2)(B) to train individuals with respect
to issues of elder abuse, neglect, and exploitation.</DELETED>
<DELETED> ``(2) Authorized activities.--</DELETED>
<DELETED> ``(A) In general.--Grant funds awarded
under paragraph (1) shall be used for training within a
discipline as well as cross-training activities that
permit individuals in multiple disciplines to train
together, fostering communication, coordinating
efforts, and ensuring collaboration.</DELETED>
<DELETED> ``(B) Targeted disciplines.--Groups
representing disciplines that will be targeted for
training through grants awarded under paragraph (1)
include--</DELETED>
<DELETED> ``(i) physicians (geriatricians,
family physicians, internists, emergency
physicians, forensic pathologists and medical
examiners, psychiatrists, and other
specialists), and medical residents, interns,
and fellows;</DELETED>
<DELETED> ``(ii) nurses and nurse's aides,
including geriatric nurse practitioners,
directors of nursing, and Sexual Abuse Nurse
Examiners (SANE) nurses;</DELETED>
<DELETED> ``(iii) social workers;</DELETED>
<DELETED> ``(iv) public health and safety
professionals including Emergency Medical
Services professionals;</DELETED>
<DELETED> ``(v) therapists, including
creative arts, occupational, speech, and
physical therapists;</DELETED>
<DELETED> ``(vi) State surveyors (who survey
nursing facilities and other long-term care
facilities);</DELETED>
<DELETED> ``(vii) long-term care facility
and hospital staff;</DELETED>
<DELETED> ``(viii) coroners and funeral home
operators;</DELETED>
<DELETED> ``(ix) Federal, State, and local
offices with responsibility for elder justice
or long-term care matters;</DELETED>
<DELETED> ``(x) employees or contractors of
State and local agencies with responsibility
for training persons who provide adult
protective services;</DELETED>
<DELETED> ``(xi) State Long-Term Care
Ombudsmen;</DELETED>
<DELETED> ``(xii) victim advocates and
advocates for elders and individuals with
disabilities;</DELETED>
<DELETED> ``(xiii) individuals involved in
volunteer organizations (including faith-based
organizations) who are involved in issues of
elder abuse, neglect, and
exploitation;</DELETED>
<DELETED> ``(xiv) police officers, sheriffs,
detectives, firefighters, Federal and State
investigators, public safety officers, and
corrections personnel;</DELETED>
<DELETED> ``(xv) Federal, State, and local
prosecutors, attorneys in private practice
involved in elder justice issues, and judges
and court employees;</DELETED>
<DELETED> ``(xvi) TRIADs (federally
recognized partnerships of elders, sheriff
departments, and the American Association of
Retired Persons);</DELETED>
<DELETED> ``(xvii) elder service
officers;</DELETED>
<DELETED> ``(xviii) individuals who work
with the public, including bank personnel,
postal workers, utility workers, providers of
home-delivered meals, and others who may work
with elders;</DELETED>
<DELETED> ``(xix) students in professional
and paraprofessional schools, internships,
fellowships, and other training programs in a
relevant profession;</DELETED>
<DELETED> ``(xx) fiduciaries, including
guardians, conservators, and agents under
powers of attorney; and</DELETED>
<DELETED> ``(xxi) staff and volunteers of
domestic violence and child abuse and neglect
programs.</DELETED>
<DELETED> ``(g) Pilot Project To Evaluate Utility of Services to
Elders in Need.--The Secretary, acting through the Director of the
Office of Elder Justice in the Department of Health and Human Services,
and after consultation with the Director of the Office of Elder Justice
in the Department of Justice, is authorized to award grants to develop
and implement pilot projects designed to ameliorate gaps in basic elder
justice-related health, social, or protective services, with the goal
of identifying what types of services are most useful to elders in
need, and in what contexts the services are useful.</DELETED>
<DELETED> ``(h) Increasing the Number of Health Care Professionals
With Geriatric Training.--The Secretary shall establish programs to
increase--</DELETED>
<DELETED> ``(1) the number of health care professionals
(including physicians, nurses, nursing personnel, social
workers, and therapists) and students in the health care
professions, who receive education and training related to
geriatrics; and</DELETED>
<DELETED> ``(2) the number of such professionals who provide
health care related to geriatrics.</DELETED>
<DELETED> ``(i) Special Needs Grants.--</DELETED>
<DELETED> ``(1) Grants authorized.--The Secretary may award
grants to eligible entities to identify, address, and make
recommendations on meeting the special needs of underserved
populations of elders.</DELETED>
<DELETED> ``(2) Populations included.--The grant funds
awarded pursuant to paragraph (1) shall be used to fund
programs including the following:</DELETED>
<DELETED> ``(A) Rural settings.--Programs designed
to meet the needs of elders living in rural locations,
including the needs of their informal caregivers and
fiduciaries. The programs shall include--</DELETED>
<DELETED> ``(i) strategies to decrease
isolation;</DELETED>
<DELETED> ``(ii) training for informal
caregivers and fiduciaries;</DELETED>
<DELETED> ``(iii) activities involving
collaboration between the entities and local
secondary schools and institutions of higher
education to offer classes for credit, focusing
on training individuals to work with elders and
caregivers;</DELETED>
<DELETED> ``(iv) training for volunteers to
serve in rural communities; and</DELETED>
<DELETED> ``(v) strategies on the use of
advance planning to avoid the need for a
guardian or other fiduciary.</DELETED>
<DELETED> ``(B) Minority populations.--Programs
designed to meet the needs of elders in minority
populations, including culturally and linguistically
appropriate programs.</DELETED>
<DELETED> ``(C) Indian tribes.--Programs designed to
provide necessary services to elders who are members of
Indian tribes including successful programs in elder
abuse, neglect, and exploitation prevention and
treatment that target Indian populations. The entities
carrying out the programs shall deliver services and
distribute educational information on elder abuse,
neglect, and exploitation to Indian tribes and other
policymakers, health and social service providers, law
enforcement, and researchers with a particular interest
in elders who are members of Indian tribes.</DELETED>
<DELETED> ``(j) Public Awareness Grants.--</DELETED>
<DELETED> ``(1) Grants authorized.--The Secretary and the
Attorney General, after consultation with the advisory board
established under section 2214 and the coordinating council
established under section 2213, shall jointly award 1 grant to
a national organization, or 1 or more grants to eligible
entities, to conduct a national multimedia campaign designed to
raise awareness about elder abuse, neglect, and
exploitation.</DELETED>
<DELETED> ``(2) Authorized activities.--Grant funds awarded
under paragraph (1) shall be used for activities including the
following:</DELETED>
<DELETED> ``(A) Raising public awareness regarding
financial schemes that target elders.</DELETED>
<DELETED> ``(B) Pilot testing of the effectiveness
of various types of multimedia campaigns in raising
awareness about--</DELETED>
<DELETED> ``(i) the types of elder abuse,
neglect, and exploitation;</DELETED>
<DELETED> ``(ii) steps to take if an
individual suspects elder abuse, neglect, or
exploitation has occurred; and</DELETED>
<DELETED> ``(iii) ways to prevent elder
abuse, neglect, or exploitation.</DELETED>
<DELETED> ``(k) Elder Justice Innovation Fund.--The Secretary and
the Attorney General are authorized to jointly award grants to
individuals or entities working in the elder justice field or related
fields for research, a demonstration project, development or
implementation of a promising program or practice, or another
innovative effort, that might not otherwise be funded or pursued in the
absence of a grant under this subsection.</DELETED>
<DELETED>``SEC. 2223. STUDIES.</DELETED>
<DELETED> ``(a) Roles of Entities Responding to Elder Abuse,
Neglect, and Exploitation.--</DELETED>
<DELETED> ``(1) In general.--The Secretary of Health and
Human Services and the Attorney General shall jointly sponsor
or conduct a study of the roles and responsibilities of
government and government-funded entities responsible for
responding to, investigating, and taking other actions in
response to reports of elder abuse, neglect, and exploitation
including--</DELETED>
<DELETED> ``(A) State and local agencies with the
responsibility for adult protective services;</DELETED>
<DELETED> ``(B) the State Long-Term Care
Ombudsmen;</DELETED>
<DELETED> ``(C) law enforcement (including
prosecutors);</DELETED>
<DELETED> ``(D) fiduciaries;</DELETED>
<DELETED> ``(E) judges and other court personnel;
and</DELETED>
<DELETED> ``(F) such other social and protective
service, advocacy, and protection organizations as the
Secretary and the Attorney General determine to be
appropriate.</DELETED>
<DELETED> ``(2) Goals.--The goals of the study authorized in
paragraph (1) (which may be conducted in distinct sections, if
there is overall coordination) are--</DELETED>
<DELETED> ``(A) to identify gaps in detection of,
investigation of, and intervention in elder abuse,
neglect, and exploitation;</DELETED>
<DELETED> ``(B) to improve the response to elder
abuse, neglect, and exploitation; and</DELETED>
<DELETED> ``(C) to reduce elder victimization and
its consequences by assessing and improving the systems
created to address reports of the problems.</DELETED>
<DELETED> ``(3) Authorized activities.--In conducting the
study authorized in paragraph (1), the Director shall--
</DELETED>
<DELETED> ``(A) conduct an evaluation of--</DELETED>
<DELETED> ``(i) how the social and
protective service, advocacy, protection,
judicial, and law enforcement entities and
systems are operating;</DELETED>
<DELETED> ``(ii) the interplay and
allocation of responsibilities among those
entities;</DELETED>
<DELETED> ``(iii) how that allocation
differs from community to community and State
to State; and</DELETED>
<DELETED> ``(iv) how those differences
impact the population intended to be protected
by the entities and systems;</DELETED>
<DELETED> ``(B) make recommendations on how to
clarify the roles (at the national level) of entities
such as State agencies with responsibility for adult
protective services, the State Long-Term Care
Ombudsmen, and other protection and advocacy entities
to enhance efficiency, eliminate gaps in service, and
identify conflicting mandates and duplication of
efforts; and</DELETED>
<DELETED> ``(C) evaluate how various communities
delineate the roles and responsibilities of the types
of entities described in subparagraph (A) in order to
identify and recommend effective models and methods to
duplicate the delineation efforts (such as duplication
through memoranda of understanding).</DELETED>
<DELETED> ``(b) Family Elder Abuse, Neglect, and Exploitation
Study.--</DELETED>
<DELETED> ``(1) In general.--The Director of the Centers for
Disease Control and Prevention (in this subsection referred to
as the `Director'), after consultation 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 perspective, including examining methods
to reduce elder abuse, neglect, and exploitation committed by
family members.</DELETED>
<DELETED> ``(2) Collaboration.--The Director, in carrying
out activities under this subsection, shall collaborate 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 determines
appropriate.</DELETED>
<DELETED>``SEC. 2224. FORENSIC MARKERS, METHODOLOGIES, AND
TRAINING.</DELETED>
<DELETED> ``(a) Forensic Centers.--</DELETED>
<DELETED> ``(1) Grants.--The Secretary shall make grants to
appropriate entities to establish and operate stationary and
mobile forensic centers, to develop forensic expertise
regarding, and provide services relating to, elder abuse,
neglect, and exploitation.</DELETED>
<DELETED> ``(2) Coordination among forensic centers 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) and with the Excellence Advisory Committee described
in section 2222(b)(5). Such coordination shall include ongoing
communication among the entities, the Centers of Excellence,
and the Excellence Advisory Committee. The entities shall
adhere to the procedures and mechanisms developed by the
Excellence Advisory Committee including procedures and
mechanisms relating to the sharing of data.</DELETED>
<DELETED> ``(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 commitment 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 institution of higher
education.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(5) Use of funds.--</DELETED>
<DELETED> ``(A) Development of forensic markers and
methodologies.--An entity that receives a grant under
this subsection shall use funds made available through
the grant to assist in the determination of whether
abuse or neglect occurred, a crime was committed, to
conduct research to describe and disseminate
information on--</DELETED>
<DELETED> ``(i) forensic markers that
indicate a case in which elder abuse, neglect,
or exploitation may have occurred;
and</DELETED>
<DELETED> ``(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
authorities.</DELETED>
<DELETED> ``(B) Applications.--An entity that
receives a grant under this subsection shall use funds
made available through the grant to develop 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.</DELETED>
<DELETED> ``(C) Collection of evidence.--An entity
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 capacity to collect forensic evidence,
including collecting forensic evidence relating to a
potential determination of elder abuse, neglect, or
exploitation.</DELETED>
<DELETED> ``(b) Training To Develop Expertise in Geriatric
Forensics.--</DELETED>
<DELETED> ``(1) Fellowship programs.--</DELETED>
<DELETED> ``(A) In general.--The Secretary shall
provide fellowships to eligible individuals, to enable
the individuals to obtain training through a standard
forensic science training program.</DELETED>
<DELETED> ``(B) Eligible individuals.--To be
eligible to receive a fellowship under this paragraph,
an individual shall be a physician who--</DELETED>
<DELETED> ``(i) is board certified or board
eligible in internal medicine or family
practice;</DELETED>
<DELETED> ``(ii) has completed a program in
geriatrics that meets such criteria as the
Secretary may prescribe; and</DELETED>
<DELETED> ``(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).</DELETED>
<DELETED> ``(C) Team training.--An individual who
receives a fellowship under this paragraph shall
provide training in forensic geriatrics to
interdisciplinary teams of health care
professionals.</DELETED>
<DELETED> ``(2) Other programs.--The Secretary shall
establish programs, and make grants to carry out the programs,
to provide forensic training to experienced
geriatricians.</DELETED>
<DELETED>``Subtitle C--Increasing Security, Quality, and Consumer
Information for Long-Term Care</DELETED>
<DELETED>``CHAPTER 1--INCREASING SECURITY FOR LONG-TERM CARE</DELETED>
<DELETED>``SEC. 2231. REPORTING TO LAW ENFORCEMENT OF CRIMES OCCURRING
IN FEDERALLY FUNDED LONG-TERM CARE FACILITIES.</DELETED>
<DELETED> ``(a) Determination and Notification.--</DELETED>
<DELETED> ``(1) Determination.--Except as provided in
paragraph (2), the owner or operator of each long-term care
facility that receives Federal funds shall annually determine
if the facility received an amount of Federal funds that was
not less than $10,000 during the past year.</DELETED>
<DELETED> ``(2) Single positive determination.--The owner or
operator shall make the determination for a year unless the
owner or operator determined that the facility received that
amount during any previous year.</DELETED>
<DELETED> ``(3) Notification.--If the owner or operator
determines that the facility received that amount during any
year, the owner or operator shall annually notify each
individual described in subsection (b) of the obligation to
comply with subsection (b).</DELETED>
<DELETED> ``(b) Reporting Requirement.--</DELETED>
<DELETED> ``(1) In general.--Each individual who is an
owner, operator, employee, manager, agent, or contractor of a
long-term care facility that is the subject of a determination
described in subsection (a)(3) shall report to 1 or more law
enforcement 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 subdivision) against any
person who is a resident of or receiving care from the
facility.</DELETED>
<DELETED> ``(2) Timing.--If the events that cause the
suspicion--</DELETED>
<DELETED> ``(A) result in serious bodily injury, the
individual shall report the suspicion immediately, but
not later than 2 hours after forming the suspicion;
and</DELETED>
<DELETED> ``(B) do not result in serious bodily
injury, the individual shall report the suspicion not
later than 24 hours after forming the
suspicion.</DELETED>
<DELETED> ``(c) Penalty.--</DELETED>
<DELETED> ``(1) In general.--If an individual described in
subsection (b) violates subsection (b)--</DELETED>
<DELETED> ``(A) the individual shall be fined not
more than $200,000 or subject to a civil money penalty
of not more than $200,000; or</DELETED>
<DELETED> ``(B) the Secretary shall classify the
individual as an excluded individual, for a period of
not more than 3 years.</DELETED>
<DELETED> ``(2) Increased harm.--If an individual described
in subsection (b) violates subsection (b), and the violation
exacerbates the harm to the victim of the crime or results in
harm to another person--</DELETED>
<DELETED> ``(A) the individual shall be fined not
more than $200,000 or subject to a civil money penalty
of not more than $200,000; and</DELETED>
<DELETED> ``(B) the Secretary shall classify the
individual as an excluded individual, for a period of
not more than 3 years.</DELETED>
<DELETED> ``(3) Excluded individual.--During any period for
which an individual is classified as an excluded individual
under this paragraph, an entity that employs the individual
shall be ineligible to receive funds under the medicare program
under title XVIII or the medicaid program under title
XIX.</DELETED>
<DELETED> ``(4) Extenuating circumstances.--The Secretary
may take into account the financial burden on providers with
underserved populations in determining the penalty.</DELETED>
<DELETED> ``(d) Regulations.--The Secretary, after consulting with
the Attorney General, shall issue regulations to carry out this
section.</DELETED>
<DELETED>``CHAPTER 2--IMPROVING THE QUALITY OF LONG-TERM CARE</DELETED>
<DELETED>``SEC. 2241. GRANTS AND INCENTIVES TO ENHANCE LONG-TERM CARE
STAFFING.</DELETED>
<DELETED> ``(a) General Authority.--The Administrator of the Centers
for Medicare & Medicaid Services (in this section referred to as the
`Administrator') shall carry out activities, including activities
described in subsection (b) and (c), to provide incentives for
individuals to train for, seek, and maintain employment providing
direct care in a long-term care facility.</DELETED>
<DELETED> ``(b) Specific Programs To Enhance Training, Recruitment,
and Retention of Staff.--</DELETED>
<DELETED> ``(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
programs carried out under section 403(a)(5) and part A of
title IV to train for and seek employment providing direct care
in a long-term care facility.</DELETED>
<DELETED> ``(2) Career ladders and wage or benefit increases
to increase staffing in long-term care facilities.--</DELETED>
<DELETED> ``(A) In general.--The Administrator shall
make grants to eligible entities to carry out programs
through which the entities--</DELETED>
<DELETED> ``(i) offer, to employees who
provide direct care in a long-term care
facility, continuing training and varying
levels of certification, based on observed
clinical care practices and the amount of time
the employees spend providing direct care;
and</DELETED>
<DELETED> ``(ii) provide, or make
arrangements with employers to provide, bonuses
or other increased compensation or benefits to
employees who achieve certification under such
a program.</DELETED>
<DELETED> ``(B) Application.--To be eligible to
receive a grant under this paragraph, an entity shall
submit an application to the Administrator at such
time, in such manner, and containing such information
as the Administrator may require.</DELETED>
<DELETED> ``(c) Specific Programs To Improve Management Practices.--
</DELETED>
<DELETED> ``(1) In general.--The Administrator shall make
grants to eligible organizations to enable the organizations to
provide training and technical assistance to eligible persons
(including administrators, directors of nursing, staff
developers, and charge nurses) who establish or implement
management practices for long-term care facilities.</DELETED>
<DELETED> ``(2) Use of funds.--An organization that receives
a grant under paragraph (1) shall use funds made available
through the grant--</DELETED>
<DELETED> ``(A) to provide training and technical
assistance regarding management practices, that are for
employees that provide direct care in a long-term care
facility, and that are demonstrated to promote
retention of those employees, such as--</DELETED>
<DELETED> ``(i) the establishment of basic
human resource policies that reward high
performance, including policies that provide
for improved wages and benefits on the basis of
job reviews;</DELETED>
<DELETED> ``(ii) the establishment of
motivational and thoughtful work organization
practices;</DELETED>
<DELETED> ``(iii) the creation of a
workplace culture that respects and values
caregivers and their needs;</DELETED>
<DELETED> ``(iv) the promotion of a
workplace culture that respects the rights of
residents of a long-term care facility and
results in improved care for the residents;
and</DELETED>
<DELETED> ``(v) the establishment of other
programs that promote the provision of high
quality care, such as a continuing education
program that provides additional hours of
