110th CONGRESS
1st Session
S. 1070
To amend the Social Security Act to enhance the social security
of the Nation by ensuring adequate public-private infrastructure and to
resolve to prevent, detect, treat, intervene in, and prosecute elder abuse,
neglect, and exploitation, and for other purposes.
IN THE SENATE OF THE UNITED STATES
March 29, 2007
Mr. HATCH (for himself, Mrs. LINCOLN, Mr. SMITH, and Mr. KOHL) introduced
the following bill; which was read twice and referred to the Committee on
Finance
A BILL
To amend the Social Security Act to enhance the social security
of the Nation by ensuring adequate public-private infrastructure and to
resolve to prevent, detect, treat, intervene in, and prosecute elder abuse,
neglect, and exploitation, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title- This Act may be cited as the `Elder Justice Act'.
(b) Table of Contents- The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
`Subtitle 2--Elder Justice
`Sec. 2011. Definitions.
`Sec. 2012. General provisions.
`Part A--National Coordination of Elder Justice Activities and Research
`SUBPART 1--ELDER JUSTICE COORDINATING COUNCIL AND ADVISORY BOARD ON ELDER
ABUSE, NEGLECT, AND EXPLOITATION
`Sec. 2021. Elder Justice Coordinating Council.
`Sec. 2022. Advisory Board on Elder Abuse, Neglect, and Exploitation.
`Sec. 2023. Research protections.
`Sec. 2024. Authorization of appropriations.
`SUBPART 2--ELDER ABUSE, NEGLECT, AND EXPLOITATION FORENSIC CENTERS
`Sec. 2031. Establishment and support of elder abuse, neglect, and Exploitation
forensic Centers.
`Part B--Programs To Promote Elder Justice
`Sec. 2041. Enhancement of long-term care.
`Sec. 2042. Adult protective services functions and grant programs.
`Sec. 2043. Long-term care ombudsman program grants and training.
`Sec. 2044. Provision of information regarding, and evaluations of, elder
justice programs.
`Sec. 2045. Report.
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 more than 76,000,000
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. In recognition of the need to improve
data collection efforts with respect to elder abuse, neglect, and exploitation,
Congress required the Secretary of Health and Human Services to conduct
a study by the end of 2008 on establishing a uniform national database
on elder abuse under section 405 of title IV of Division C of the Tax
Relief and Health Care Act of 2006 (Public Law 109-432).
(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 multifaceted
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, and data collection, and 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--
(i) treat, assess, and provide services relating to elder abuse, neglect,
and exploitation; and
(ii) 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 resolving 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, in order
to ensure that elder justice receives the attention it deserves as the
Nation's population ages.
(7) 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.
(8) To create short- and long-term strategic plans for the development
and coordination of elder justice research, programs, studies, training,
and other efforts nationwide.
(9) To promote collaborative efforts and diminish overlap and gaps in
efforts in developing the important field of elder justice.
(10) To honor and respect the right of all individuals with diminished
capacity to decisionmaking autonomy, self-determination, and dignity of
choice.
(11) To respect the wishes of individuals 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
2011 of the Social Security Act (as added by section 5(a)) and is used in
this Act has the meaning given such term by such section.
SEC. 5. ELDER JUSTICE.
(1) IN GENERAL- Title XX of the Social Security Act (42 U.S.C. 1397 et
seq.) is amended--
(A) in the heading, by inserting `AND ELDER JUSTICE' after `SOCIAL
SERVICES';
(B) by inserting before section 2001 the following:
`Subtitle 1--Block Grants to States for Social Services';
(C) by adding at the end the following:
`Subtitle 2--Elder Justice
`SEC. 2011. DEFINITIONS.
`(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--
`(i) prevent, detect, treat, intervene in, and prosecute elder abuse,
neglect, and exploitation; and
`(ii) 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 tribal organization, 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.
`(A) IN GENERAL- The term `Indian tribe' has the meaning given such
term in section 4 of the Indian Self-Determination and Education Assistance
Act (25 U.S.C. 450b).
`(B) INCLUSION OF PUEBLO AND RANCHERIA- The term `Indian tribe' includes
any Pueblo or Rancheria.
`(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;
`(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 1 or more 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
`(A) IN GENERAL- The term `nursing facility' has the meaning given such
term under section 1919(a).
`(B) INCLUSION OF SKILLED NURSING FACILITY- The term `nursing facility'
includes a skilled nursing facility (as defined in section 1819(a)).