training, including on-the-job training, for
employees who are certified nurse aides;
or</DELETED>
<DELETED> ``(B) to disseminate training materials
for the training described in subparagraph (A), and to
provide the materials to the National Elder Justice
Library established in section 2221(a)(4), so that the
materials are available to other providers of such
training.</DELETED>
<DELETED> ``(3) Application.--To be eligible to receive a
grant under this subsection, an organization shall submit an
application to the Administrator at such time, in such manner,
and containing such information as the Administrator may
require.</DELETED>
<DELETED> ``(d) Evaluating Programs.--After the first programs
developed under this section have been completed, the Administrator
shall evaluate the outcomes of such programs in determining which
future applications to fund.</DELETED>
<DELETED> ``(e) Accountability Measures.--The Administrator shall
develop accountability measures to assure that funds made available
under this section benefit the staff who are the intended beneficiaries
of the programs provided under this section, to promote increases and
stability in the long-term care workforce.</DELETED>
<DELETED> ``(f) Compliance With Applicable Laws.--In order to
receive funds under this section, an eligible entity shall comply with
all applicable laws, regulations, and guidelines.</DELETED>
<DELETED>``SEC. 2242. COLLABORATIVE EFFORTS TO ENHANCE COMMUNICATION ON
PROMOTING QUALITY OF AND PREVENTING ABUSE AND NEGLECT IN
LONG-TERM CARE.</DELETED>
<DELETED> ``(a) In General.--The Director of the Agency for
Healthcare Research and Quality (in this section referred to as the
`Director'), after consultation with the Attorney General, may
establish pilot projects to improve long-term care. In carrying out the
projects, the Director shall make grants to eligible partnerships to
develop collaborative and innovative approaches to improve the quality
of, including preventing abuse and neglect in, long-term
care.</DELETED>
<DELETED> ``(b) Eligible Partnerships.--To be eligible to receive a
grant under this section, a partnership shall be a multidisciplinary
community partnership, such as a partnership consisting of
representatives in a community of nursing facility providers, advocates
for residents of long-term care facilities, State Long-Term Care
Ombudsmen, surveyors, the State agency with responsibility for adult
protective services, the State agency with responsibility for licensing
long-term care facilities, law enforcement agencies, courts, family
councils, residents, certified nurse aides, registered nurses,
physicians, and other appropriate entities and individuals.</DELETED>
<DELETED> ``(c) Application.--To be eligible to receive a grant
under this section, a partnership shall submit an application to the
Director at such time, in such manner, and containing such information
as the Director may require.</DELETED>
<DELETED>``SEC. 2243. COLLABORATIVE EFFORTS TO DEVELOP CONSENSUS AROUND
THE MANAGEMENT OF CERTAIN QUALITY-RELATED
FACTORS.</DELETED>
<DELETED> ``(a) In General.--The Director of the Agency for
Healthcare Research and Quality (in this section referred to as the
`Director'), after consultation with the Attorney General and the
Advisory Board established under section 2214, may make grants to
eligible entities to establish multidisciplinary panels to address, and
develop consensus on, subjects relating to improving the quality of
long-term care. The Director shall make a limited number of such
grants, including at least 1 grant for the establishment of such a
panel to address, and develop consensus on, methods of managing
resident-to-resident abuse in long-term care.</DELETED>
<DELETED> ``(b) Use of Funds.--An entity that receives a grant under
this section shall--</DELETED>
<DELETED> ``(1) establish a multidisciplinary panel to
address a specific subject; and</DELETED>
<DELETED> ``(2) ensure that the panel uses the funds made
available through the grant to establish a goal with respect to
the subject, examine relevant research and data, identify best
practices with respect to the subject, determine the best way
to carry out those best practices in a practical and feasible
manner, and determine an effective manner of distributing
information on the subject.</DELETED>
<DELETED> ``(c) Application.--To be eligible to receive a grant
under this section, an entity shall submit an application to the
Director at such time, in such manner, and containing such information
as the Director may require.</DELETED>
<DELETED>``CHAPTER 3--INCREASING CONSUMER INFORMATION ABOUT LONG-TERM
CARE</DELETED>
<DELETED>``SEC. 2251. LONG-TERM CARE CONSUMER CLEARINGHOUSE.</DELETED>
<DELETED> ``(a) In General.--The Director of the Office of Elder
Justice in the Department of Health and Human Services, in coordination
with the Director of the Agency for Healthcare Research and Quality and
the Administrator of the Centers for Medicare & Medicaid Services,
shall establish a long-term care consumer clearinghouse in the
Department of Health and Human Services.</DELETED>
<DELETED> ``(b) Information.--The clearinghouse shall be established
as part of the Elder Justice Resource Center (established under section
2221) and shall provide comprehensive detailed information, in a
consumer-friendly form, to consumers about choices relating to long-
term care providers, such as information (including links to websites
and other resources that provide information) about--</DELETED>
<DELETED> ``(1) obtaining the services of, and employing,
caregivers who provide long-term care at an individual's home;
and</DELETED>
<DELETED> ``(2) options for residential long-term care, such
as--</DELETED>
<DELETED> ``(A)(i) the type of care provided by
nursing facilities; and</DELETED>
<DELETED> ``(ii) the type of care provided by group
homes and other residential long-term care facilities
that are not nursing facilities;</DELETED>
<DELETED> ``(B) the benefits available through the
programs carried out under titles XVIII and XIX of the
Social Security Act (42 U.S.C. 1395 et seq. and 1396 et
seq.); and</DELETED>
<DELETED> ``(C) the care available through specific
long-term care facilities, including data on the
satisfaction level of residents of, and families of
residents of, the facilities.</DELETED>
<DELETED> ``(c) Providers.--In providing information on long-term
care providers under this section, the clearinghouse shall provide
information (from States and other sources) on assisted living
facilities, board and care facilities, congregate care facilities, home
health care providers, and other long-term care providers.</DELETED>
<DELETED>``SEC. 2252. CONSUMER INFORMATION ABOUT THE CONTINUUM OF
RESIDENTIAL LONG-TERM CARE FACILITIES.</DELETED>
<DELETED> ``(a) Study.--</DELETED>
<DELETED> ``(1) In general.--The Director of the Agency for
Healthcare Research and Quality, after consultation 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, directly or
through a grant, conduct a study on consumer concerns relating
to residential long-term care facilities, other than nursing
facilities.</DELETED>
<DELETED> ``(2) Specific topics.--The entity conducting the
study shall--</DELETED>
<DELETED> ``(A) develop definitions for classes of
the residential long-term care facilities described in
paragraph (1); and</DELETED>
<DELETED> ``(B) collect information on the prices
of, level of services provided by, oversight and
enforcement provisions of, and admission and discharge
criteria of, the facilities.</DELETED>
<DELETED> ``(b) Report.--The Director of the Agency for Healthcare
Research and Quality shall prepare a report containing the results of
the study, and submit the report to the Elder Justice Coordinating
Council established under section 2213, the Committee on Ways and Means
of the House of Representatives, and the Special Committee on Aging of
the Senate.</DELETED>
<DELETED>``Subtitle D--Administration</DELETED>
<DELETED>``SEC. 2261. EVALUATIONS.</DELETED>
<DELETED> ``(a) Grants.--</DELETED>
<DELETED> ``(1) In general.--In making a grant under a
provision of this title (other than this section), the granting
authority shall--</DELETED>
<DELETED> ``(A) require the recipient of the grant
to--</DELETED>
<DELETED> ``(i) reserve a portion of the
funds made available through the grant;
and</DELETED>
<DELETED> ``(ii) use the reserved funds to
conduct an evaluation of the other activities
carried out through the grant; or</DELETED>
<DELETED> ``(B)(i) reserve a portion of the funds
available for the grant; and</DELETED>
<DELETED> ``(ii) use the reserved funds to provide
assistance to an eligible entity to conduct an
evaluation of the activities carried out through the
grant.</DELETED>
<DELETED> ``(2) Use of funds.--A recipient of a grant
described in paragraph (1)(A), or assistance described in
paragraph (1)(B)(ii), shall use the funds made available
through the grant, or the assistance, respectively, to conduct
a validated evaluation of the effectiveness of the activities
described in subparagraph (A) or (B), respectively, of
paragraph (1).</DELETED>
<DELETED> ``(3) Applications.--</DELETED>
<DELETED> ``(A) Submission.--</DELETED>
<DELETED> ``(i) Grants for projects
containing evaluations.--To be eligible to
receive a grant for which the granting
authority requires the reservation described in
paragraph (1)(A)(i), an entity shall include a
proposal for the evaluation in the application
submitted for the grant.</DELETED>
<DELETED> ``(ii) Assistance for
evaluations.--To be eligible to receive
assistance under paragraph (1)(B)(ii), an
entity shall submit an application to the
granting authority at such time, in such
manner, and containing such information as the
granting authority may require, including a
proposal for the evaluation.</DELETED>
<DELETED> ``(B) Review and assistance.--An employee
of the National Institute on Aging, and a private
expert, with expertise in evaluation methodology shall
review each proposal described in clause (i) or (ii) of
subparagraph (A), and determine whether the methodology
described in the proposal is adequate to gather
meaningful information. If the employee and expert
determine that the methodology is inadequate, the
employee and expert shall recommend that the granting
authority deny the application for the grant described
in subparagraph (A)(i), or the assistance described in
subparagraph (B)(ii), as appropriate, or make
recommendations for how the application should be
amended. If the granting authority denies the
application on the basis of the proposal, the granting
authority shall inform the applicant why the
application was denied, and offer assistance to the
applicant in modifying the proposal.</DELETED>
<DELETED> ``(b) Other Grants.--The granting authority shall make
grants to appropriate entities to conduct validated evaluations of
activities, to reduce elder abuse, neglect, and exploitation, that are
not funded under this title.</DELETED>
<DELETED> ``(c) Condition of Participation.--As a condition of
participation in any grant under this title, individuals, facilities,
and other entities shall agree to be subject to sections 3729 through
3733 of title 31, United States Code and other applicable
laws.</DELETED>
<DELETED>``SEC. 2262. HUMAN SUBJECT RESEARCH.</DELETED>
<DELETED> ``(a) In General.--For purposes of the application of
subpart A of part 46 of title 45, Code of Federal Regulations to
research conducted under this title, the term `legally authorized
representative' means, unless otherwise provided by law, the
individual, or judicial or other body authorized under the applicable
law to consent to medical treatment on behalf of another
person.</DELETED>
<DELETED> ``(b) Guidelines.--The Secretary of Health and Human
Services, through the Director of the National Institute on Aging,
after consultation with the Director of the Office for Human Research
Protections and the Excellence Advisory Committee established under
section 2222(b)(5), shall promulgate guidelines to assist researchers
working in the area of elder abuse, neglect, and exploitation, with
issues relating to human subject protections.</DELETED>
<DELETED>``SEC. 2263. REGULATIONS.</DELETED>
<DELETED> ``The Secretary may issue such regulations as may be
necessary to carry out this title.</DELETED>
<DELETED>``SEC. 2264. AUTHORIZATION OF APPROPRIATIONS.</DELETED>
<DELETED> ``There are authorized to be appropriated to carry out
this title such sums as may be necessary for each of fiscal years 2004
through 2010.''.</DELETED>
<DELETED>SEC. 102. PATIENT ABUSE PREVENTION.</DELETED>
<DELETED> (a) Establishment of Program To Prevent Abuse of Nursing
Facility Residents.--</DELETED>
<DELETED> (1) Screening of Skilled Nursing Facility and
Nursing Facility Employee Applicants.--</DELETED>
<DELETED> (A) Medicare program.--Section 1819(b) of
the Social Security Act (42 U.S.C. 1395i-3(b)) is
amended by adding at the end the following:</DELETED>
<DELETED> ``(8) Screening of skilled nursing facility
workers.--</DELETED>
<DELETED> ``(A) Background checks on applicants.--
Subject to subparagraph (B)(ii), before hiring a
skilled nursing facility worker, a skilled nursing
facility shall--</DELETED>
<DELETED> ``(i) give the worker written
notice that the facility is required to
perform background checks with respect to applicants;</DELETED>
<DELETED> ``(ii) require, as a condition of
employment, that such worker--</DELETED>
<DELETED> ``(I) provide a written
statement disclosing any conviction for
a relevant crime;</DELETED>
<DELETED> ``(II) provide a statement
signed by the worker authorizing the
facility to request the search and
exchange of criminal records;</DELETED>
<DELETED> ``(III) provide in person
to the facility a copy of the worker's
fingerprints or thumb print, depending
upon available technology;
and</DELETED>
<DELETED> ``(IV) provide any other
identification information the
Secretary may specify in regulation;
and</DELETED>
<DELETED> ``(iii) request through the
appropriate State agency that the State
initiate a State and national criminal
background check on such worker in accordance
with the provisions of subsection (e)(6) and
submit to such State agency the information
described in subclauses (II) through (IV) of
clause (ii).</DELETED>
<DELETED> ``(B) Prohibition on hiring of abusive
workers.--</DELETED>
<DELETED> ``(i) In general.--A skilled
nursing facility may not knowingly employ any
skilled nursing facility worker who has any
conviction for a relevant crime.</DELETED>
<DELETED> ``(ii) Provisional employment.--
After complying with the requirements of
clauses (i) and (ii) of subparagraph (A), a
skilled nursing facility may provide for a
provisional period of employment for a skilled
nursing facility worker pending completion of
the check against the background check
described under subparagraph (A)(iii). Subject
to clause (iii), such facility shall maintain
direct supervision of the covered individual
during the worker's provisional period of
employment.</DELETED>
<DELETED> ``(iii) Exception for small rural
skilled nursing facilities.--In the case of a
small rural skilled nursing facility (as
defined by the Secretary), the Secretary shall
provide, by regulation after consultation with
providers of skilled nursing facility services
and entities representing beneficiaries of such
services, for an appropriate level of
supervision with respect to any provisional
employees employed by the facility in
accordance with clause (ii). Such regulation
should encourage the provision of direct
supervision of such employees whenever
practicable with respect to such a facility and
if such supervision would not impose an
unreasonable cost or other burden on the
facility.</DELETED>
<DELETED> ``(C) Reporting requirements.--A skilled
nursing facility shall report to the State any instance
in which the facility determines that a skilled nursing
facility worker has committed an act of resident
neglect or abuse or misappropriation of resident
property in the course of employment by the
facility.</DELETED>
<DELETED> ``(D) Use of information.--</DELETED>
<DELETED> ``(i) In general.--A skilled
nursing facility that obtains information about
a skilled nursing facility worker pursuant to
subparagraph (A)(iii) may use such information
only for the purpose of determining the
suitability of the worker for
employment.</DELETED>
<DELETED> ``(ii) Immunity from liability.--A
skilled nursing facility that, in denying
employment for an applicant (including during
the period described in subparagraph (B)(ii)),
reasonably relies upon information about such
applicant provided by the State pursuant to
subsection (e)(6) shall not be liable in any
action brought by such applicant based on the
employment determination resulting from the
information.</DELETED>
<DELETED> ``(iii) Criminal penalty.--Whoever
knowingly violates the provisions of clause (i)
shall be fined in accordance with title 18,
United States Code, imprisoned for not more
than 2 years, or both.</DELETED>
<DELETED> ``(E) Civil penalty.--</DELETED>
<DELETED> ``(i) In general.--A skilled
nursing facility that violates the provisions
of this paragraph shall be subject to a civil
penalty in an amount not to exceed--</DELETED>
<DELETED> ``(I) for the first such
violation, $2,000; and</DELETED>
<DELETED> ``(II) for the second and
each subsequent violation within any 5-
year period, $5,000.</DELETED>
<DELETED> ``(ii) Knowing retention of
worker.--In addition to any civil penalty under
clause (i), a skilled nursing facility that--
</DELETED>
<DELETED> ``(I) knowingly continues
to employ a skilled nursing facility
worker in violation of subparagraph (A)
or (B); or</DELETED>
<DELETED> ``(II) knowingly fails to
report a skilled nursing facility
worker under subparagraph
(C),</DELETED>
<DELETED>shall be subject to a civil penalty in
an amount not to exceed $5,000 for the first
such violation, and $10,000 for the second and
each subsequent violation within any 5-year
period.</DELETED>
<DELETED> ``(F) Definitions.--In this
paragraph:</DELETED>
<DELETED> ``(i) Conviction for a relevant
crime.--The term `conviction for a relevant
crime' means any Federal or State criminal
conviction for--</DELETED>
<DELETED> ``(I) any offense
described in paragraphs (1) through (4)
of section 1128(a); and</DELETED>
<DELETED> ``(II) such other types of
offenses as the Secretary may specify
in regulations, taking into account the
severity and relevance of such
offenses, and after consultation with
representatives of long-term care
providers, representatives of long-term
care employees, consumer advocates, and
appropriate Federal and State
officials.</DELETED>
<DELETED> ``(ii) Disqualifying
information.--The term `disqualifying
information' means information about a
conviction for a relevant crime.</DELETED>
<DELETED> ``(iii) Skilled nursing facility
worker.--The term `skilled nursing facility
worker' means any individual (other than a
volunteer) that has access to a patient of a
skilled nursing facility under an employment or
other contract, or both, with such facility.
Such term includes individuals who are licensed
or certified by the State to provide such
services, and nonlicensed individuals providing
such services, as defined by the Secretary,
including nurse assistants, nurse aides, home
health aides, and personal care workers and
attendants.''.</DELETED>
<DELETED> (B) Medicaid program.--Section 1919(b) of
the Social Security Act (42 U.S.C. 1396r(b)) is amended
by adding at the end the following new
paragraph:</DELETED>
<DELETED> ``(8) Screening of nursing facility workers.--
</DELETED>
<DELETED> ``(A) Background checks on applicants.--
Subject to subparagraph (B)(ii), before hiring a
nursing facility worker, a nursing facility shall--
</DELETED>
<DELETED> ``(i) give the worker written
notice that the facility is required to perform
background checks with respect to
applicants;</DELETED>
<DELETED> ``(ii) require, as a condition of
employment, that such worker--</DELETED>
<DELETED> ``(I) provide a written
statement disclosing any conviction for
a relevant crime;</DELETED>
<DELETED> ``(II) provide a statement
signed by the worker authorizing the
facility to request the search and
exchange of criminal records;</DELETED>
<DELETED> ``(III) provide in person
to the facility a copy of the worker's
fingerprints or thumb print, depending
upon available technology;
and</DELETED>
<DELETED> ``(IV) provide any other
identification information the
Secretary may specify in regulation;
and</DELETED>
<DELETED> ``(iii) request through the
appropriate State agency that the State
initiate a State and national criminal
background check on such worker in accordance
with the provisions of subsection (e)(8) and
submit to such State agency the information
described in subclauses (II) through (IV) of
clause (ii).</DELETED>
<DELETED> ``(B) Prohibition on hiring.--</DELETED>
<DELETED> ``(i) In general.--A nursing
facility may not knowingly employ any nursing
facility worker who has any conviction for a
relevant crime.</DELETED>
<DELETED> ``(ii) Provisional employment.--
After complying with the requirements of
clauses (i) and (ii) of subparagraph (A), a
nursing facility may provide for a provisional
period of employment for a nursing facility
worker pending completion of the check against
the background check described under
subparagraph (A)(iii). Subject to clause (iii),
such facility shall maintain direct supervision
of the worker during the worker's provisional
period of employment.</DELETED>
<DELETED> ``(iii) Exception for small rural
nursing facilities.--In the case of a small
rural nursing facility (as defined by the
Secretary), the Secretary shall provide, by
regulation after consultation with providers of
nursing facility services and entities
representing beneficiaries of such services,
for an appropriate level of supervision with
respect to any provisional employees employed
by the facility in accordance with clause (ii).
Such regulation should encourage the provision
of direct supervision of such employees
whenever practicable with respect to such a
facility and if such supervision would not
impose an unreasonable cost or other burden on
the facility.</DELETED>
<DELETED> ``(C) Reporting requirements.--A nursing
facility shall report to the State any instance in
which the facility determines that a nursing facility
worker has committed an act of resident neglect or
abuse or misappropriation of resident property in the
course of employment by the facility.</DELETED>
<DELETED> ``(D) Use of information.--</DELETED>
<DELETED> ``(i) In general.--A nursing
facility that obtains information about a
nursing facility worker pursuant to
subparagraph (A)(iii) may use such information
only for the purpose of determining the
suitability of the worker for
employment.</DELETED>
<DELETED> ``(ii) Immunity from liability.--A
nursing facility that, in denying employment
for an applicant (including during the period
described in subparagraph (B)(ii)), reasonably
relies upon information about such applicant
provided by the State pursuant to subsection
(e)(8) shall not be liable in any action
brought by such applicant based on the
employment determination resulting from the
information.</DELETED>
<DELETED> ``(iii) Criminal penalty.--Whoever
knowingly violates the provisions of clause (i)
shall be fined in accordance with title 18,
United States Code, imprisoned for not more
than 2 years, or both.</DELETED>
<DELETED> ``(E) Civil penalty.--</DELETED>
<DELETED> ``(i) In general.--A nursing
facility that violates the provisions of this
paragraph shall be subject to a civil penalty
in an amount not to exceed--</DELETED>
<DELETED> ``(I) for the first such
violation, $2,000; and</DELETED>
<DELETED> ``(II) for the second and
each subsequent violation within any 5-
year period, $5,000.</DELETED>
<DELETED> ``(ii) Knowing retention of
worker.--In addition to any civil penalty under
clause (i), a nursing facility that--</DELETED>
<DELETED> ``(I) knowingly continues
to employ a nursing facility worker in
violation of subparagraph (A) or (B);
or</DELETED>
<DELETED> ``(II) knowingly fails to
report a nursing facility worker under
subparagraph (C),</DELETED>
<DELETED>shall be subject to a civil penalty in
an amount not to exceed $5,000 for the first
such violation, and $10,000 for the second and
each subsequent violation within any 5-year
period.</DELETED>
<DELETED> ``(F) Definitions.--In this
paragraph:</DELETED>
<DELETED> ``(i) Conviction for a relevant
crime.--The term `conviction for a relevant
crime' means any Federal or State criminal
conviction for--</DELETED>
<DELETED> ``(I) any offense
described in paragraphs (1) through (4)
of section 1128(a); and</DELETED>
<DELETED> ``(II) such other types of
offenses as the Secretary may specify
in regulations, taking into account the
severity and relevance of such
offenses, and after consultation with
representatives of long-term care
providers, representatives of long-term
care employees, consumer advocates, and
appropriate Federal and State
officials.</DELETED>
<DELETED> ``(ii) Disqualifying
information.--The term `disqualifying
information' means information about a
conviction for a relevant crime.</DELETED>
<DELETED> ``(iii) Nursing facility worker.--
The term `nursing facility worker' means any
individual (other than a volunteer) that has
access to a patient of a nursing facility under
an employment or other contract, or both, with
such facility. Such term includes individuals
who are licensed or certified by the State to
provide such services, and nonlicensed
individuals providing such services, as defined
by the Secretary, including nurse assistants,
nurse aides, home health aides, and personal
care workers and attendants.''.</DELETED>
<DELETED> (C) Federal responsibilities.--</DELETED>
<DELETED> (i) Development of standard
federal and state background check form.--The
Secretary of Health and Human Services, after
consultation with the Attorney General and
representatives of appropriate State agencies,
shall develop a model form that an applicant
for employment at a nursing facility may
complete and Federal and State agencies may use
to conduct the criminal background checks
required under sections 1819(b)(8) and
1919(b)(8) of the Social Security Act (42
U.S.C. 1395i-3(b), 1396r(b)) (as added by this
section).</DELETED>
<DELETED> (ii) Periodic evaluation.--The
Secretary of Health and Human Services, after
consultation with the Attorney General,
periodically shall evaluate the background
check system imposed under sections 1819(b)(8)
and 1919(b)(8) of the Social Security Act (42
U.S.C. 1395i-3(b), 1396r(b)) (as added by this
section) and shall implement changes, as
necessary, based on available technology, to
make the background check system more efficient
and able to provide a more immediate response
to long-term care providers using the
system.</DELETED>
<DELETED> (D) No preemption of stricter state
laws.--Nothing in section 1819(b)(8) or 1919(b)(8) of
the Social Security Act (42 U.S.C. 1395i-3(b)(8),
1396r(b)(8)) (as so added) shall be construed to
supersede any provision of State law that--</DELETED>
<DELETED> (i) specifies a relevant crime for
purposes of prohibiting the employment of an
individual at a long-term care facility that is
not included in the list of such crimes
specified in such sections or in regulations
promulgated by the Secretary of Health and
Human Services to carry out such sections;
or</DELETED>
<DELETED> (ii) requires a long-term care
facility (as so defined) to conduct a
background check prior to employing an
individual in an employment position that is
not included in the positions for which a
background check is required under such
sections.</DELETED>
<DELETED> (E) Technical amendments.--Effective as if
included in the enactment of section 941 of the
Medicare, Medicaid, and SCHIP Benefits Improvement and
Protection Act of 2000 (114 Stat. 2763A-585), as
enacted into law by section 1(a)(6) of Public Law 106-
554, sections 1819(b) and 1919(b) of the Social
Security Act (42 U.S.C. 1395i-3(b), 1396r(b)), as
amended by such section 941 (as so enacted into law)
are each amended by redesignating the paragraph (8)
added by such section as paragraph (9).</DELETED>
<DELETED> (2) Federal and state requirements concerning
background checks.--</DELETED>
<DELETED> (A) Medicare.--Section 1819(e) of the
Social Security Act (42 U.S.C. 1395i-3(e)) is amended
by adding at the end the following:</DELETED>
<DELETED> ``(6) Federal and state requirements concerning
criminal background checks on skilled nursing facility
employees.--</DELETED>
<DELETED> ``(A) In general.--Upon receipt of a
request by a skilled nursing facility pursuant to
subsection (b)(8) that is accompanied by the
information described in subclauses (II) through (IV)
of subsection (b)(8)(A)(ii), a State, after checking
appropriate State records and finding no disqualifying
information (as defined in subsection (b)(8)(F)(ii)),
shall immediately submit such request and information
to the Attorney General and shall request the Attorney
General to conduct a search and exchange of records
with respect to the individual as described in
subparagraph (B).</DELETED>
<DELETED> ``(B) Search and exchange of records by
attorney general.--Upon receipt of a submission
pursuant to subparagraph (A), the Attorney General
shall direct a search of the records of the Federal
Bureau of Investigation for any criminal history
records corresponding to the fingerprints and other
positive identification information submitted. The
Attorney General shall provide any corresponding
information resulting from the search to the
State.</DELETED>
<DELETED> ``(C) State reporting of information to
skilled nursing facility.--Upon receipt of the
information provided by the Attorney General pursuant
to subparagraph (B), the State shall--</DELETED>
<DELETED> ``(i) review the information to
determine whether the individual has any
conviction for a relevant crime (as defined in
subsection (b)(8)(F)(i)); and</DELETED>
<DELETED> ``(ii) immediately report to the
skilled nursing facility in writing the results
of such review.</DELETED>
<DELETED> ``(D) Fees for performance of criminal
background checks.--</DELETED>
<DELETED> ``(i) Authority to charge fees.--
</DELETED>
<DELETED> ``(I) Attorney general.--
The Attorney General may charge a fee
to any State requesting a search and
exchange of records pursuant to this
paragraph and subsection (b)(8) for
conducting the search and providing the
records. The amount of such fee shall
not exceed the lesser of the actual
cost of such activities or $50. Such
fees shall be available to the Attorney
General, or, in the Attorney General's
discretion, to the Federal Bureau of
Investigation until expended.</DELETED>
<DELETED> ``(II) State.--A State may
charge a skilled nursing facility a fee
for initiating the criminal background
check under this paragraph and
subsection (b)(8), including fees
charged by the Attorney General, and
for performing the review and report
required by subparagraph (C). The
amount of such fee shall not exceed the
actual cost of such
activities.</DELETED>
<DELETED> ``(ii) Prohibition on charging
applicants or employees.--An entity may not
impose on an applicant for employment or an
employee any charges relating to the
performance of a background check under this
paragraph.</DELETED>
<DELETED> ``(E) Regulations.--</DELETED>
<DELETED> ``(i) In general.--In addition to
the Secretary's authority to promulgate
regulations under this title, the Attorney
General, after consultation with the Secretary,
may promulgate such regulations as are
necessary to carry out the Attorney General's
responsibilities under this paragraph and
subsection (b)(9), including regulations
regarding the security confidentiality,
accuracy, use, destruction, and dissemination
of information, audits and recordkeeping, and
the imposition of fees.</DELETED>
<DELETED> ``(ii) Appeal procedures.--The
Attorney General, after consultation with the
Secretary, shall promulgate such regulations as
are necessary to establish procedures by which
an applicant or employee may appeal or dispute
the accuracy of the information obtained in a
background check conducted under this
paragraph. Appeals shall be limited to
instances in which an applicant or employee is
incorrectly identified as the subject of the
background check, or when information about the
applicant or employee has not been updated to
reflect changes in the applicant's or
employee's criminal record.</DELETED>
<DELETED> ``(F) Report.--Not later than 2 years
after the date of enactment of this paragraph, the
Attorney General shall submit a report to Congress on--
</DELETED>
<DELETED> ``(i) the number of requests for
searches and exchanges of records made under
this section;</DELETED>
<DELETED> ``(ii) the disposition of such
requests; and</DELETED>
<DELETED> ``(iii) the cost of responding to
such requests.''.</DELETED>
<DELETED> (B) Medicaid.--Section 1919(e) of the
Social Security Act (42 U.S.C. 1396r(e)) is amended by
adding at the end the following:</DELETED>
<DELETED> ``(8) Federal and state requirements concerning
criminal background checks on nursing facility employees.--
</DELETED>
<DELETED> ``(A) In general.--Upon receipt of a
request by a nursing facility pursuant to subsection
(b)(8) that is accompanied by the information described
in subclauses (II) through (IV) of subsection
(b)(8)(A)(ii), a State, after checking appropriate
State records and finding no disqualifying information
(as defined in subsection (b)(8)(F)(ii)), shall
immediately submit such request and information to the
Attorney General and shall request the Attorney General
to conduct a search and exchange of records with
respect to the individual as described in subparagraph
(B).</DELETED>
<DELETED> ``(B) Search and exchange of records by
attorney general.--Upon receipt of a submission
pursuant to subparagraph (A), the Attorney General
shall direct a search of the records of the Federal
Bureau of Investigation for any criminal history
records corresponding to the fingerprints and other
positive identification information submitted. The
Attorney General shall provide any corresponding
information resulting from the search to the
State.</DELETED>
<DELETED> ``(C) State reporting of information to
nursing facility.--Upon receipt of the information
provided by the Attorney General pursuant to
subparagraph (B), the State shall--</DELETED>
<DELETED> ``(i) review the information to
determine whether the individual has any
conviction for a relevant crime (as defined in
subsection (b)(8)(F)(i)); and</DELETED>
<DELETED> ``(ii) immediately report to the
nursing facility in writing the results of such
review.</DELETED>
<DELETED> ``(D) Fees for performance of criminal
background checks.--</DELETED>
<DELETED> ``(i) Authority to charge fees.--
</DELETED>
<DELETED> ``(I) Attorney general.--
The Attorney General may charge a fee
to any State requesting a search and
exchange of records pursuant to this
paragraph and subsection (b)(8) for
conducting the search and providing the
records. The amount of such fee shall
not exceed the lesser of the actual
cost of such activities or $50. Such
fees shall be available to the Attorney
General, or, in the Attorney General's
discretion, to the Federal Bureau of
Investigation, until
expended.</DELETED>
<DELETED> ``(II) State.--A State may
charge a nursing facility a fee for
initiating the criminal background
check under this paragraph and
subsection (b)(8), including fees
charged by the Attorney General, and
for performing the review and report
required by subparagraph (C). The
amount of such fee shall not exceed the
actual cost of such
activities.</DELETED>
<DELETED> ``(ii) Prohibition on charging
applicants or employees.--An entity may not
impose on an applicant for employment or an
employee any charges relating to the
performance of a background check under this
paragraph.</DELETED>
<DELETED> ``(E) Regulations.--</DELETED>
<DELETED> ``(i) In general.--In addition to
the Secretary's authority to promulgate
regulations under this title, the Attorney
General, after consultation with the Secretary,
may promulgate such regulations as are
necessary to carry out the Attorney General's
responsibilities under this paragraph and
subsection (b)(8), including regulations
regarding the security, confidentiality,
accuracy, use, destruction, and dissemination
of information, audits and recordkeeping, and
the imposition of fees.</DELETED>
<DELETED> ``(ii) Appeal procedures.--The
Attorney General, after consultation with the
Secretary, shall promulgate such regulations as
are necessary to establish procedures by which
an applicant or employee may appeal or dispute
the accuracy of the information obtained in a
background check conducted under this
paragraph. Appeals shall be limited to
instances in which an applicant or employee is
incorrectly identified as the subject of the
background check, or when information about the
applicant or employee has not been updated to
reflect changes in the applicant's or
employee's criminal record.</DELETED>
<DELETED> ``(F) Report.--Not later than 2 years
after the date of enactment of this paragraph, the
Attorney General shall submit a report to Congress on--
</DELETED>
<DELETED> ``(i) the number of requests for
searches and exchanges of records made under
this section;</DELETED>
<DELETED> ``(ii) the disposition of such
requests; and</DELETED>
<DELETED> ``(iii) the cost of responding to
such requests.''.</DELETED>
<DELETED> (3) Application to other entities providing home
health or long-term care services.--</DELETED>
<DELETED> (A) Medicare.--Part D of title XVIII of
the Social Security Act (42 U.S.C. 1395x et seq.) is
amended by adding at the end the following:</DELETED>
<DELETED>``application of skilled nursing facility preventive abuse
provisions to any provider of services or other entity providing home
health or long-term care services</DELETED>
<DELETED> ``Sec. 1897. (a) In General.--The requirements of
subsections (b)(8) and (e)(6) of section 1819 shall apply to any
provider of services or any other entity that is eligible to be paid
under this title for providing home health services, hospice care
(including routine home care and other services included in hospice
care under this title), or long-term care services to an individual
entitled to benefits under part A or enrolled under part B, including
an individual provided with a Medicare+Choice plan offered by a
Medicare+Choice organization under part C (in this section referred to
as a `medicare beneficiary').</DELETED>
<DELETED> ``(b) Supervision of Provisional Employees.--</DELETED>
<DELETED> ``(1) In general.--With respect to an entity that
provides home health services, such entity shall be considered
to have satisfied the requirements of section 1819(b)(8)(B)(ii)
or 1919(b)(8)(B)(ii) if the entity meets such requirements for
supervision of provisional employees of the entity as the
Secretary shall, by regulation, specify in accordance with
paragraph (2).</DELETED>
<DELETED> ``(2) Requirements.--The regulations required
under paragraph (1) shall provide the following:</DELETED>
<DELETED> ``(A) Supervision of a provisional
employee shall consist of ongoing, good faith,
verifiable efforts by the supervisor of the provisional
employee to conduct monitoring and oversight activities
to ensure the safety of a medicare
beneficiary.</DELETED>
<DELETED> ``(B) For purposes of subparagraph (A),
monitoring and oversight activities may include (but
are not limited to) the following:</DELETED>
<DELETED> ``(i) Follow-up telephone calls to
the medicare beneficiary.</DELETED>
<DELETED> ``(ii) Unannounced visits to the
medicare beneficiary's home while the
provisional employee is serving the medicare
beneficiary.</DELETED>
<DELETED> ``(iii) To the extent practicable,
limiting the provisional employee's duties to
serving only those medicare beneficiaries in a
home or setting where another family member or
resident of the home or setting of the medicare
beneficiary is present.</DELETED>
<DELETED> ``(C) In promulgating such regulations,
the Secretary shall take into account the staffing and
geographic issues faced by small rural entities (as
defined by the Secretary) that provide home health
services, hospice care (including routine home care and
other services included in hospice care under this
title), or other long-term care services. Such
regulations should encourage the provision of
monitoring and oversight activities whenever
practicable with respect to such an entity, and if such
activities would not impose an unreasonable cost or
other burden on the entity.''.</DELETED>
<DELETED> (B) Medicaid.--Section 1902(a) of the
Social Security Act (42 U.S.C. 1396a) is amended--
</DELETED>
<DELETED> (i) in paragraph (64), by striking
``and'' at the end;</DELETED>
<DELETED> (ii) in paragraph (65), by
striking the period and inserting ``; and'';
and</DELETED>
<DELETED> (iii) by inserting after paragraph
(65) the following:</DELETED>
<DELETED> ``(66) provide that any entity that is eligible to
be paid under the State plan for providing home health
services, hospice care (including routine home care and other
services included in hospice care under title XVIII), or long-
term care services for which medical assistance is available
under the State plan to individuals requiring long-term care
complies with the requirements of subsections (b)(8) and (e)(8)
of section 1919 and section 1897(b) (in the same manner as such
section applies to a medicare beneficiary).''.</DELETED>
<DELETED> (b) Prevention and Training Demonstration Project.--
</DELETED>
<DELETED> (1) Establishment.--The Secretary of Health and
Human Services shall establish a demonstration program to
provide grants to develop information on best practices in
patient abuse prevention training (including behavior training
and interventions) for managers and staff of hospital and
health care facilities.</DELETED>
<DELETED> (2) Eligibility.--To be eligible to receive a
grant under paragraph (1), an entity shall be a public or
private nonprofit entity and prepare and submit to the
Secretary of Health and Human Services an application at such
time, in such manner, and containing such information as the
Secretary may require.</DELETED>
<DELETED> (3) Use of funds.--Amounts received under a grant
under this subsection shall be used to--</DELETED>
<DELETED> (A) examine ways to improve collaboration
between State health care survey and provider
certification agencies, long-term care ombudsman
programs, the long-term care industry, and local
community members;</DELETED>
<DELETED> (B) examine patient care issues relating
to regulatory oversight, community involvement, and
facility staffing and management with a focus on staff
training, staff stress management, and staff
supervision;</DELETED>
<DELETED> (C) examine the use of patient abuse
prevention training programs by long-term care
entities, including the training program developed by
the National Association of Attorneys General, and the
extent to which such programs are used; and</DELETED>
<DELETED> (D) identify and disseminate best
practices for preventing and reducing patient
abuse.</DELETED>
<DELETED> (4) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection such
sums as may be necessary.</DELETED>
<DELETED> (c) Sense of the Senate Regarding the Establishment of a
National Background Check System for Long-Term Care Employees.--
</DELETED>
<DELETED> (1) Findings.--The Senate makes the following
findings:</DELETED>
<DELETED> (A) Nearly 1,500,000 Americans reside in
17,000 nursing homes throughout the Nation, and the
vast majority of nursing homes participate in the
medicare and medicaid programs.</DELETED>
<DELETED> (B) The Federal Government spent
$82,100,000,000 through the medicare and medicaid
programs in fiscal year 2000 for long-term care services.</DELETED>
<DELETED> (C) The impending retirement of the baby
boom generation will greatly increase the demand and
need for quality long-term care, and it is incumbent on
Congress and the President to ensure that medicare and
medicaid beneficiaries are protected from abuse,
neglect, and mistreatment.</DELETED>
<DELETED> (D) On July 30, 2001, the minority staff
of the special investigations division of the Committee
on Government Reform of the House of Representatives
issued a report which found that in the past 2 years,
over 30 percent of nursing homes in the United States
were cited for a physical, sexual, or verbal abuse
violation that had the potential to harm residents, and
nearly 10 percent of nursing homes had violations that
caused actual harm to residents.</DELETED>
<DELETED> (E) Although the majority of long-term
care facilities do an excellent job in caring for
elderly and disabled patients, incidents of abuse and
neglect and mistreatment do occur at an unacceptable
rate and are not limited to nursing homes
alone.</DELETED>
<DELETED> (F) Without a national background check
system to screen applicants for employment, all long-
term care providers, including nursing facilities, home
health, home care, and hospice providers, are at risk
for hiring workers with a history of abuse and
violence.</DELETED>
<DELETED> (G) A March 2002 report by the General
Accounting Office found that few prosecutions and
criminal convictions result from allegations of abuse
in nursing homes.</DELETED>
<DELETED> (H) Federal law requires all States to
maintain a nurse aide registry which includes any
substantiated findings of abuse committed by nurse
aides in nursing homes.</DELETED>
<DELETED> (I) In March 2002, the General Accounting
Office testified before the Special Committee on Aging
of the Senate that the existing State registries
contained significant gaps because many nursing home
employees are not included in the registries and the
registries do not track abuses committed in other
States.</DELETED>
<DELETED> (J) A 1998 report from the Office of the
Inspector General of the Department of Health and Human
Services entitled ``Safeguarding Long-Term Care
Residents'' recommended establishing a national
registry of abusive long-term care workers to be
checked by all long-term care facilities before hiring
an employee.</DELETED>
<DELETED> (2) Sense of the senate.--It is the Sense of the
Senate that Congress should pass legislation that will--
</DELETED>
<DELETED> (A) require the Secretary of Health and
Human Services to establish a national registry of
abusive long-term care workers that will incorporate
abuse information from all existing State nurse aide
registries, and expand information included in the
State registries and the national registry to include
abuse information about all employees of all long-term
care providers that receive funding through the
medicare or medicaid programs (42 U.S.C. 1395 et seq.;
1396 et seq.);</DELETED>
<DELETED> (B) require all long-term care providers,
before hiring a potential employee, to conduct checks
of both the national registry and criminal conviction
records maintained by the Federal Bureau of
Investigation, and prohibit long-term care providers
from hiring potential employees with relevant abuse and
criminal histories;</DELETED>
<DELETED> (C) require the Secretary of Health and
Human Services and the Attorney General to develop an
efficient system for long-term care providers to use to
check both the national registry and the criminal
conviction records maintained by the Federal Bureau of
Investigation before hiring an employee; and</DELETED>
<DELETED> (D) ensure adequate safeguards to protect
the privacy and accuracy of information regarding
applicants for employment being checked through the
national registry and the criminal conviction records
maintained by the Federal Bureau of
Investigation.</DELETED>
<DELETED> (d) Effective Date.--</DELETED>
<DELETED> (1) In general.--Except as provided in paragraph
(2), this section and the amendments made by this section shall
take effect on the date that is 6 months after the effective
date of final regulations promulgated to carry out this section
and such amendments.</DELETED>
<DELETED> (2) Sense of the senate.--Subsection (c) shall
take effect on the date of enactment of this section.</DELETED>
<DELETED>SEC. 103. INCREASING THE NUMBER OF HEALTH CARE PROFESSIONALS
WITH GERIATRIC TRAINING.</DELETED>
<DELETED> Section 338C of the Public Health Service Act (42 U.S.C.