`(18) 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.
`(19) 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.
`(20) SOCIAL- The term `social', when used with respect to a service,
includes adult protective services.
`(21) STATE LEGAL ASSISTANCE DEVELOPER- The term `State legal assistance
developer' means an individual described in section 731 of the Older Americans
Act of 1965.
`(22) 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.
`SEC. 2012. GENERAL PROVISIONS.
`(a) Protection of Privacy- In pursuing activities under this subtitle,
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 applicable State and local
privacy regulations.
`(b) Rule of Construction- Nothing in this subtitle shall be construed to
interfere with or abridge an elder's right to practice his or her religion
through reliance on prayer alone for healing when this choice--
`(1) is contemporaneously expressed, either orally or in writing, with
respect to a specific illness or injury which the elder has at the time
of the decision by an elder who is competent at the time of the decision;
`(2) is previously set forth in a living will, health care proxy, or other
advance directive document that is validly executed and applied under
State law; or
`(3) may be unambiguously deduced from the elder's life history.
`PART A--NATIONAL COORDINATION OF ELDER JUSTICE ACTIVITIES AND RESEARCH
`Subpart 1--Elder Justice Coordinating Council and Advisory Board
on Elder Abuse, Neglect, and Exploitation
`SEC. 2021. 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').
`(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 Chair 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) Chair- The member described in subsection (b)(1)(A) shall be Chair
of the Council.
`(e) Meetings- The Council shall meet at least 2 times per year, as determined
by the Chair.
`(1) IN GENERAL- The Council shall make recommendations to the Secretary
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 Elder Justice Act and every 2 years thereafter, the Council
shall submit to the Committee on Finance of the Senate and the Committee
on Ways and Means and the Committee on Energy and Commerce of the House
of Representatives a report that--
`(A) describes the activities and accomplishments of, and challenges
faced by--
`(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- Subject to the requirements of
section 2012(a), 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 Chair of the Council, the head of
such department or agency shall furnish such information to the Council.
`(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.
`(j) Status as Permanent Council- Section 14 of the Federal Advisory Committee
Act (5 U.S.C. App.) shall not apply to the Council.
`SEC. 2022. 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- 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 2021.
`(b) 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.
`(c) 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 (b).
`(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.
`(A) IN GENERAL- Any vacancy on 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.
`(1) ENHANCE COMMUNICATION ON PROMOTING QUALITY OF, AND PREVENTING ABUSE
AND NEGLECT IN, LONG-TERM CARE- The Advisory Board shall develop collaborative
and innovative approaches to improve the quality of, including preventing
abuse and neglect in, long-term care.
`(2) COLLABORATIVE EFFORTS TO DEVELOP CONSENSUS AROUND THE MANAGEMENT
OF CERTAIN QUALITY-RELATED FACTORS-
`(A) IN GENERAL- The Advisory Board shall establish multidisciplinary
panels to address, and develop consensus on, subjects relating to improving
the quality of long-term care. At least 1 such panel shall address,
and develop consensus on, methods for managing resident-to-resident
abuse in long-term care.
`(B) ACTIVITIES CONDUCTED- The multidisciplinary panels established
under subparagraph (A) shall examine relevant research and data, identify
best practices with respect to the subject of the panel, 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 such subject.
`(3) REPORT- Not later than the date that is 18 months after the date
of enactment of the Elder Justice Act, and annually thereafter, the Advisory
Board shall prepare and submit to the Elder Justice Coordinating Council,
the Committee on Finance of the Senate, and the Committee on Ways and
Means and the Committee on Energy and Commerce of the House of Representatives
a report containing--
`(A) information on the status of Federal, State, and local public and
private elder justice activities;
`(B) recommendations (including recommended priorities) regarding--
`(i) elder justice programs, research, training, services, practice,
enforcement, and coordination;
`(ii) 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
`(iii) activities relating to adult fiduciary systems, including guardianship
and other fiduciary arrangements;
`(C) 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;
`(D) recommendations on methods for the most effective coordinated national
data collection with respect to elder justice, and elder abuse, neglect,
and exploitation; and
`(E) 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- Subject to the requirements of
section 2012(a), 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 of the
Advisory Board, the head of such department or agency shall furnish such
information to the Advisory Board.
`(2) SHARING OF DATA AND REPORTS- The Advisory Board may request 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.