254m) is amended by adding at the end the following:</DELETED>
<DELETED> ``(f) For purposes of this section and section 338B, the
term `obligated service', with respect to an individual who has entered
into a written contract with the Secretary under section 338B, includes
any period in which the individual is enrolled and participating in an
accredited (as determined by the Secretary) educational program that
provides geriatric training. Upon the completion of such training, such
individual, after consultation with the Secretary, shall provide
geriatric services as appropriate during the remainder of such
individual's period of obligated service.''.</DELETED>
<DELETED>SEC. 104. SUPPORTING THE LONG-TERM CARE OMBUDSMAN
PROGRAM.</DELETED>
<DELETED> Section 712(h) of the Older Americans Act of 1965 (42
U.S.C. 3058g(h)) is amended--</DELETED>
<DELETED> (1) in paragraph (8), by striking ``; and'' and
inserting a semicolon;</DELETED>
<DELETED> (2) in paragraph (9), by striking the period and
inserting ``; and''; and</DELETED>
<DELETED> (3) by adding at the end the following:</DELETED>
<DELETED> ``(10) make grants, in consultation 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, to eligible
entities with relevant expertise and experience to conduct
evaluations and pilot studies relating to various programs and
methods carried out by the Office of the State Long-Term Care
Ombudsman or a local Ombudsman entity under section 307(a)(9)
or this chapter, or to provide support (such as an ombudsman
resource center).''.</DELETED>
<DELETED>SEC. 105. ESTABLISHMENT OF OFFICE OF ADULT PROTECTIVE
SERVICES.</DELETED>
<DELETED> (a) In General.--Part A of title XI of the Social Security
Act (42 U.S.C. 1301 et seq.) is amended by adding at the end the
following:</DELETED>
<DELETED>``office of adult protective services</DELETED>
<DELETED> ``Sec. 1150A. (a) In General.--There is established within
the Department of Health and Human Services, within the Administration
on Children and Families, the Office of Adult Protective Services (in
this section referred to as the `Office'). The Office shall be headed
by a Director, who shall be appointed by the Secretary.</DELETED>
<DELETED> ``(b) Duties.--The Office shall--</DELETED>
<DELETED> ``(1) provide necessary funding and support to
State and local adult protective services offices that
investigate reports of abuse, neglect, and exploitation of
elders;</DELETED>
<DELETED> ``(2) annually collect and disseminate data
relating to the abuse, exploitation, and neglect of elderly
individuals in coordination with the Centers for Disease
Control and Prevention efforts to collect national data under
section 2221(b);</DELETED>
<DELETED> ``(3) develop and disseminate best practices
regarding, and provide training on, carrying out protective
services for elders;</DELETED>
<DELETED> ``(4) in conjunction with the necessary experts,
conduct research related to the provision of such protective
services;</DELETED>
<DELETED> ``(5) provide technical assistance to States and
other entities that provide or fund the provision of such
protective services, including through grants made under title
XX;</DELETED>
<DELETED> ``(6) participate in the Intra-Agency Elder
Justice Steering Committee established under section 2212;
and</DELETED>
<DELETED> ``(7) coordinate activities with the Office of
Elder Justice established under section 2211 and with other
Federal and State agencies that have responsibility for issues
related to elder justice.</DELETED>
<DELETED> ``(c) Appropriations.--There are appropriated such sums as
may be necessary to carry out this section.''.</DELETED>
<DELETED> (b) Effective Date.--The amendments made by this section
take effect 90 days after the date of enactment of the Elder Justice
Act.</DELETED>
<DELETED>SEC. 106. ASSURING SAFETY OF RESIDENTS WHEN NURSING FACILITIES
CLOSE.</DELETED>
<DELETED> (a) Medicare.--Section 1819(c)(2) of the Social Security
Act (42 U.S.C. 1395i-3(c)(2)) is amended by adding at the end the
following:</DELETED>
<DELETED> ``(D) Notification of facility closure.--
</DELETED>
<DELETED> ``(i) In general.--A skilled
nursing facility shall--</DELETED>
<DELETED> ``(I) submit to the
Secretary and the appropriate State
regulatory agency written notification
of an impending closure not later than
the date that is 60 days prior to the
date of such closure;</DELETED>
<DELETED> ``(II) include in the
notice a plan for the transfer and
adequate relocation of the residents
prior to closure, including assurances
that residents will not be transferred
to facilities providing substandard
care for which administrative or law
enforcement action is pending;
and</DELETED>
<DELETED> ``(III) not later than 10
days after the facility closure, submit
to the Secretary and the appropriate
State agency information identifying
where residents of the closed facility
were transferred and on what
date.</DELETED>
<DELETED> ``(ii) Sanctions.--Any person
owning a skilled nursing facility that fails to
comply with the requirements of clause (i)
shall be subject to--</DELETED>
<DELETED> ``(I) a civil monetary
penalty of up to $1,000,000;</DELETED>
<DELETED> ``(II) exclusion from
participation in the programs under
this Act (in accordance with the
procedures of section 1128);
and</DELETED>
<DELETED> ``(III) any other
applicable civil monetary penalties and
assessments.</DELETED>
<DELETED> ``(iii) Procedure.--A civil
monetary penalty or assessment authorized under
clause (ii) shall be imposed against a person
in the same manner as a civil monetary penalty,
assessment, or exclusion is imposed under
section 1128A.''.</DELETED>
<DELETED> (b) Medicaid.--Section 1919(c)(2) of the Social Security
Act (42 U.S.C. 1396r(c)(2)) is amended by adding at the end the
following:</DELETED>
<DELETED> ``(G) Notification of facility closure.--
</DELETED>
<DELETED> ``(i) In general.--A nursing
facility shall--</DELETED>
<DELETED> ``(I) submit to the
Secretary and the appropriate State
regulatory agency written notification
of an impending closure not later than
the date that is 60 days prior to the
date of such closure;</DELETED>
<DELETED> ``(II) include in the
notice a plan for the transfer and
adequate relocation of the residents
prior to closure, including assurances
that residents will not be transferred
to facilities providing substandard
care for which administrative or law
enforcement action is pending;
and</DELETED>
<DELETED> ``(III) not later than 10
days after the facility closure submit
to the Secretary and the appropriate
State agency information identifying
where residents of the closed facility
were transferred and on what
date.</DELETED>
<DELETED> ``(ii) Sanctions.--Any person
owning a nursing facility that fails to comply
with the requirements of clause (i) shall be
subject to--</DELETED>
<DELETED> ``(I) a civil monetary
penalty of up to $1,000,000;</DELETED>
<DELETED> ``(II) exclusion from
participation in the programs under
this Act (in accordance with the
procedures of section 1128);
and</DELETED>
<DELETED> ``(III) any other
applicable civil monetary penalties and
assessments.</DELETED>
<DELETED> ``(iii) Procedure.--A civil
monetary penalty or assessment authorized under
clause (ii) shall be imposed against a person
in the same manner as a civil monetary penalty,
assessment, or exclusion is imposed under
section 1128A.''.</DELETED>
<DELETED> (c) Regulations.--The Secretary, after consulting with the
Attorney General, shall issue regulations to carry out this
section.</DELETED>
<DELETED>TITLE II--DEPARTMENT OF JUSTICE</DELETED>
<DELETED>SEC. 201. DEFINITIONS; RULE.</DELETED>
<DELETED> (a) Definitions.--In this title the terms ``abuse'',
``elder'', ``elder justice'', ``exploitation'', ``fiduciary'',
``grant'', ``granting authority'', ``guardianship'', ``knowingly'',
``law enforcement'', ``neglect'', ``serious bodily injury'',
``social'', ``State'', and ``vulnerable adult'' have the meanings given
such terms in title XXII of the Social Security Act.</DELETED>
<DELETED> (b) Rule.--The Attorney General may determine, in an
appropriate case, that a provision of this title that applies to elders
also applies to vulnerable adults.</DELETED>
<DELETED>SEC. 202. MODEL STATE LAWS AND PRACTICES.</DELETED>
<DELETED> (a) In General.--The Attorney General, after consultation
with the Secretary of Health and Human Services, shall--</DELETED>
<DELETED> (1) conduct a study and prepare a report of the
findings of that study of State laws and practices relating to
elder abuse, neglect, and exploitation and provide such report
or periodic reports to the Elder Justice Resource Center
established under section 2221 of the Social Security Act, to
be made available to the public; and</DELETED>
<DELETED> (2) not later than 2 years after the date of
enactment of this Act, submit to the Chairman and Ranking
Member of the Special Committee on Aging of the Senate, and the
Speaker and Minority leader of the House of Representatives a
report that--</DELETED>
<DELETED> (A) provides recommendations on a
comprehensive description and comparative analysis of
the State laws and practices; and</DELETED>
<DELETED> (B) provides recommended models for State
laws and practices based on an analysis of the most
effective State laws and practices, including
recommendations with respect to the definitions
referred to in subsection (b)(1).</DELETED>
<DELETED> (b) State Laws and Practices.--The Attorney General shall
examine State laws and practices under subsection (a) on issues
including--</DELETED>
<DELETED> (1) definitions of ``elder'', ``abuse'',
``neglect'', and ``exploitation'', and related terms;</DELETED>
<DELETED> (2) mandatory reporting laws, with respect to--
</DELETED>
<DELETED> (A) who is a mandated reporter;</DELETED>
<DELETED> (B) to whom must they report and within
what timeframe; and</DELETED>
<DELETED> (C) any consequences for
nonreporting;</DELETED>
<DELETED> (3) evidentiary, procedural, sentencing, choice of
remedies, and data retention issues relating to pursuing cases
relating to elder abuse, neglect, and exploitation;</DELETED>
<DELETED> (4) laws requiring immediate reporting of all
nursing home deaths to the county coroner or to some other
individual or entity;</DELETED>
<DELETED> (5) fiduciary laws, including guardianship and
power of attorney laws;</DELETED>
<DELETED> (6) laws that permit or encourage banks and bank
employees to prevent and report suspected elder abuse, neglect,
and exploitation;</DELETED>
<DELETED> (7) laws that may impede research on elder abuse,
neglect, and exploitation;</DELETED>
<DELETED> (8) practices relating to the enforcement of laws
relating to elder abuse, neglect, and exploitation;
and</DELETED>
<DELETED> (9) practices relating to other aspects of elder
justice.</DELETED>
<DELETED>SEC. 203. OFFICE OF ELDER JUSTICE OF THE DEPARTMENT OF
JUSTICE.</DELETED>
<DELETED> (a) Establishment.--There is established within the
Department of Justice under the Assistant Attorney General, Office of
Justice Programs, an Office of Elder Justice.</DELETED>
<DELETED> (b) Director.--</DELETED>
<DELETED> (1) Appointment.--The President, with the advice
and consent of the Senate, shall appoint a Director of the
Office of Elder Justice, from among individuals with experience
and expertise in elder justice issues, to manage the Office of
Elder Justice established under this section.</DELETED>
<DELETED> (2) Duties.--The Director of the Office of Elder
Justice shall--</DELETED>
<DELETED> (A)(i) develop objectives, priorities,
policy, and a long-term plan for elder justice programs
and activities relating to prevention, detection,
training, treatment, evaluation, intervention,
research, and improvement of the elder justice system
in the United States;</DELETED>
<DELETED> (ii) implement the overall policy and a
strategy to carry out the plan described in clause (i);
and</DELETED>
<DELETED> (iii) hire personnel to assist the
director in carrying out the policy, program, and
administrative activities related to the duties under
clauses (i) and (ii);</DELETED>
<DELETED> (B) provide advice to the Attorney General
on elder justice issues; and</DELETED>
<DELETED> (C) coordinate activities with the Senior
Counsel on Elder Justice.</DELETED>
<DELETED> (3) Reporting relationship.--The Director of the
Office of Elder Justice shall have the same reporting
relationship with the Attorney General and the Assistant
Attorney General, Office of Justice Programs, as the directors
of the other offices headed by presidential appointees within
the Office of Justice Programs.</DELETED>
<DELETED> (4) Compensation.--The Director shall be
compensated at a rate that shall not exceed the rate
established for level I of the Executive Schedule under section
5312 of title 5, United States Code.</DELETED>
<DELETED> (c) Senior Counsel.--</DELETED>
<DELETED> (1) Appointment.--The Attorney General shall
appoint a Senior Counsel on Elder Justice, from among
individuals with experience and expertise in elder justice
issues.</DELETED>
<DELETED> (2) Duties.--The Senior Counsel on Elder Justice
shall--</DELETED>
<DELETED> (A) coordinate elder justice activities
among--</DELETED>
<DELETED> (i) the Office of Elder
Justice;</DELETED>
<DELETED> (ii) other offices (including
bureaus) within the Office of Justice Programs
that are involved with elder justice
issues;</DELETED>
<DELETED> (iii) litigating divisions with
cases relating to elder justice
matters;</DELETED>
<DELETED> (iv) the Executive Office of
United States Attorneys and the United States
Attorneys' offices; and</DELETED>
<DELETED> (v) any other office or division
of the Department of Justice that the Attorney
General considers appropriate for such
coordination; and</DELETED>
<DELETED> (B) provide advice to the Attorney General
on elder justice issues.</DELETED>
<DELETED> (3) Location.--The Senior Counsel on Elder Justice
shall be located in--</DELETED>
<DELETED> (A) the Office of the Attorney
General;</DELETED>
<DELETED> (B) the Office of the Deputy Attorney
General; or</DELETED>
<DELETED> (C) the Office of the Associate Attorney
General.</DELETED>
<DELETED> (4) Position.--The position of the Senior Counsel
on Elder Justice shall be a Senior Executive Service position,
as defined in section 3132 of title 5, United States
Code.</DELETED>
<DELETED> (5) Staff.--The Senior Counsel on Elder Justice
may appoint and terminate 1 full-time employee to enable the
Senior Counsel to perform the duties described in paragraph
(2). The Senior Counsel on Elder Justice may fix the
compensation of the employee in accord with chapter 51 and
subchapter III of chapter 53 of title 5, United States Code,
relating to classification of positions and General Schedule
pay rates.</DELETED>
<DELETED> (6) Relation to other law.--The positions
described in paragraphs (4) and (5), and the salary for the
positions, shall be in addition to the total number of
positions and the total amount of salary provided for in Public
Law 107-77.</DELETED>
<DELETED>SEC. 204. GRANTS UNDER THE SOCIAL SECURITY ACT.</DELETED>
<DELETED> The Attorney General is authorized to award grants under
subsections (a), (c)(1), (c)(2), (d), (e)(1), (f), (h), and (i) of
section 2222 and under section 2224 of the Social Security Act in
accordance with such subsections.</DELETED>
<DELETED>SEC. 205. VICTIM ADVOCACY GRANTS.</DELETED>
<DELETED> (a) Grants Authorized.--The Attorney General, after
consultation with the Secretary of Health and Human Services, may award
grants to eligible entities to study the special needs of victims of
elder abuse, neglect, and exploitation.</DELETED>
<DELETED> (b) Authorized Activities.--Funds awarded pursuant to
subsection (a) shall be used for pilot programs that develop programs,
provide training to health care, social and protective services
providers, law enforcement, fiduciaries including guardians, judges and
court personnel, and victim advocates, and examine special approaches
designed to meet the needs of victims of elder abuse, neglect, and
exploitation.</DELETED>
<DELETED>SEC. 206. SUPPORTING LOCAL PROSECUTORS IN ELDER JUSTICE
MATTERS.</DELETED>
<DELETED> (a) Grant Authorized.--The Attorney General, after
consultation with the Director of Office of Elder Justice in the
Department of Health and Human Services, shall award grants to provide
training, technical assistance, policy development, multidisciplinary
coordination, and other types of support to local prosecutors, handling
elder justice-related cases, including the funding of specially
designated elder justice positions or units, or funding the creation of
a Center for the Prosecution of Elder Abuse, Neglect, and Exploitation
by the American Prosecutor Research Institute of the National District
Attorneys Association, or other similarly situated entity to advise and
support local prosecutors nationwide in their pursuit of cases
involving elder abuse, neglect, and exploitation.</DELETED>
<DELETED> (b) Duties.--The Center created under subsection (a)
shall, among other things--</DELETED>
<DELETED> (1) collaborate with experts in elder abuse,
neglect, and exploitation;</DELETED>
<DELETED> (2) collaborate with the Advisory Board created by
section 2214 of the Social Security Act; and</DELETED>
<DELETED> (3) provide local prosecutors and personnel
assisting such prosecutors with training, technical assistance,
multidisciplinary teams and input, in the handling, prevention
and prosecution of, and special circumstances surrounding elder
abuse, neglect, and exploitation.</DELETED>
<DELETED>SEC. 207. SUPPORTING STATE PROSECUTORS IN ELDER JUSTICE
MATTERS.</DELETED>
<DELETED> (a) In General.--The Attorney General shall, after
consultation with the Secretary of Health and Human Services, award
grants to provide training, technical assistance, multidisciplinary
coordination, policy development, and other types of support to State
prosecutors, including employees of State Attorneys General and
Medicaid Fraud Control Units, handling elder justice-related
matters.</DELETED>
<DELETED> (b) Creating Specialized Positions.--Grants under this
section may be made for--</DELETED>
<DELETED> (1) the establishment of specially designated
elder justice positions or units; or</DELETED>
<DELETED> (2) the creation of a position to coordinate elder
justice-related cases, training, technical assistance, and
policy development for State prosecutors, by the National
Association of Attorneys General (NAAG) or other similarly
situated entity.</DELETED>
<DELETED>SEC. 208. SUPPORTING FEDERAL CASES INVOLVING ELDER
JUSTICE.</DELETED>
<DELETED> (a) Support and Assistance.--</DELETED>
<DELETED> (1) In general.--The Attorney General shall
support cases relating to elder justice.</DELETED>
<DELETED> (2) Additional staff.--The Attorney General shall
have additional Federal prosecutors and make funding available
to Federal prosecutors to hire nurse-investigators or other
experts needed to identify, assist with, or pursue cases
relating to elder justice.</DELETED>
<DELETED> (3) Resource group.--The Attorney General may fund
through the Executive Office of United States Attorneys for a
Resource Group to assist prosecutors throughout the Nation in
pursuing failure of care and other cases relating to elder
justice matters.</DELETED>
<DELETED> (b) Office of Inspector General.--The Office of Inspector
General of the Department of Health and Human Services shall hire nurse
investigators and other experts to investigate and pursue failure of
care allegations.</DELETED>
<DELETED>SEC. 209. COMMUNITY POLICING.</DELETED>
<DELETED> (a) Grant Authorized.--The Attorney General, after
consultation with the Secretary of the Department of Health and Human
Services, shall establish a grant program to develop community policing
and other law enforcement efforts to make communities safer for elders
living in all settings.</DELETED>
<DELETED> (b) Special Elder Units.--The Attorney General, after
consultation with the Secretary of Health and Human Services, shall
establish a grant program to support--</DELETED>
<DELETED> (1) special elder units and officers;</DELETED>
<DELETED> (2) in rural areas with fewer law enforcement
personnel, a specially trained elder officer;</DELETED>
<DELETED> (3) programs, including the Alzheimer
Association's ``Safe Return Program'' or other similar program;
and</DELETED>
<DELETED> (4) training, technical assistance, policy
development, multidisciplinary coordination, and other support
and programs relating to elder justice.</DELETED>
<DELETED>SEC. 210. SUPPORTING LAW ENFORCEMENT IN ELDER JUSTICE
MATTERS.</DELETED>
<DELETED> The Attorney General shall, after consultation with the
Secretary of Health and Human Services, award grants to provide
training, technical assistance, multidisciplinary coordination, policy
development, and other types of support to police, sheriffs,
detectives, public safety officers, corrections personnel, and other
front line law enforcement responders who handle elder justice-related
matters, to fund specially designated elder justice positions or units,
designed to support front line law enforcement in elder justice
matters.</DELETED>
<DELETED>SEC. 211. EVALUATIONS.</DELETED>
<DELETED> (a) Grants.--</DELETED>
<DELETED> (1) In general.--In making a grant under a
provision of this title (other than this section), the granting
authority shall--</DELETED>
<DELETED> (A) require the recipient of the grant
to--</DELETED>
<DELETED> (i) reserve a portion of the funds
made available through the grant; and</DELETED>
<DELETED> (ii) use the reserved funds to
conduct an evaluation of the other activities
carried out through the grant; or</DELETED>
<DELETED> (B)(i) reserve a portion of the funds
available for the grant; and</DELETED>
<DELETED> (ii) use the reserved funds to provide
assistance to an eligible entity to conduct an
evaluation of the activities carried out through the
grant.</DELETED>
<DELETED> (2) Use of funds.--A recipient of a grant
described in paragraph (1)(A), or assistance described in
paragraph (1)(B)(ii), shall use the funds made available
through the grant, or the assistance, respectively, to conduct
a validated evaluation of the effectiveness of the activities
described in subparagraph (A) or (B), respectively, of
paragraph (1).</DELETED>
<DELETED> (3) Applications.--</DELETED>
<DELETED> (A) Submission.--</DELETED>
<DELETED> (i) Grants for projects containing
evaluations.--To be eligible to receive a grant
for which the granting authority requires the
reservation described in paragraph (1)(A)(i),
an entity shall include a proposal for the
evaluation in the application submitted for the
grant.</DELETED>
<DELETED> (ii) Assistance for evaluations.--
To be eligible to receive assistance under
paragraph (1)(B)(ii), an entity shall submit an
application to the granting authority at such
time, in such manner, and containing such
information as the granting authority may
require, including a proposal for the
evaluation.</DELETED>
<DELETED> (B) Review and assistance.--An employee of
the Department of Justice, after consultation with an
employee of the Department of Health and Human Services
and a nongovernmental member of the advisory board
established under section 2214 of the Social Security
Act, with expertise in evaluation methodology shall
review each proposal described in clause (i) or (ii) of
subparagraph (A), and determine whether the methodology
described in the proposal is adequate to gather
meaningful information. If the reviewers determine that
the methodology is inadequate, they shall recommend
that the granting authority deny the application for
the grant described in subparagraph (A)(i), or the
assistance described in subparagraph (B)(ii), as
appropriate, or make recommendations for how the
application should be amended. If the granting
authority denies the application on the basis of the
proposal, the granting authority shall inform the
applicant why the application was denied, and offer
assistance to the applicant in modifying the
proposal.</DELETED>
<DELETED> (b) Other Grants.--The granting authority shall make
grants to appropriate entities to conduct validated evaluations of
activities, to reduce elder abuse, neglect, and exploitation, that are
not funded under this title.</DELETED>
<DELETED> (c) Condition of Participation.--As a condition of
participation in any grant under this title, individuals, facilities,
and other entities shall agree to be subject to the provisions of
section 571 of title 18, United States Code, as added by this
Act.</DELETED>
<DELETED>SEC. 212. AUTHORIZATION OF APPROPRIATIONS.</DELETED>
<DELETED> There are authorized to be appropriated such sums as are
necessary for fiscal years 2004 through 2010 to carry out this
title.</DELETED>
<DELETED>SEC. 213. CAUSE OF ACTION FOR ELDER ABUSE AND
NEGLECT.</DELETED>
<DELETED> (a) In General.--Part I of title 18, United States Code,
is amended by adding after chapter 27 the following:</DELETED>
<DELETED>``CHAPTER 28--ELDER ABUSE AND NEGLECT</DELETED>
<DELETED>``Sec.
<DELETED>``571. Harm to residents of nursing facilities.
<DELETED>``Sec. 571. Harm to residents of nursing facilities</DELETED>
<DELETED> ``(a) Definitions.--In this section:</DELETED>
<DELETED> ``(1) Entity.--The term `entity' means--</DELETED>
<DELETED> ``(A) any nursing facility (including
facilities that do not exclusively provide nursing
care);</DELETED>
<DELETED> ``(B) any entity that manages a nursing
facility; or</DELETED>
<DELETED> ``(C) any entity that owns, directly or
indirectly, a controlling interest or a 50 percent or
greater interest in 1 or more nursing
facilities.</DELETED>
<DELETED> ``(2) Neglect.--The term `neglect' means the
failure of a caregiver (as defined in section 2201 of the
Social Security Act) to provide the goods or services that are
necessary to avoid physical harm, disability, mental anguish,
or mental illness.</DELETED>
<DELETED> ``(3) Nursing facility.--The term `nursing
facility' means both a nursing facility (as defined in section
1919(a) of the Social Security Act) and a skilled nursing
facility as defined in section 1819(a) of the Social Security
Act (42 U.S.C. 1395i-3(a).</DELETED>
<DELETED> ``(4) Person.--The term `person' has the same
meaning as in section 921(a)(1) of this title.</DELETED>
<DELETED> ``(b) Offense.--</DELETED>
<DELETED> ``(1) In general.--It shall be unlawful for any
person or entity to, with the intent to cause injury or with
reckless disregard for the safety of human life, act or fail to
act, if such act or omission results in--</DELETED>
<DELETED> ``(A) serious bodily injury to 1 or more
residents of a nursing facility; and</DELETED>
<DELETED> ``(B) abuse or neglect of an additional 2
or more residents of the same nursing
facility.</DELETED>
<DELETED> ``(2) Penalty for individual.--Any individual who
violates paragraph (1) shall be--</DELETED>
<DELETED> ``(A) imprisoned for not more than 20
years and, if death results, shall be imprisoned for
any term of years or for life; and</DELETED>
<DELETED> ``(B) fined in accordance with section
3571.</DELETED>
<DELETED> ``(3) Other penalty.--Any entity or person, other
than an individual, that violates paragraph (1) shall be fined
not more than $3,000,000 per nursing facility
involved.''.</DELETED>
<DELETED> (b) Health Care Offense.--Section 24(a)(1) of title 18,
United States Code, is amended by inserting ``571,'' before
``669,''.</DELETED>
<DELETED> (c) Technical and Conforming Amendment.--The table of
chapters for part I of title 18, United States Code, is amended by
inserting after the item relating to chapter 27 the
following:</DELETED>
<DELETED>``28. Elder Abuse and Neglect...................... 571''.
<DELETED>SEC. 214. CIVIL ACTIONS FOR ELDER ABUSE AND NEGLECT.</DELETED>
<DELETED> (a) Definitions.--In this section:</DELETED>
<DELETED> (1) Entity.--</DELETED>
<DELETED> (A) In general.--The term ``entity''
means--</DELETED>
<DELETED> (i) any nursing facility
(including facilities that do not exclusively
provide nursing care);</DELETED>
<DELETED> (ii) any entity that manages a
nursing facility; or</DELETED>
<DELETED> (iii) any entity that owns,
directly or indirectly, a controlling interest
or a 50 percent or greater interest in 1 or
more nursing facilities.</DELETED>
<DELETED> (B) Additional entities.--The term shall
include States, localities, and political subdivisions
thereof.</DELETED>
<DELETED> (2) Neglect.--The term ``neglect'' means the
failure of a caregiver (as defined in section 2201 of the
Social Security Act, as added by this Act) to provide the goods
or services that are necessary to avoid physical harm,
disability, mental anguish, or mental illness.</DELETED>
<DELETED> (3) Nursing facility.--The term ``nursing
facility'' means both a nursing facility (as defined in section
1919(a) of the Social Security Act (42 U.S.C. 1396r(a))) and a
skilled nursing facility as defined in section 1819(a) of the
Social Security Act.</DELETED>
<DELETED> (4) Person.--The term ``person'' has the same
meaning as in section 921(a)(1) of title 18, United States
Code.</DELETED>
<DELETED> (5) Other terms.--The terms ``abuse'', ``State'',
and ``serious bodily injury'' shall have the meanings given
those terms in section 2201 of the Social Security
Act.</DELETED>
<DELETED> (b) Civil Actions Brought by the Attorney General.--
</DELETED>
<DELETED> (1) In general.--The Attorney General may bring an
action under this subsection against any person or entity that
knowingly, or in reckless disregard for the safety of human
life, acts or fails to act, if such act or omission results in
serious bodily injury to 1 or more residents of a nursing
facility and in abuse or neglect of an additional 2 or more
residents of the same nursing facility.</DELETED>
<DELETED> (2) Civil penalty.--A person or entity that acts
or fails to act as described in paragraph (1) shall be liable
to the United States for a civil penalty of--</DELETED>
<DELETED> (A) in the case of an individual (other
than an owner, operator, officer, or manager of such a
nursing facility, such as a nurse or a certified
nurse's aide) up to $50,000 for each violation of this
subsection;</DELETED>
<DELETED> (B) in the case of an individual who is an
owner, operator, officer, or manager of such a nursing
facility, up to $500,000 for each violation of this
subsection;</DELETED>
<DELETED> (C) in the case of a violation of this
subsection involving a single nursing facility, that
facility, or its management company, up to $3,000,000
for that facility for such violation; and</DELETED>
<DELETED> (D) in the case of a violation of this
subsection at 2 or more nursing facilities with common
ownership or under common management, up to $6,000,000
for each entity that owns such facilities where there
were such violations.</DELETED>
<DELETED>The amount shall be set by the district court,
depending on the number of residents who suffered abuse or
neglect, the severity of the injury to residents relating to
abuse or neglect, and the number of resident deaths relating to
abuse or neglect at the facilities in violation of this
subsection.</DELETED>
<DELETED> (3) Other appropriate relief.--If the Attorney
General has reason to believe that a person or entity is
engaging in or is about to engage in an act or omission that
results in or has the potential for resulting in serious bodily
injury to 1 or more residents of a nursing facility and in
abuse or neglect of an additional 2 or more residents of the
same nursing facility, the Attorney General may petition an
appropriate United States district court for appropriate
equitable and declaratory relief to eliminate the circumstances
giving rise to the actual or potential harm.</DELETED>
<DELETED> (3) Procedures.--</DELETED>
<DELETED> (A) In general.--A subpoena requiring the
attendance of a witness at a trial or hearing conducted
under this subsection may be served at any place in the
United States.</DELETED>
<DELETED> (B) Limitation.--An action brought under
paragraph (1) may not be brought more than 6 years
after the date on which the violation of this
subsection occurred, except that the time for filing is
tolled during the period when the right of action was
not known and reasonably could not have been known by
an official of the United States charged with
responsibility to act in the circumstances.</DELETED>
<DELETED> (C) Standard of proof.--The United States
shall be required to prove all actions under this
subsection by a preponderance of the
evidence.</DELETED>
<DELETED> (D) Civil investigative demand
procedures.--The civil investigative demand procedures
set forth in The Antitrust Civil Process Act (15 U.S.C.
1511 et seq.) may be used in investigations and actions
pursued under this subsection.</DELETED>
<DELETED> (d) Relationship to Other Laws.--This section is not
intended to supplant or otherwise bar any existing equitable, common
law, or criminal or civil statutory remedies possessed by the United
States, including under the False Claims Act (31 U.S.C. 33729-3733).
The Federal Rules of Civil Procedure shall apply to actions brought
under subsection (b).</DELETED>
<DELETED> (e) No Private Cause of Action.--Nothing in this title
creates a private cause of action or in any other way increases the
liability of any person under any other law.</DELETED>
<DELETED>TITLE III--TAX PROVISIONS</DELETED>
<DELETED>SEC. 301. LONG-TERM CARE FACILITY WORKER EMPLOYMENT TAX
CREDIT.</DELETED>
<DELETED> (a) Work Opportunity Tax Credit.--</DELETED>
<DELETED> (1) In general.--Section 51(d)(1) of the Internal
Revenue Code of 1986 (relating to members of targeted groups)
is amended by striking ``or'' at the end of subparagraph (G),
by striking the period at the end of subparagraph (H) and
inserting ``, or'', and by adding at the end the
following:</DELETED>
<DELETED> ``(I) a qualified long-term care facility
worker.''.</DELETED>
<DELETED> (2) Qualified long-term care facility worker.--
Section 51(d) of such Code is amended by redesignating
paragraphs (10) through (12) as paragraphs (11) through (13),
respectively, and by inserting after paragraph (9) the
following:</DELETED>
<DELETED> ``(10) Qualified long-term care facility worker.--
The term `qualified long-term care facility worker' means any
individual who--</DELETED>
<DELETED> ``(A) is hired by a long-term care
facility (as defined in section 2201 of the Social
Security Act, and</DELETED>
<DELETED> ``(B) is certified by the designated local
agency as being qualified to provide long-term care (as
defined in section 2201 of such Act) at such
facility.''.</DELETED>
<DELETED> (b) Effective Date.--The amendments made by this section
shall apply to individuals who begin work for the employer after the
date of enactment of this Act.</DELETED>
SECTION 1. SHORT TITLE; TABLE OF CONTENTS; DEFINITIONS.
(a) Short Title.--This Act may be cited as the ``John Breaux Elder
Justice Act''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents; definitions.
Sec. 2. Findings.
Sec. 3. Purposes.
Sec. 4. Definitions.
TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES
Sec. 101. Amendments to the Social Security Act.
``TITLE XXII--ELDER JUSTICE
``Sec. 2200. Definitions.
``Subtitle A--Federal Elder Justice System
``Sec. 2201. Elder Justice Coordinating Council.
``Sec. 2202. Advisory Board on Elder Abuse, Neglect, and
Exploitation.
``Sec. 2203. Human subject research.
``Sec. 2204. Regulations.
``Sec. 2205. Authorization of appropriations.
``Subtitle B--Elder Justice Programs
``Sec. 2211. Enhancement of long-term care.
``Sec. 2212. Collaborative efforts to enhance communication on
promoting quality of and preventing abuse
and neglect in long-term care.
``Sec. 2213. Collaborative efforts to develop consensus around
the management of certain quality-related
factors.
``Sec. 2214. Adult protective services functions and grant
programs.
``Subtitle C--Collection of Data, Dissemination of Information, and
Studies
``Sec. 2221. Collection of uniform national data on elder
abuse, neglect, and exploitation.
``Sec. 2222. Long-term care consumer clearinghouse.
``Sec. 2223. Consumer information about the continuum of
residential long-term care facilities.
``Sec. 2224. Provision of information regarding, and
evaluations of, elder justice programs.''.
TITLE II--DEPARTMENT OF JUSTICE
Sec. 201. Victim advocacy grants.
Sec. 202. Supporting State and local prosecutors in elder justice
matters.