`(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.
`(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. 2023. RESEARCH PROTECTIONS.
`(a) Guidelines- The Secretary shall promulgate guidelines to assist researchers
working in the area of elder abuse, neglect, and exploitation, with issues
relating to human subject protections.
`(b) Definition of Legally Authorized Representative for Application of
Regulations- For purposes of the application of subpart A of part 46 of
title 45, Code of Federal Regulations, to research conducted under this
subpart, 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.
`SEC. 2024. AUTHORIZATION OF APPROPRIATIONS.
`There are authorized to be appropriated to carry out this subpart--
`(1) for fiscal year 2008, $6,500,000; and
`(2) for each of fiscal years 2009 through 2011, $7,000,000.
`Subpart 2--Elder Abuse, Neglect, and Exploitation Forensic Centers
`SEC. 2031. ESTABLISHMENT AND SUPPORT OF ELDER ABUSE, NEGLECT, AND EXPLOITATION
FORENSIC CENTERS.
`(a) In General- The Secretary, in consultation with 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 Secretary 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 Secretary 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) DEVELOPMENT OF FORENSIC EXPERTISE- 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 Secretary, in coordination with the Attorney
General, shall use data made available by grant recipients under this
section to develop the capacity of geriatric health care professionals
and law enforcement to collect forensic evidence, including collecting
forensic evidence relating to a potential determination of elder abuse,
neglect, or exploitation.
`(e) Application- To be eligible to receive a grant under this section,
an entity shall submit an application to the Secretary at such time, in
such manner, and containing such information as the Secretary may require.
`(f) Authorization of Appropriations- There are authorized to be appropriated
to carry out this section--
`(1) for fiscal year 2008, $4,000,000;
`(2) for fiscal year 2009, $6,000,000; and
`(3) for each of fiscal years 2010 and 2011, $8,000,000.
`PART B--PROGRAMS TO PROMOTE ELDER JUSTICE
`SEC. 2041. ENHANCEMENT OF LONG-TERM CARE.
`(a) Grants and Incentives for Long-Term Care Staffing-
`(1) IN GENERAL- 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 SECRETARY OF LABOR TO RECRUIT AND TRAIN LONG-TERM
CARE STAFF- The Secretary shall coordinate activities under this subsection
with the Secretary of Labor in order to provide incentives for individuals
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) IN GENERAL- 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 (which may include evidence of consultation
with the State in which the long-term care facility is located with
respect to carrying out activities funded under the grant).
`(iii) AUTHORITY TO LIMIT NUMBER OF APPLICANTS- Nothing in this subparagraph
shall be construed as prohibiting the Secretary from limiting the
number of applicants for a grant under this subparagraph.
`(3) SPECIFIC PROGRAMS TO IMPROVE MANAGEMENT PRACTICES-
`(A) IN GENERAL- 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 standard 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 (which may include evidence of consultation with
the State in which the long-term care facility is located with respect
to carrying out activities funded under the grant).
`(D) AUTHORITY TO LIMIT NUMBER OF APPLICANTS- Nothing in this paragraph
shall be construed as prohibiting the Secretary from limiting the number
of applicants for a grant under this paragraph.
`(E) 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 (which may include evidence of consultation with the State
in which the long-term care facility is located with respect to carrying
out activities funded under the grant).
`(4) AUTHORITY TO LIMIT NUMBER OF APPLICANTS- Nothing in this subsection
shall be construed as prohibiting the Secretary from limiting the number
of applicants for a grant under this subsection.
`(5) 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) Inclusion of Adjudicated Crimes on Nursing Home Compare Website- Not
later than 1 year after the date of enactment of the Elder Justice Act,
the Secretary shall ensure that the Department of Health and Human Services
includes, as part of the information provided for comparison of nursing
facilities on the official Internet website of the Federal Government for
Medicare beneficiaries (commonly referred to as the `Nursing Home Compare'
Medicare website), the number of adjudicated instances of criminal violations
by a nursing facility or crimes committed by an employee of a nursing facility--
`(1) that were committed inside of the facility; and
`(2) with respect to such instances of violations or crimes committed
outside of the facility, that were the violations or crimes of elder abuse,
neglect, and exploitation, criminal sexual abuse of an elder, or other
violations or crimes that resulted in the serious bodily injury of an
elder.