Sec. 203. Supporting Federal cases involving elder justice.
Sec. 204. Supporting law enforcement in elder justice matters.
Sec. 205. Establishment and support of elder abuse, neglect, and
exploitation forensic centers.
Sec. 206. Model State laws and practices.
Sec. 207. Provision of information regarding, and evaluations of,
Department of Justice elder justice
programs.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The proportion of the United States population age 60
years or older will drastically increase in the next 30 years
as 77,000,000 baby boomers approach retirement and old age.
(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, gender, and
geographic lines.
(4) Victims of elder abuse, neglect, and exploitation are
not only subject to injury from mistreatment and neglect, they
are also 3.1 times more likely than elders who were not victims
of elder abuse, neglect, and exploitation to die at an earlier
age than expected.
(5) There is a general dearth of data as to the nature and
scope of elder abuse, neglect, and exploitation.
(6) Despite the dearth of data in the field, experts agree
that most cases of elder abuse, neglect, and exploitation are
never reported and that abuse, neglect, and exploitation
shorten a victim's life, often triggering a downward spiral of
an otherwise productive, self-sufficient elder's life. Programs
addressing other difficult 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.
(7) For over 20 years, Congress has been presented with
facts and testimony calling for a coordinated 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, neglect, and exploitation or
to undertake prevention efforts.
(9) No Federal law has been enacted that adequately and
comprehensively addresses the issues of elder abuse, neglect,
and exploitation and there are very limited resources available
to those in the field that directly deal with the issues.
(10) Differences in State laws and practices in the areas
of elder abuse, neglect, and exploitation lead to significant
disparities in prevention, protective 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, public safety, data collection,
the identification, development, and dissemination of promising
health care, social, and protective services, and law
enforcement practices, relating to child abuse and neglect,
domestic violence, and violence against women. The Federal
Government should promote similar efforts and protections
relating to elder abuse, neglect, and exploitation.
(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 relevant 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 communities
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, reporting,
investigation, assessment, treatment, and prosecution
of elder abuse, neglect, and exploitation at all levels
of government;
(C) ensures that sufficient numbers of properly
trained personnel with specialized knowledge are in
place to treat, assess, and provide services relating
to elder abuse, neglect, and exploitation, and carry
out elder protection duties;
(D) is sensitive to ethnic and cultural diversity;
(E) recognizes the role of mental health,
disability, dementia, substance abuse, medication
mismanagement, and family dysfunction problems in
increasing and exacerbating elder abuse, neglect, and
exploitation; and
(F) balances elders' right to self-determination
with society's responsibility to protect elders.
(14) The human, social, and economic cost of elder abuse,
neglect, and exploitation is high and includes unnecessary
expenditures of funds from many public programs.
(15) The failure to coordinate activities relating to, and
comprehensively prevent and treat, elder abuse, neglect, and
exploitation threatens the future and well-being of millions of
elders in the United States.
(16) All elements of society in the United States have a
shared responsibility in responding to a national problem of
elder abuse, neglect, and exploitation.
SEC. 3. PURPOSES.
The purposes of this Act are as follows:
(1) To enhance the social security of the Nation by
ensuring adequate public-private infrastructure and resolve to
prevent, detect, treat, understand, and intervene in, and where
appropriate, aid in the prosecution of, elder abuse, neglect,
and exploitation.
(2) To bring a comprehensive approach to preventing and
combating elder abuse, neglect, and exploitation, a long
invisible problem that afflicts the most vulnerable among the
aging population of the United States.
(3) To raise the issue of elder abuse, neglect, and
exploitation to national attention, and to create the
infrastructure at the Federal, State, and local levels, to
ensure that individuals and organizations on the front lines,
who are fighting elder abuse, neglect, and exploitation with
scarce resources and fragmented systems, have the resources and
information needed to carry out their fight.
(4) To bring a comprehensive multidisciplinary approach to
elder justice.
(5) To set in motion research and data collection to fill
gaps in knowledge about elder abuse, neglect, and exploitation.
(6) To supplement the activities of service providers and
programs, to enhance training, and to leverage scarce resources
efficiently to ensure that elder justice receives the attention
it deserves as the Nation's population ages.
(7) To examine the many different laws and practices
relating to elder justice in different States and jurisdictions
to ascertain which among those laws and practices are the most
effective.
(8) To promote the development of an effective adult
fiduciary system, including an adult guardianship system,
that--
(A) maximizes the autonomy, self-determination, and
dignity of choice of individuals with diminished
capacity and that fully protects the due process rights
of elders that are the subjects of contested or
uncontested guardianship hearings; and
(B) honors properly executed advance directives of
persons with diminished capacity, unless there is
evidence of a breach in a designated agent's fiduciary
responsibility or the advance directive does not give
sufficient authority to meet the needs of the elder.
(9) To recognize and address the role of mental health,
disability, dementia, substance abuse, medication
mismanagement, and family dysfunction problems in increasing
and exacerbating elder abuse, neglect, and exploitation.
(10) To create short- and long-term strategic plans for the
development and coordination of elder justice research,
programs, studies, training, and other efforts nationwide.
(11) To promote collaborative efforts and diminish overlap
and gaps in efforts in developing the important field of elder
justice.
(12) To honor and respect the right of all persons with
diminished capacity to decisionmaking autonomy, self-
determination, and dignity of choice.
(13) To respect the wishes of persons with diminished
capacity and their family members in providing supportive
services and care plans intended to protect elders from abuse,
neglect (including self-neglect), and exploitation.
SEC. 4. DEFINITIONS.
Except as otherwise specifically provided, any term that is defined
in section 2200 of the Social Security Act (as added by section 101)
and that is used in this Act has the meaning given such term by such
title.
TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES
SEC. 101. AMENDMENTS TO THE SOCIAL SECURITY ACT.
(a) In General.--The Social Security Act (42 U.S.C. 301 et seq.) is
amended by adding at the end the following:
``TITLE XXII--ELDER JUSTICE
``SEC. 2200. DEFINITIONS.
``In this title:
``(1) Abuse.--The term `abuse' means the knowing infliction
of physical or psychological harm or the knowing deprivation of
goods or services that are necessary to meet essential needs or
to avoid physical or psychological harm.
``(2) Adult protective services.--The term `adult
protective services' means such services provided to adults as
the Secretary may specify and includes services such as--
``(A) disseminating reports of adult abuse,
neglect, or exploitation;
``(B) investigating the reports described in
subparagraph (A);
``(C) case planning, monitoring, evaluation, and
other case work and services; and
``(D) providing, arranging for, or facilitating the
provision of medical, social service, economic, legal,
housing, law enforcement, or other protective,
emergency, or support services.
``(3) Caregiver.--The term `caregiver' means an individual
who has the responsibility for the care of an elder, either
voluntarily, by contract, by receipt of payment for care, or as
a result of the operation of law and means a family member or
other individual who provides (on behalf of such individual or
of a public or private agency, organization, or institution)
compensated or uncompensated care to an elder who needs
supportive services in any setting.
``(4) Direct care.--The term `direct care' means care by an
employee or contractor who provides assistance or long-term
care services to a recipient.
``(5) Elder.--The term `elder' means an individual age 60
or older.
``(6) Elder justice.--The term `elder justice' means--
``(A) from a societal perspective, efforts to
prevent, detect, treat, intervene in, and prosecute
elder abuse, neglect, and exploitation and to protect
elders with diminished capacity while maximizing their
autonomy; and
``(B) from an individual perspective, the
recognition of an elder's rights, including the right
to be free of abuse, neglect, and exploitation.
``(7) Eligible entity.--The term `eligible entity' means a
State or local government agency, Indian tribe, or any other
public or private entity that is engaged in and has expertise
in issues relating to elder justice or in a field necessary to
promote elder justice efforts.
``(8) Exploitation.--The term `exploitation' means the
fraudulent or otherwise illegal, unauthorized, or improper act
or process of an individual, including a caregiver or
fiduciary, that uses the resources of an elder for monetary or
personal benefit, profit, or gain, or that results in depriving
an elder of rightful access to, or use of, benefits, resources,
belongings, or assets.
``(9) Fiduciary.--The term `fiduciary'--
``(A) means a person or entity with the legal
responsibility--
``(i) to make decisions on behalf of and
for the benefit of another person; and
``(ii) to act in good faith and with
fairness; and
``(B) includes a trustee, a guardian, a
conservator, an executor, an agent under a financial
power of attorney or health care power of attorney, or
a representative payee.
``(10) Grant.--The term `grant' includes a contract,
cooperative agreement, or other mechanism for providing
financial assistance.
``(11) Guardianship.--The term `guardianship' means--
``(A) the process by which a State court determines
that an adult individual lacks capacity to make
decisions about self-care and property, and appoints
another individual or entity known as a guardian, as a
conservator, or by a similar term, as a surrogate
decisionmaker;
``(B) the manner in which the court-appointed
surrogate decisionmaker carries out duties to the
individual and the court; or
``(C) the manner in which the court exercises
oversight of the surrogate decisionmaker.
``(12) Indian tribe.--The term `Indian tribe' means any
tribe, band, nation, or other organized group or community of
Indians, including any Native village, Regional Corporation, or
Village Corporation as defined in or established pursuant to
the Alaska Native Claims Settlement Act (43 U.S.C. 1601 et
seq.), that is recognized as eligible for the special programs
and services provided by the United States to Indians because
of their status as Indians.
``(13) Law enforcement.--The term `law enforcement' means
the full range of potential responders to elder abuse, neglect,
and exploitation including--
``(A) police, sheriffs, detectives, public safety
officers, and corrections personnel;
``(B) prosecutors;
``(C) medical examiners;
``(D) investigators; and
``(E) coroners.
``(14) Long-term care.--
``(A) In general.--The term `long-term care' means
supportive and health services specified by the
Secretary for individuals who need assistance because
the individuals have a loss of capacity for self-care
due to illness, disability, or vulnerability.
``(B) Loss of capacity for self-care.--For purposes
of subparagraph (A), the term `loss of capacity for
self-care' means an inability to engage in activities
of daily living, including eating, dressing, bathing,
and management of one's financial affairs.
``(15) Long-term care facility.--The term `long-term care
facility' means a residential care provider that arranges for,
or directly provides, long-term care.
``(16) Neglect.--The term `neglect' means--
``(A) the failure of a caregiver or fiduciary to
provide the goods or services that are necessary to
maintain the health or safety of an elder; or
``(B) self-neglect.
``(17) Nursing facility.--The term `nursing facility' has
the meaning given such term under section 1919(a).
``(18) Secretary.--The term `Secretary' means the Secretary
of Health and Human Services.
``(19) Self-neglect.--The term `self-neglect' means an
adult's inability, due to physical or mental impairment or
diminished capacity, to perform essential self-care tasks
including--
``(A) obtaining essential food, clothing, shelter,
and medical care;
``(B) obtaining goods and services necessary to
maintain physical health, mental health, or general
safety; or
``(C) managing one's own financial affairs.
``(20) Serious bodily injury.--
``(A) In general.--The term `serious bodily injury'
means an injury--
``(i) involving extreme physical pain;
``(ii) involving substantial risk of death;
``(iii) involving protracted loss or
impairment of the function of a bodily member,
organ, or mental faculty; or
``(iv) requiring medical intervention such
as surgery, hospitalization, or physical
rehabilitation.
``(B) Criminal sexual abuse.--Serious bodily injury
shall be considered to have occurred if the conduct
causing the injury is conduct described in section 2241
(relating to aggravated sexual abuse) or 2242 (relating
to sexual abuse) of title 18, United States Code or any
similar offense under State law.
``(21) Social.--The term `social', when used with respect
to a service, includes adult protective services.
``(22) State.--The term `State' means any of the 50 States,
the District of Columbia, the Commonwealth of Puerto Rico, the
United States Virgin Islands, Guam, American Samoa, and the
Commonwealth of the Northern Mariana Islands.
``(23) State legal assistance developer.--The term `State
legal assistance developer' means an individual described in
section 731 of the Older Americans Act of 1965.
``(24) State long-term care ombudsman.--The term `State
Long-Term Care Ombudsman' means the State Long-Term Care
Ombudsman described in section 712(a)(2) of the Older Americans
Act of 1965.
``Subtitle A--Federal Elder Justice System
``SEC. 2201. ELDER JUSTICE COORDINATING COUNCIL.
``(a) Establishment.--There is established within the Office of the
Secretary an Elder Justice Coordinating Council (in this section
referred to as the `Council').
``(b) Membership.--
``(1) In general.--The Council shall be composed of the
following members:
``(A) The Secretary (or the Secretary's designee).
``(B) The Attorney General (or the Attorney
General's designee).
``(C) The head of each Federal department or agency
or other governmental entity identified by the Co-
Chairs referred to in subsection (d) as having
responsibilities or administering programs relating to
elder abuse, neglect, and exploitation.
``(2) Requirement.--Each member of the Council shall be an
officer or employee of the Federal Government.
``(c) Vacancies.--Any vacancy in the Council shall not affect its
powers, but shall be filled in the same manner as the original
appointment was made.
``(d) Co-Chairs.--The members described in subparagraphs (A) and
(B) of subsection (b)(1) shall be Co-Chairs of the Council.
``(e) Meetings.--The Council shall meet at least 2 times per year,
as determined by the Co-Chairs.
``(f) Duties.--
``(1) In general.--The Council shall make recommendations
to the Secretary and the Attorney General for the coordination
of activities of the Department of Health and Human Services,
the Department of Justice, and other relevant Federal, State,
local, and private agencies and entities, relating to elder
abuse, neglect, and exploitation and other crimes against
elders.
``(2) Report.--Not later than the date that is 2 years
after the date of enactment of the John Breaux Elder Justice
Act and every 2 years thereafter, the Council shall submit to
Congress a report that--
``(A) describes the activities of, accomplishments
of, and challenges faced by--
``(i) the Council; and
``(ii) the entities represented on the
Council; and
``(B) makes such recommendations for legislation,
model laws, or other action as the Council determines
to be appropriate.
``(g) Powers of the Council.--
``(1) Information from federal agencies.--
``(A) In general.--Subject to subparagraph (B), the
Council may secure directly from any Federal department
or agency such information as the Council considers
necessary to carry out this section. Upon request of
the Co-Chairs of the Council, the head of such
department or agency shall furnish such information to
the Council.
``(B) Protection of privacy.--The Secretary shall
oversee the activities of the Council under this
paragraph in order to ensure the protection of
individual health privacy consistent with the
regulations promulgated under section 264(c) of the
Health Insurance Portability and Accountability Act of
1996 and State and local privacy regulations (as
applicable).
``(2) Postal services.--The Council may use the United
States mails in the same manner and under the same conditions
as other departments and agencies of the Federal Government.
``(h) Travel Expenses.--The members of the Council shall not
receive compensation for the performance of services for the Council.
The members shall be allowed travel expenses, including per diem in
lieu of subsistence, at rates authorized for employees of agencies
under subchapter I of chapter 57 of title 5, United States Code, while
away from their homes or regular places of business in the performance
of services for the Council. Notwithstanding section 1342 of title 31,
United States Code, the Secretary may accept the voluntary and
uncompensated services of the members of the Council.
``(i) Detail of Government Employees.--Any Federal Government
employee may be detailed to the Council without reimbursement, and such
detail shall be without interruption or loss of civil service status or
privilege.
``SEC. 2202. ADVISORY BOARD ON ELDER ABUSE, NEGLECT, AND EXPLOITATION.
``(a) Establishment.--There is established a board to be known as
the `Advisory Board on Elder Abuse, Neglect, and Exploitation' (in this
section referred to as the `Advisory Board') to create short-term and
long-term multidisciplinary strategic plans for the development of the
field of elder justice and to make recommendations to the Elder Justice
Coordinating Council established under section 2201.
``(b) Solicitation of Nominations.--The Secretary shall publish a
notice in the Federal Register soliciting nominations for the
appointment of members of the Advisory Board under subsection (c).
``(c) Composition.--The Advisory Board shall be composed of 27
members appointed by the Secretary from among members of the general
public who are individuals with experience and expertise in elder
abuse, neglect, and exploitation prevention, detection, treatment,
intervention, or prosecution.
``(d) Terms.--
``(1) In general.--Each member of the Advisory Board shall
be appointed for a term of 3 years, except that, of the members
first appointed--
``(A) 9 shall be appointed for a term of 3 years;
``(B) 9 shall be appointed for a term of 2 years;
and
``(C) 9 shall be appointed for a term of 1 year.
``(2) Vacancies.--
``(A) In general.--Any vacancy in the Advisory
Board shall not affect its powers, but shall be filled
in the same manner as the original appointment was
made.
``(B) Filling unexpired term.--An individual chosen
to fill a vacancy shall be appointed for the unexpired
term of the member replaced.
``(3) Expiration of terms.--The term of any member shall
not expire before the date on which the member's successor
takes office.
``(e) Election of Officers.--The Advisory Board shall elect a Chair
and Vice Chair from among its members. The Advisory Board shall elect
its initial Chair and Vice Chair at its initial meeting.
``(f) Duties.--Not later than the date that is 18 months after the
date of enactment of the John Breaux Elder Justice Act, and annually
thereafter, the Advisory Board shall prepare and submit to the Elder
Justice Coordinating Council and the appropriate committees of Congress
a report containing--
``(1) information on the status of Federal, State, and
local public and private elder justice activities;
``(2) recommendations (including recommended priorities)
regarding--
``(A) elder justice programs, research, training,
services, practice, enforcement, and coordination;
``(B) coordination between entities pursuing elder
justice efforts and those involved in related areas
that may inform or overlap with elder justice efforts,
such as activities to combat violence against women and
child abuse and neglect; and
``(C) activities relating to adult fiduciary
systems, including guardianship and other fiduciary
arrangements;
``(3) recommendations for specific modifications needed in
Federal and State laws (including regulations) or for programs,
research, and training to enhance prevention, detection, and
treatment (including diagnosis) of, intervention in (including
investigation of), and prosecution of elder abuse, neglect, and
exploitation;
``(4) recommendations on methods for the most effective
coordinated national data collection with respect to elder
justice, and elder abuse, neglect, and exploitation; and
``(5) recommendations for a multidisciplinary strategic
plan to guide the effective and efficient development of the
field of elder justice.
``(g) Powers of the Advisory Board.--
``(1) Information from federal agencies.--
``(A) In general.--Subject to subparagraph (B), the
Advisory Board may secure directly from any Federal
department or agency such information as the Advisory
Board considers necessary to carry out this section.
Upon request of the Chair, the head of such department
or agency shall furnish such information to the
Advisory Board.
``(B) Protection of privacy.--The Secretary shall
oversee the activities of the Advisory Board under this
paragraph in order to ensure the protection of
individual health privacy consistent with the
regulations promulgated under section 264(c) of the
Health Insurance Portability and Accountability Act of
1996 and State and local privacy regulations (as
applicable).
``(2) Sharing of data and reports.--The Advisory Board may
request from any entity pursuing elder justice activities under
the John Breaux Elder Justice Act or an amendment made by that
Act, any data, reports, or recommendations generated in
connection with such activities.
``(3) Postal services.--The Advisory Board may use the
United States mails in the same manner and under the same
conditions as other departments and agencies of the Federal
Government.
``(4) Gifts.--The Advisory Board may accept, use, and
dispose of gifts or donations of services or property.
``(h) Travel Expenses.--The members of the Advisory Board shall not
receive compensation for the performance of services for the Advisory
Board. The members shall be allowed travel expenses for up to 4
meetings per year, including per diem in lieu of subsistence, at rates
authorized for employees of agencies under subchapter I of chapter 57
of title 5, United States Code, while away from their homes or regular
places of business in the performance of services for the Advisory
Board. Notwithstanding section 1342 of title 31, United States Code,
the Secretary may accept the voluntary and uncompensated services of
the members of the Advisory Board.
``(i) Detail of Government Employees.--Any Federal Government
employee may be detailed to the Advisory Board without reimbursement,
and such detail shall be without interruption or loss of civil service
status or privilege.
``(j) Status as Permanent Advisory Committee.--Section 14 of the
Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the
advisory board.
``SEC. 2203. HUMAN SUBJECT RESEARCH.
``(a) In General.--For purposes of the application of subpart A of
part 46 of title 45, Code of Federal Regulations to research conducted
under this title, the term `legally authorized representative' means,
unless otherwise provided by law, the individual or judicial or other
body authorized under the applicable law to consent to medical
treatment on behalf of another person.
``(b) Guidelines.--The Secretary, acting through the Director of
the National Institute on Aging, shall promulgate guidelines to assist
researchers working in the area of elder abuse, neglect, and
exploitation, with issues relating to human subject protections.
``SEC. 2204. REGULATIONS.
``The Secretary may issue such regulations as may be necessary to
carry out this title.
``SEC. 2205. AUTHORIZATION OF APPROPRIATIONS.
``There are authorized to be appropriated to carry out this
subtitle--
``(1) for fiscal year 2006, $3,000,000; and
``(2) for each of fiscal years 2007 through 2009,
$3,500,000.
``Subtitle B--Elder Justice Programs
``SEC. 2211. ENHANCEMENT OF LONG-TERM CARE.
``(a) Grants and Incentives for Long-Term Care Staffing.--
``(1) General authority.--The Secretary shall carry out
activities, including activities described in paragraphs (2)
and (3), to provide incentives for individuals to train for,
seek, and maintain employment providing direct care in a long-
term care facility.
``(2) Specific programs to enhance training, recruitment,
and retention of staff.--
``(A) Coordination with other programs to recruit
and train long-term care staff.--The Secretary shall
coordinate activities under this subsection with the
Secretary of Labor and the Assistant Secretary for the
Administration for Children and Families in order to
provide incentives to participants in programs carried
out under section 403(a)(5) or under part A of title IV
to train for and seek employment providing direct care
in a long-term care facility.
``(B) Career ladders and wage or benefit increases
to increase staffing in long-term care facilities.--
``(i) Grants authorized.--The Secretary
shall make grants to long-term care facilities
to carry out programs through which the
facilities--
``(I) offer, to employees who
provide direct care to residents of a
long-term care facility, continuing
training and varying levels of
certification, based on observed
clinical care practices and the amount
of time the employees spend providing
direct care; and
``(II) provide, or make
arrangements to provide, bonuses or
other increased compensation or
benefits to employees who achieve
certification under such a program.
``(ii) Application.--To be eligible to
receive a grant under this subparagraph, a
long-term care facility shall submit an
application to the Secretary at such time, in
such manner, and containing such information as
the Secretary may require.
``(3) Specific programs to improve management practices.--
``(A) Grants authorized.--The Secretary shall make
grants to long-term care facilities to enable the
facilities to provide training and technical assistance
to eligible employees.
``(B) Authorized activities.--A long-term care
facility that receives a grant under subparagraph (A)
shall use funds made available through the grant to
provide training and technical assistance to eligible
employees regarding management practices using methods
that are demonstrated to promote retention of
individuals who provide direct care to residents of the
long-term care facility, such as--
``(i) the establishment of basic human
resource policies that reward high performance,
including policies that provide for improved
wages and benefits on the basis of job reviews;
``(ii) the establishment of motivational
and thoughtful work organization practices;
``(iii) the creation of a workplace culture
that respects and values caregivers and their
needs;
``(iv) the promotion of a workplace culture
that respects the rights of residents of a
long-term care facility and results in improved
care for the residents; and
``(v) the establishment of other programs
that promote the provision of high quality
care, such as a continuing education program
that provides additional hours of training,
including on-the-job training, for employees
who are certified nurse aides.
``(C) Application.--To be eligible to receive a
grant under this paragraph, a long-term care facility
shall submit an application to the Secretary at such
time, in such manner, and containing such information
as the Secretary may require.
``(D) Eligible employee defined.--In this
paragraph, the term `eligible employee' means an
individual who establishes or implements management
practices applicable with respect to individuals who
provide direct care to residents of a long-term care
facility and includes administrators, directors of
nursing, staff developers, and charge nurses.
``(4) Accountability measures.--The Secretary shall develop
accountability measures to ensure that the activities conducted
using funds made available under this subsection benefit
eligible employees and increase the stability of the long-term
care workforce.
``(b) Informatics Systems Grant Program.--
``(1) Grants authorized.--The Secretary is authorized to
make grants to long-term care facilities for the purpose of
assisting such entities in offsetting the costs related to
purchasing, leasing, developing, and implementing standardized
clinical health care informatics systems designed to improve
patient safety and reduce adverse events and health care
complications resulting from medication errors.
``(2) Use of grant funds.--Funds provided under grants
under this subsection may be used for any of the following:
``(A) Purchasing, leasing, and installing computer
software and hardware, including handheld computer
technologies.
``(B) Making improvements to existing computer
software and hardware.
``(C) Making upgrades and other improvements to
existing computer software and hardware to enable e-
prescribing.
``(D) Providing education and training to eligible
long-term care facility staff on the use of technology
to implement the electronic transmission of
prescription and patient information.
``(3) Application.--To be eligible to receive a grant under
this subsection, a long-term care facility shall submit an
application to the Secretary at such time, in such manner, and
containing such information as the Secretary may require.
``(4) Accountability measures.--The Secretary shall develop
accountability measures to ensure that the activities conducted
using funds made available under this subsection help improve
patient safety and reduce adverse events and health care
complications resulting from medication errors.
``(c) Development and Adoption of Standards for Transactions
Involving Clinical Data by Long-Term Care Facilities.--
``(1) Standards.--The Secretary shall develop and adopt
uniform open electronic standards for transactions involving
clinical data by long-term care facilities. Such standards
shall include messaging and nomenclature standards.
``(2) Compatibility with other standards.--The standards
developed and adopted under paragraph (1) shall be compatible
with standards established under part C of title XI, standards
established under subsections (b)(2)(B)(i) and (e)(4) of
section 1860D-4, and with general health information technology
standards.
``(3) Electronic submission of data to the secretary.--
``(A) In general.--Not later than 10 years after
the date of enactment of the John Breaux Elder Justice
Act, the Secretary shall have procedures in place to
accept the optional electronic submission of clinical
data by long-term care facilities pursuant to the
standards developed and adopted under paragraph (1).
``(B) Rule of construction.--Nothing in this
subsection shall be construed to require a long-term
care facility to submit clinical data electronically to
the Secretary.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, for each of fiscal years 2006
through 2009, $25,000,000.
``SEC. 2212. COLLABORATIVE EFFORTS TO ENHANCE COMMUNICATION ON
PROMOTING QUALITY OF AND PREVENTING ABUSE AND NEGLECT IN
LONG-TERM CARE.
``(a) Pilot Projects Authorized.--The Secretary, after consultation
with the Attorney General, may establish pilot projects to improve
long-term care. In carrying out the pilot projects, the Secretary shall
make grants to eligible partnerships (as defined in subsection (b)) to
develop collaborative and innovative approaches to improve the quality
of, including preventing abuse and neglect in, long-term care.
``(b) Eligible Partnerships.--In this section, the term `eligible
partnership' means a multidisciplinary community partnership consisting
of eligible entities or appropriate individuals, such as a partnership
consisting of representatives in a community of nursing facility
providers, State legal assistance developers, advocates for residents
of long-term care facilities, State Long-Term Care Ombudsmen,
surveyors, the State agency with responsibility for adult protective
services, the State agency with responsibility for licensing long-term
care facilities, law enforcement agencies, courts, family councils,
residents, certified nurse aides, registered nurses, physicians, and
other eligible entities and appropriate individuals.
``(c) Application.--To be eligible to receive a grant under this
section, a partnership shall submit an application to the Secretary at
such time, in such manner, and containing such information as the
Secretary may require.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, for each of fiscal years 2006
through 2009, $2,500,000.
``SEC. 2213. COLLABORATIVE EFFORTS TO DEVELOP CONSENSUS AROUND THE
MANAGEMENT OF CERTAIN QUALITY-RELATED FACTORS.
``(a) Grants Authorized.--The Secretary, after consultation with
the Attorney General, may make grants to eligible entities to establish
multidisciplinary panels to address, and develop consensus on, subjects
relating to improving the quality of long-term care. The Secretary
shall make a limited number of such grants, including at least 1 grant
for the establishment of such a panel to address, and develop consensus
on, methods of managing resident-to-resident abuse in long-term care.
``(b) Authorized Activities.--An eligible entity that receives a
grant under this section shall--
``(1) establish a multidisciplinary panel to address a
specific subject; and
``(2) ensure that the panel uses the funds made available
through the grant to establish a goal with respect to the
subject, examine relevant research and data, identify best
practices with respect to the subject, determine the best way
to carry out those best practices in a practical and feasible
manner, and determine an effective manner of distributing
information on the subject.
``(c) Application.--To be eligible to receive a grant under this
section, an eligible entity shall submit an application to the
Secretary at such time, in such manner, and containing such information
as the Secretary may require.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, for each of fiscal years 2006
through 2009, $2,000,000.
``SEC. 2214. ADULT PROTECTIVE SERVICES FUNCTIONS AND GRANT PROGRAMS.
``(a) Functions.--
``(1) In general.--The Secretary shall ensure that the
Department of Health and Human Services--
``(A) provides funding authorized by this title to
State and local adult protective services offices that
investigate reports of the abuse, neglect, and
exploitation of elders;
``(B) collects and disseminates data annually
relating to the abuse, exploitation, and neglect of
elders in coordination with the Bureau of Justice
Statistics of the Office of Justice Programs of the
Department of Justice efforts to collect national data
under section 2221;
``(C) develops and disseminates information on best
practices regarding, and provides training on, carrying
out adult protective services;
``(D) in conjunction with the necessary experts,
conducts research related to the provision of adult
protective services; and
``(E) provides technical assistance to States and
other entities that provide or fund the provision of
adult protective services, including through grants
made under subsections (b) and (c).
``(2) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection,
$3,000,000 for fiscal year 2006 and $4,000,000 for each of
fiscal years 2007 through 2009.
``(b) Grant Program.--
``(1) Establishment.--There is established an adult
protective services grant program under which the Secretary
shall annually award grants to States in the amounts calculated
under paragraph (2) for the purposes of enhancing adult
protective services provided to elders by States and local
units of government by employing workers who carry caseloads
consisting only of elders and identifying the number of cases
that should comprise a reasonable caseload consisting only of
elders.
``(2) Amount of payment.--
``(A) In general.--Subject to subparagraphs (B) and
(C), the amount paid to a State for a year under the
program under this subsection shall equal the amount
appropriated for the year under paragraph (5)
multiplied by, of the total number of elders who reside
in the United States, the percentage who reside in the
State.
``(B) Guaranteed minimum payment amount.--
``(i) 50 states.--Subject to clause (ii),
if the amount determined under subparagraph (A)
for a State for a year is less than 0.75
percent of the amount appropriated under
paragraph (5), the Secretary shall increase
such determined amount so that the total amount
paid under this subsection to the State for the
year is equal to 0.75 percent of the amount so
appropriated.
``(ii) Territories.--In the case of a State
other than 1 of the 50 States, clause (i) shall
be applied as if each reference to `0.75' were
a reference to `0.1'.
``(C) Pro rata reductions.--The Secretary shall
make such pro rata reductions to the amounts described
in subparagraph (A) as are necessary to comply with the
requirements of subparagraph (B).
``(3) Authorized activities.--
``(A) Adult protective services.--Funds made
available pursuant to this subsection may only be used
by States and local units of government to provide
adult protective services for elders and may not be
used for any other purpose.
``(B) Use by agency.--Each State receiving funds
pursuant to this subsection shall provide such funds to
the agency or unit of State government having legal
responsibility for providing adult protective services
within the State.
``(C) Supplement not supplant.--Each State or local
unit of government shall use funds made available
pursuant to this subsection to supplement and not
supplant other Federal, State, and local public funds
expended to provide adult protective services in the
State.
``(4) Reports.--
``(A) State reports.--Each State receiving funds
under this subsection shall submit to the Secretary, at
such time and in such manner as the Secretary may
require, a report--
``(i) containing a comparison of the
outcomes of workers who carry caseloads
consisting only of elders with outcomes of
workers carrying caseloads that include other
individuals; and
``(ii) identifying a number of cases that
should comprise a reasonable caseload
consisting only of elders.
``(B) Report by the secretary.--Not later than
October 1, 2010, the Secretary shall submit to the
appropriate committees of Congress a report compiling,
summarizing, and analyzing the information contained in
the reports submitted under subparagraph (A) together
with such recommendations for legislative or
administrative action as the Secretary determines to be
appropriate.
``(5) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection, for each of
fiscal years 2006 through 2009, $100,000,000.
``(c) State Demonstration Programs.--
``(1) Establishment.--There is established a program under
which the Secretary shall award grants to States for the
purposes of conducting demonstration programs in accordance
with paragraph (2).
``(2) Demonstration programs.--Funds made available
pursuant to this subsection may be used by States and local
units of government to conduct demonstration programs that
test--
``(A) training modules developed for the purpose of
detecting or preventing elder abuse;
``(B) methods to detect or prevent financial
exploitation of elders;
``(C) methods to detect elder abuse;
``(D) whether training on elder abuse forensics
enhances the detection of elder abuse by employees of
the State or local unit of government; or
``(E) other matters relating to the detection or
prevention of elder abuse.
``(3) Application.--To be eligible to receive a grant under
this subsection, a State shall submit an application to the
Secretary at such time, in such manner, and containing such
information as the Secretary may require.
``(4) Reports.--
``(A) State reports.--Each State that receives
funds under this subsection shall submit a report to
the Secretary at such time, in such manner, and
containing such information as the Secretary may
require on the results of the demonstration program
conducted by the State using funds made available under
this subsection.
``(B) Report by the secretary.--Not later than
October 1, 2010, the Secretary shall submit to the
appropriate committees of Congress a report compiling,
summarizing, and analyzing the information contained in
the reports submitted under subparagraph (A) together
with such recommendations for legislative or
administrative action as the Secretary determines to be
appropriate.
``(5) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection, for the period
of fiscal years 2006 through 2009, $25,000,000.
``Subtitle C--Collection of Data, Dissemination of Information, and
Studies
``SEC. 2221. COLLECTION OF UNIFORM NATIONAL DATA ON ELDER ABUSE,
NEGLECT, AND EXPLOITATION.
``(a) Purpose.--The purpose of this section is to improve,
streamline, and promote uniform collection, maintenance, and
dissemination of national data relating to the various types of elder
abuse, neglect, and exploitation.
``(b) Phase I.--
``(1) In general.--Not later than the date that is 1 year
after the date of enactment of the John Breaux Elder Justice
Act, the Secretary, after consultation with the Attorney
General and working with experts in relevant disciplines from
the Bureau of Justice Statistics of the Office of Justice
Programs, shall--
``(A) develop a method for collecting national data
regarding elder abuse, neglect, and exploitation; and
``(B) develop uniform national data reporting forms
adapted to each relevant entity or discipline (such as
health, public safety, social and protective services,
and law enforcement) reflecting--
``(i) the distinct manner in which each
entity or discipline receives and maintains
information; and
``(ii) the sequence and history of reports
to or involvement of different entities or
disciplines, independently, or the sequence and
history of reports from 1 entity or discipline
to another over time.
``(2) Forms.--
``(A) In general.--Subject to subparagraph (B), the
national data reporting forms described in paragraph
(1)(B) shall incorporate the definitions of this title,
for use in determining whether an event is reportable.
``(B) Protection of privacy.--In pursuing
activities under this paragraph, the Secretary shall
ensure the protection of individual health privacy
consistent with the regulations promulgated under
section 264(c) of the Health Insurance Portability and
Accountability Act of 1996 and State and local privacy
regulations (as applicable).
``(c) Phase II.--
``(1) In general.--Not later than the date that is 1 year
after the date on which the activities described in subsection
(b)(1) are completed, the Secretary (or the Secretary's
designee) shall ensure that the national data reporting forms
and data collection methods developed in accordance with such
subsection are pilot tested in 6 States selected by the
Secretary.
``(2) Adjustments to the form and methods.--The Secretary,
after considering the results of the pilot testing described in
paragraph (1) and consultation with the Attorney General and
relevant experts, shall adjust the national data reporting
forms and data collection methods as necessary.
``(d) Phase III.--
``(1) Distribution of national data reporting forms.--After
completion of the adjustment to the national data reporting
forms under subsection (c)(2), the Secretary shall submit the
national data reporting forms along with instructions to--
``(A) the heads of the relevant components of the
Department of Health and Human Services, the Department
of Justice, and the Department of the Treasury, and
such other Federal entities as may be appropriate; and
``(B) the Governor's office of each State for
collection from all relevant State entities of data,
including health care, social services, and law
enforcement data.
``(2) Data collection grants.--
``(A) Authorization.--The Secretary is authorized
to award grants to States to improve data collection
activities relating to elder abuse, neglect, and
exploitation.
``(B) Application.--To be eligible to receive a
grant under this paragraph, a State shall submit an
application to the Secretary at such time, in such
manner, and containing such information as the
Secretary may require.
``(C) Requirements.--Each State receiving a grant
under this paragraph for a fiscal year shall report
data for the calendar year that begins during that
fiscal year, using the national data reporting forms
described in paragraph (1).
``(D) Funding.--
``(i) First year.--For the first fiscal
year for which a State receives grant funds
under this subsection the Secretary shall
initially distribute 50 percent of such funds.
The Secretary shall distribute the remaining
funds at the end of the calendar year that
begins during that fiscal year, if the
Secretary determines that the State has
properly reported data required under this
subsection for the calendar year.
``(ii) Subsequent years.--Except as
provided in clause (i), the Secretary shall
distribute grant funds to a State under this
subsection for a fiscal year if the Secretary
determines that the State properly reported
data required under this subsection for the
calendar year that ends during that fiscal
year.
``(3) Required information.--Each report submitted under
this subsection shall--
``(A) indicate the State and year in which each
event occurred; and
``(B) identify the total number of events that
occurred in each State during the year and the type of
each event.
``(e) Report.--Not later than 1 year after the date of enactment of
the John Breaux Elder Justice Act and annually thereafter, the
Secretary shall prepare and submit to the appropriate committees of
Congress, including to the Committee on Finance and the Special
Committee on Aging of the Senate, a report regarding activities
conducted under this section.
``(f) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
``(1) for fiscal year 2006, $10,000,000;
``(2) for fiscal year 2007, $30,000,000; and
``(3) for each of fiscal years 2008 and 2009, $100,000,000.
``SEC. 2222. LONG-TERM CARE CONSUMER CLEARINGHOUSE.
``(a) Establishment.--The Secretary shall establish a long-term
care consumer clearinghouse.