`(d) Development of Consumer Rights Information Page on Nursing Home Compare
Website- Not later than 1 year after the date of enactment of the Elder
Justice Act, the Secretary shall ensure that the Department of Health and
Human Services, as part of the information provided for comparison of nursing
facilities on the Nursing Home Compare Medicare website develops and includes
a consumer rights information page that contains links to descriptions of,
and information with respect to, the following:
`(1) The documentation on nursing facilities that is available to the
public.
`(2) General information and tips on choosing a nursing facility that
meets the needs of the individual.
`(3) General information on consumer rights with respect to nursing facilities.
`(4) The nursing facility survey process (on a national and State-specific
basis).
`(5) On a State-specific basis, the services available through the State
long-term care ombudsman for such State.
`(e) 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 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.
`(f) Regulations- The Secretary shall promulgate regulations to carry out
subsections (c), (d), and (e) of this section. Such regulations shall require
a State, as a condition of the receipt of funds under this part, to conduct
such data collection and reporting as the Secretary determines are necessary
to satisfy the requirements of such subsections.
`(g) Authorization of Appropriations- There are authorized to be appropriated
to carry out this section--
`(1) for fiscal year 2008, $20,000,000;
`(2) for fiscal year 2009, $17,500,000; and
`(3) for each of fiscal years 2010 and 2011, $15,000,000.
`SEC. 2042. ADULT PROTECTIVE SERVICES FUNCTIONS AND GRANT PROGRAMS.
`(a) Secretarial Responsibilities-
`(1) IN GENERAL- The Secretary shall ensure that the Department of Health
and Human Services--
`(A) provides funding authorized by this part 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 Department
of Justice;
`(C) develops and disseminates information on best practices regarding,
and provides training on, carrying out adult protective services;
`(D) 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 2008 and $4,000,000
for each of fiscal years 2009 through 2011.
`(b) Grants To Enhance the Provision of Adult Protective Services-
`(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 by States and local units
of government.
`(A) IN GENERAL- Subject to the availability of appropriations and subparagraphs
(B) and (C), the amount paid to a State for a fiscal year under the
program under this subsection shall equal the amount appropriated for
that year to carry out this subsection multiplied by the percentage
of the total number of elders who reside in the United States who reside
in that 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 fiscal year is less than 0.75 percent
of the amount appropriated for such year, 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 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) 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 on the number of elders served by the grants awarded
under this subsection.
`(5) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated
to carry out this subsection, $100,000,000 for each of fiscal years 2008
through 2011.
`(c) State Demonstration Programs-
`(1) ESTABLISHMENT- 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) 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.
`(5) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated
to carry out this subsection, $25,000,000 for each of fiscal years 2008
through 2011.
`SEC. 2043. LONG-TERM CARE OMBUDSMAN PROGRAM GRANTS AND TRAINING.
`(a) Grants To Support the Long-Term Care Ombudsman Program-
`(1) IN GENERAL- The Secretary shall make grants to eligible entities
with relevant expertise and experience in abuse and neglect in long-term
care facilities or long-term care ombudsman programs and responsibilities,
for the purpose of--
`(A) improving the capacity of State long-term care ombudsman programs
to respond to and resolve complaints about abuse and neglect;
`(B) conducting pilot programs with State long-term care ombudsman offices
or local ombudsman entities; and
`(C) providing support for such State long-term care ombudsman programs
and such pilot programs (such as through the establishment of a national
long-term care ombudsman resource center).
`(2) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated
to carry out this subsection--
`(A) for fiscal year 2008, $5,000,000;
`(B) for fiscal year 2009, $7,500,000; and
`(C) for each of fiscal years 2010 and 2011, $10,000,000.
`(b) Ombudsman Training Programs-
`(1) IN GENERAL- The Secretary shall establish programs to provide and
improve ombudsman training with respect to elder abuse, neglect, and exploitation
for national organizations and State long-term care ombudsman programs.
`(2) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated
to carry out this subsection, for each of fiscal years 2008 through 2011,
$10,000,000.
`SEC. 2044. PROVISION OF INFORMATION REGARDING, AND EVALUATIONS OF, ELDER
JUSTICE PROGRAMS.
`(a) Provision of Information- To be eligible to receive a grant under this
part, 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 2041(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 (not less than 2 percent) of the funds appropriated
with respect to each program carried out under this part; 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 part.