``(b) Information.--The clearinghouse shall provide comprehensive
detailed information, in a consumer-friendly form, to consumers about
choices relating to long-term care providers, such as information
about--
``(1) obtaining the services of, and employing, caregivers
who provide long-term care at an individual's home; and
``(2) options for residential long-term care, such as--
``(A)(i) the type of care provided by nursing
facilities; and
``(ii) the type of care provided by group homes and
other residential long-term care facilities that are
not nursing facilities;
``(B) the benefits available through the programs
carried out under titles XVIII and XIX; and
``(C) links to Federal and State websites that
describe the care available through specific long-term
care facilities, including data on the satisfaction
level of residents of, and families of residents of,
the facilities.
``(c) Providers.--In providing information on long-term care
providers under this section, the clearinghouse shall provide
information (from States and other sources) on assisted living
facilities, board and care facilities, congregate care facilities, home
health care providers, and other long-term care providers.
``(d) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
``(1) for fiscal year 2006, $2,000,000;
``(2) for fiscal year 2007, $3,000,000; and
``(3) for each of fiscal years 2008 and 2009, $4,000,000.
``SEC. 2223. CONSUMER INFORMATION ABOUT THE CONTINUUM OF RESIDENTIAL
LONG-TERM CARE FACILITIES.
``(a) Study.--
``(1) In general.--The Secretary, after consultation with
the Attorney General, shall, directly or through a grant,
conduct a study on consumer concerns relating to residential
long-term care facilities, other than nursing facilities.
``(2) Specific topics.--The entity conducting the study
shall--
``(A) develop definitions for classes of the
residential long-term care facilities described in
paragraph (1); and
``(B) collect information on the prices of, level
of services provided by, oversight and enforcement
provisions of, and admission and discharge criteria of,
the facilities.
``(b) Report.--The Secretary shall prepare a report containing the
results of the study, and submit the report to the Elder Justice
Coordinating Council and all the appropriate committees of Congress,
including the Committee on Ways and Means of the House of
Representatives, and the Committee on Finance and the Special Committee
on Aging of the Senate.
``(c) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, for each of fiscal years 2006
through 2009, $3,000,000.
``SEC. 2224. PROVISION OF INFORMATION REGARDING, AND EVALUATIONS OF,
ELDER JUSTICE PROGRAMS.
``(a) Provision of Information.--To be eligible to receive a grant
under this title, an applicant shall agree--
``(1) except as provided in paragraph (2), to provide the
eligible entity conducting an evaluation under subsection (b)
of the activities funded through the grant with such
information as the eligible entity may require in order to
conduct such evaluation; or
``(2) in the case of an applicant for a grant under section
2211(b), to provide the Secretary with such information as the
Secretary may require to conduct an evaluation or audit under
subsection (c).
``(b) Use of Eligible Entities To Conduct Evaluations.--
``(1) Evaluations required.--Except as provided in
paragraph (2), the Secretary shall--
``(A) reserve a portion of the funds appropriated
with respect to each program carried out under this
title; and
``(B) use the funds reserved under subparagraph (A)
to provide assistance to eligible entities to conduct
evaluations of the activities funded under each program
carried out under this title.
``(2) Informatics systems grant program not included.--The
provisions of this subsection shall not apply to the
informatics systems grant program under section 2211(b).
``(3) Authorized activities.--A recipient of assistance
described in paragraph (1)(B) shall use the funds made
available through the assistance to conduct a validated
evaluation of the effectiveness of the activities funded under
a program carried out under this title.
``(4) Applications.--To be eligible to receive assistance
under paragraph (1)(B), an entity shall submit an application
to the Secretary at such time, in such manner, and containing
such information as the Secretary may require, including a
proposal for the evaluation.
``(5) Reports.--Not later than a date specified by the
Secretary, an eligible entity receiving assistance under
paragraph (1)(B) shall submit to the Secretary and the
appropriate committees of Congress a report containing the
results of the evaluation conducted using such assistance
together with such recommendations as the entity determines to
be appropriate.
``(c) Evaluations and Audits of Informatics Systems Grant Program
by the Secretary.--
``(1) Evaluations.--The Secretary shall conduct an
evaluation of the activities funded under the informatics
systems grant program under section 2211(b). Such evaluation
shall include an evaluation of whether the funding provided
under the grant is expended only for the purposes for which it
is made.
``(2) Audits.--The Secretary shall conduct appropriate
audits of grants made under section 2211(b).''.
(b) Long-Term Care Facilities.--Part A of title XI of the Social
Security Act (42 U.S.C. 1301 et seq.) is amended by adding at the end
the following new sections:
``reporting to law enforcement of crimes occurring in federally funded
long-term care facilities
``Sec. 1150A. (a) Determination and Notification.--
``(1) Determination.--The owner or operator of each long-
term care facility that receives Federal funds shall annually
determine whether the facility received at least $10,000 in
Federal funds during the preceding year.
``(2) Notification.--If the owner or operator determines
under paragraph (1) that the facility received at least $10,000
in Federal funds during the preceding year, such owner or
operator shall annually notify each covered individual (as
defined in paragraph (3)) of that individual's obligation to
comply with the reporting requirements described in subsection
(b).
``(3) Covered individual defined.--In this section, the
term `covered individual' means each individual who is an
owner, operator, employee, manager, agent, or contractor of a
long-term care facility that is the subject of a determination
described in paragraph (2).
``(b) Reporting Requirements.--
``(1) In general.--Each covered individual shall report to
the Secretary and 1 or more law enforcement entities for the
political subdivision in which the facility is located any
reasonable suspicion of a crime (as defined by the law of the
applicable political subdivision) against any person who is a
resident of or receiving care from the facility.
``(2) Timing.--If the events that cause the suspicion--
``(A) result in serious bodily injury, the
individual shall report the suspicion immediately, but
not later than 2 hours after forming the suspicion; and
``(B) do not result in serious bodily injury, the
individual shall report the suspicion not later than 24
hours after forming the suspicion.
``(c) Penalties.--
``(1) In general.--If a covered individual violates
subsection (b)--
``(A) the individual shall be subject to a civil
money penalty of not more than $200,000; or
``(B) the Secretary shall classify the individual
as an excluded individual, for a period of not more
than 3 years.
``(2) Increased harm.--If a covered individual violates
subsection (b) and the violation exacerbates the harm to the
victim of the crime or results in harm to another person--
``(A) the individual shall be subject to a civil
money penalty of not more than $300,000; and
``(B) the Secretary shall classify the individual
as an excluded individual, for a period of not more
than 3 years.
``(3) Excluded individual.--During any period for which an
individual is classified as an excluded individual under
paragraph (1)(B) or (2)(B), a long-term care facility that
employs the individual shall be ineligible to receive Federal
funds.
``(4) Extenuating circumstances.--
``(A) In general.--The Secretary may take into
account the financial burden on providers with
underserved populations in determining any penalty to
be imposed under this subsection.
``(B) Underserved population defined.--In this
paragraph, the term `underserved population' means the
population of an area designated by the Secretary as an
area with a shortage of elder justice programs or a
population group designated by the Secretary as having
a shortage of such programs. Such areas or groups
designated by the Secretary may include--
``(i) areas or groups that are
geographically isolated (such as isolated in a
rural area);
``(ii) racial and ethnic minority
populations; and
``(iii) populations underserved because of
special needs (such as language barriers,
disabilities, alien status, or age).
``(d) Additional Penalties for Retaliation.--
``(1) In general.--A long-term care facility may not--
``(A) discharge, demote, suspend, threaten, harass,
or deny a promotion or other employment-related benefit
to an employee, or in any other manner discriminate
against an employee in the terms and conditions of
employment because of lawful acts done by the employee;
or
``(B) file a complaint or a report against a nurse
with the appropriate State professional disciplinary
agency because of lawful acts done by the nurse,
for making a report, causing a report to be made, or for taking
steps in furtherance of making a report pursuant to subsection
(b)(1).
``(2) Penalties for retaliation.--If a long-term care
facility violates subparagraph (A) or (B) of paragraph (1) the
facility shall be subject to a civil money penalty of not more
than $200,000 or the Secretary may classify the entity as an
excluded entity for a period of 2 years pursuant to section
1128(b), or both.
``(3) Requirement to post notice.--Each long-term care
facility shall post conspicuously in an appropriate location a
sign (in a form specified by the Secretary) specifying rights
of employees under this section. Such sign shall include a
statement that an employee may file a complaint with the
Secretary against a long-term care facility that violates the
provisions of this subsection and information with respect to
the manner of filing such a complaint.
``(e) Definitions.--In this section:
``(1) Elder justice; long-term care facility.--The terms
`elder justice' and `long-term care facility' have the meanings
given the terms in section 2200.
``(2) Law enforcement.--The term `law enforcement' means
police or sheriffs.
``ensuring safety of residents when federally funded long-term care
facilities close
``Sec. 1150B. (a) Notification of Facility Closure.--If the owner
or operator determines under section 1150A(a)(1) that a long-term care
facility received at least $10,000 in Federal funds during the
preceding year, the owner or operator of the facility shall--
``(1) submit to the Secretary and the appropriate State
regulatory agency written notification of an impending closure
not later than the date that is 60 days prior to the date of
such closure;
``(2) include in the notice a plan for the transfer and
adequate relocation of the residents prior to closure,
including assurances that residents will not be transferred to
facilities providing substandard care for which administrative
or law enforcement action is pending; and
``(3) not later than 10 days after the facility closure,
submit to the Secretary and the appropriate State agency
information identifying where residents of the closed facility
were transferred and on what date.
``(b) Sanctions.--Any person owning a long-term care facility that
fails to comply with the requirements of subsection (a) shall be
subject to--
``(1) a civil monetary penalty of up to $1,000,000;
``(2) exclusion from participation in the programs under
this Act (in accordance with the procedures of section 1128);
and
``(3) any other applicable civil monetary penalties and
assessments.
``(c) Procedure.--A civil monetary penalty or assessment authorized
under subsection (b) shall be imposed against a person in the same
manner as a civil monetary penalty or assessment is imposed under
section 1128A.
``(d) Definition.--In this section, the term `long-term care
facility' has the meaning given the term in section 2200.''.
TITLE II--DEPARTMENT OF JUSTICE
SEC. 201. VICTIM ADVOCACY GRANTS.
(a) Grants Authorized.--The Attorney General, after consultation
with the Secretary, may award grants to eligible entities to study the
special needs of victims of elder abuse, neglect, and exploitation.
(b) Authorized Activities.--Funds awarded pursuant to subsection
(a) shall be used for pilot programs through which the eligible
entities develop programs, provide training to health care, social and
protective services providers, law enforcement, fiduciaries including
guardians, judges and court personnel, and victim advocates, and
examine special approaches, designed to meet the needs of victims of
elder abuse, neglect, and exploitation.
(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
(1) for fiscal year 2006, $2,500,000; and
(2) for each of fiscal years 2007 through 2009, $3,000,000.
SEC. 202. SUPPORTING STATE AND LOCAL PROSECUTORS IN ELDER JUSTICE
MATTERS.
(a) Grants Authorized.--The Attorney General, after consultation
with the Secretary, shall award grants to eligible entities to provide
training, technical assistance, policy development, multidisciplinary
coordination, and other types of support to State and local prosecutors
handling elder justice-related cases, including funding the creation of
a Center for the Prosecution of Elder Abuse, Neglect, and Exploitation
by the American Prosecutor Research Institute of the National District
Attorneys Association, or another similarly situated entity, to advise
and support local prosecutors nationwide in their pursuit of cases
involving elder abuse, neglect, and exploitation.
(b) Duties.--The Center created under subsection (a) shall, among
other things--
(1) coordinate activities with experts in the areas of
elder abuse, neglect, and exploitation;
(2) coordinate activities with the Advisory Board
established by section 2202 of the Social Security Act; and
(3) provide local prosecutors and personnel assisting such
prosecutors with multidisciplinary teams, and training,
technical assistance, and input, in the handling, prevention,
and prosecution of, and special circumstances surrounding,
elder abuse, neglect, and exploitation.
(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
(1) for fiscal year 2006, $6,000,000; and
(2) for each of fiscal years 2007 through 2009, $8,000,000.
SEC. 203. SUPPORTING FEDERAL CASES INVOLVING ELDER JUSTICE.
(a) Support and Assistance.--
(1) Additional staff.--The Attorney General shall hire
additional Federal prosecutors, and make funding available to
Federal prosecutors to enter into contracts with nurse
investigators or other experts, needed to identify, assist
with, or pursue cases relating to elder justice.
(2) Resource group.--The Attorney General may fund, through
the Executive Office for United States Attorneys, a resource
group to assist prosecutors throughout the Nation in pursuing
failure of care and other cases relating to elder justice
matters.
(b) Office of Inspector General.--The Office of Inspector General
of the Department of Health and Human Services shall enter into
contracts with nurse investigators and other experts to investigate and
pursue failure of care allegations.
(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
(1) for fiscal year 2006, $3,250,000; and
(2) for each of fiscal years 2007 through 2009, $4,500,000.
SEC. 204. SUPPORTING LAW ENFORCEMENT IN ELDER JUSTICE MATTERS.
(a) Grants Authorized.--The Attorney General shall, after
consultation with the Secretary, award grants to eligible entities to
provide training, technical assistance, multidisciplinary coordination,
policy development, and other types of support to police, sheriffs,
detectives, public safety officers, corrections personnel, and other
front line law enforcement responders who handle elder justice-related
matters.
(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
(1) for fiscal year 2006, $6,000,000; and
(2) for each of fiscal years 2007 through 2009, $8,000,000.
SEC. 205. ESTABLISHMENT AND SUPPORT OF ELDER ABUSE, NEGLECT, AND
EXPLOITATION FORENSIC CENTERS.
(a) Grants Authorized.--The Attorney General shall make grants to
eligible entities to establish and operate stationary and mobile
forensic centers, to develop forensic expertise regarding, and provide
services relating to, elder abuse, neglect, and exploitation.
(b) Stationary forensic centers.--The Attorney General shall make 4
of the grants described in subsection (a) to institutions of higher
education with demonstrated expertise in forensics or commitment to
preventing or treating elder abuse, neglect, or exploitation, to
establish and operate stationary forensic centers.
(c) Mobile centers.--The Attorney General shall make 6 of the
grants described in subsection (a) to appropriate entities to establish
and operate mobile forensic centers.
(d) Authorized Activities.--
(1) Development of forensic markers and methodologies.--An
eligible entity that receives a grant under this section shall
use funds made available through the grant to assist in
determining whether abuse, neglect, or exploitation occurred
and whether a crime was committed and to conduct research to
describe and disseminate information on--
(A) forensic markers that indicate a case in which
elder abuse, neglect, or exploitation may have
occurred; and
(B) methodologies for determining, in such a case,
when and how health care, emergency service, social and
protective services, and legal service providers should
intervene and when the providers should report the case
to law enforcement authorities.
(2) Applications.--An eligible entity that receives a grant
under this section shall use funds made available through the
grant to develop 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.
(3) Collection of evidence.--The Attorney General, in
coordination with the Secretary, shall use data made available
by grant recipients under this section to develop the capacity
of law enforcement and geriatric health care professionals to
collect forensic evidence, including collecting forensic
evidence relating to a potential determination of elder abuse,
neglect, or exploitation.
(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
(1) for fiscal year 2006, $4,000,000;
(2) for fiscal year 2007, $6,000,000; and
(3) for each of fiscal years 2008 and 2009, $8,000,000.
SEC. 206. MODEL STATE LAWS AND PRACTICES.
(a) In General.--The Attorney General, after consultation with the
Secretary, shall--
(1)(A) conduct a study of State laws and practices relating
to elder abuse, neglect, and exploitation; and
(B) prepare and publish a report or periodic reports
containing the findings of the study; and
(2) not later than 2 years after the date of enactment of
the John Breaux Elder Justice Act, prepare and submit to the
chairpersons and ranking members of all the appropriate
committees of Congress, including the chairperson and ranking
member of the Special Committee on Aging of the Senate and the
chairperson and ranking member of the Committee on the
Judiciary of the Senate, and the Speaker and minority leader of
the House of Representatives a report that provides--
(A) a comprehensive description and comparative
analysis of the State laws and practices; and
(B) recommended models for State laws and practices
based on an analysis of the most effective of the State
laws and practices, including recommendations with
respect to the definitions referred to in subsection
(b)(1).
(b) State Laws and Practices.--Each report published or submitted
under subsection (a) shall examine State laws and practices described
in such subsection and address the following issues with respect to
such laws and practices:
(1) Definitions of ``elder'', ``abuse'', ``neglect'', and
``exploitation'', and related terms.
(2) Issues relating to mandatory reporting laws, with
respect to--
(A) who is a mandated reporter;
(B) to whom must the reporter report and within
what timeframe; and
(C) any consequences for nonreporting.
(3) Evidentiary, procedural, sentencing, choice of
remedies, and data retention issues relating to pursuing cases
relating to elder abuse, neglect, and exploitation.
(4) Issues relating to laws requiring immediate reporting
of all nursing home deaths to the county coroner or to some
other individual or entity.
(5) Issues relating to fiduciary laws, including
guardianship and power of attorney laws.
(6) Issues relating to laws that permit or encourage banks
and bank employees to prevent and report suspected elder abuse,
neglect, and exploitation.
(7) Issues relating to laws that may impede research on
elder abuse, neglect, and exploitation.
(8) Practices relating to the enforcement of laws relating
to elder abuse, neglect, and exploitation.
(9) Practices relating to other aspects of elder justice.
(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section--
(1) for fiscal year 2006, $2,500,000; and
(2) for each of fiscal years 2007 through 2009, $3,000,000.
SEC. 207. PROVISION OF INFORMATION REGARDING, AND EVALUATIONS OF,
DEPARTMENT OF JUSTICE ELDER JUSTICE PROGRAMS.
(a) Provision of Information.--To be eligible to receive assistance
under this title, an applicant shall agree to provide the eligible
entity conducting an evaluation under subsection (b) of the activities
funded through the assistance with such information as the eligible
entity may require in order to conduct such evaluation.
(b) Use of Eligible Entities To Conduct Evaluations.--
(1) Evaluations required.--The Attorney General shall--
(A) reserve a portion of the funds appropriated
with respect to each program carried out under this
title; and
(B) use the funds reserved under subparagraph (A)
to provide assistance to eligible entities to conduct
evaluations of the activities funded under each program
carried out under this title.
(2) Authorized activities.--A recipient of assistance
described in paragraph (1)(B) shall use the funds made
available through the assistance to conduct a validated
evaluation of the effectiveness of the activities funded under
a program carried out under this title.
(3) Applications.--To be eligible to receive assistance
under paragraph (1)(B), an entity shall submit an application
to the Attorney General at such time, in such manner, and
containing such information as the Attorney General may
require, including a proposal for the evaluation.
(4) Reports.--Not later than a date specified by the
Attorney General, an eligible entity receiving assistance under
paragraph (1)(B) shall submit to the Attorney General and the
appropriate committees of Congress a report containing the
results of the evaluation conducted using such assistance
together with such recommendations as the entity determines to
be appropriate.
The title is amended to read as follows: ``A bill to amend
the Social Security Act to enhance the social security of the
Nation by ensuring adequate public-private infrastructure and
resolve to prevent, detect, treat, intervene in, and prosecute
elder abuse, neglect, and exploitation, and for other
purposes.''.
Calendar No. 740
108th CONGRESS
2d Session
S. 333
_______________________________________________________________________
A BILL
To promote elder justice, and for other purposes.
_______________________________________________________________________
September 28, 2004
Reported with an amendment