`(2) INFORMATICS SYSTEMS GRANT PROGRAM NOT INCLUDED- The provisions of
this subsection shall not apply to the informatics systems grant program
under section 2041(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 part.
`(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, the Committee on Ways and Means and the Committee on Energy
and Commerce of the House of Representatives, and the Committee on Finance
of the Senate 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 2041(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 2041(b).
`SEC. 2045. REPORT.
`Not later than October 1, 2011, the Secretary shall submit to the Elder
Justice Coordinating Council, the Committee on Ways and Means and the Committee
on Energy and Commerce of the House of Representatives, and the Committee
on Finance of the Senate a report--
`(1) compiling, summarizing, and analyzing the information contained in
the State reports submitted under subsections (b)(4) and (c)(4) of section
2042; and
`(2) containing such recommendations for legislative or administrative
action as the Secretary determines to be appropriate.'.
(2) OPTION FOR STATE PLAN UNDER PROGRAM FOR TEMPORARY ASSISTANCE FOR NEEDY
FAMILIES-
(A) IN GENERAL- Section 402(a)(1)(B) of the Social Security Act (42
U.S.C. 602(a)(1)(B)) is amended by adding at the end the following new
clause:
`(v) The document shall indicate whether the State intends to assist
individuals to train for, seek, and maintain employment--
`(I) providing direct care in a long-term care facility (as such
terms are defined under section 2011); or
`(II) in other occupations related to elder care determined appropriate
by the State for which the State identifies an unmet need for service
personnel,
and, if so, shall include an overview of such assistance.'.
(B) EFFECTIVE DATE- The amendment made by subparagraph (A) shall take
effect on October 1, 2008.
(b) Protecting Residents of Long-Term Care Facilities-
(1) NATIONAL TRAINING INSTITUTE FOR SURVEYORS-
(A) IN GENERAL- The Secretary of Health and Human Services shall enter
into a contract with an entity for the purpose of establishing and operating
a National Training Institute for Federal and State surveyors. Such
Institute shall provide and improve the training of surveyors with respect
to investigating allegations of abuse, neglect, and misappropriation
of property in programs and long-term care facilities that receive payments
under title XVIII or XIX of the Social Security Act.
(B) ACTIVITIES CARRIED OUT BY THE INSTITUTE- The contract entered into
under subparagraph (A) shall require the Institute established and operated
under such contract to carry out the following activities:
(i) Assess the extent to which State agencies use specialized surveyors
for the investigation of reported allegations of abuse, neglect, and
misappropriation of property in such programs and long-term care facilities.
(ii) Evaluate how the competencies of surveyors may be improved to
more effectively investigate reported allegations of such abuse, neglect,
and misappropriation of property, and provide feedback to Federal
and State agencies on the evaluations conducted.
(iii) Provide a national program of training, tools, and technical
assistance to Federal and State surveyors on investigating reports
of such abuse, neglect, and misappropriation of property.
(iv) Develop and disseminate information on best practices for the
investigation of such abuse, neglect, and misappropriation of property.
(v) Assess the performance of State complaint intake systems, in order
to ensure that the intake of complaints occurs 24 hours per day, 7
days a week (including holidays).
(vi) To the extent approved by the Secretary of Health and Human Services,
provide a national 24 hours per day, 7 days a week (including holidays),
back-up system to State complaint intake systems in order to ensure
optimum national responsiveness to complaints of such abuse, neglect,
and misappropriation of property.
(vii) Analyze and report annually on the following:
(I) The total number and sources of complaints of such abuse, neglect,
and misappropriation of property.
(II) The extent to which such complaints are referred to law enforcement
agencies.
(III) General results of Federal and State investigations of such
complaints.
(viii) Conduct a national study of the cost to State agencies of conducting
complaint investigations of skilled nursing facilities and nursing
facilities under sections 1819 and 1919, respectively, of the Social
Security Act (42 U.S.C. 1395i-3; 1396r), and making recommendations
to the Secretary of Health and Human Services with respect to options
to increase the efficiency and cost-effectiveness of such investigations.
(C) AUTHORIZATION- There are authorized to be appropriated to carry
out this paragraph, for the period of fiscal years 2008 through 2011,
$12,000,000.
(2) GRANTS TO STATE SURVEY AGENCIES-
(A) IN GENERAL- The Secretary of Health and Human Services shall make
grants to State agencies that perform surveys of skilled nursing facilities
or nursing facilities under sections 1819 or 1919, respectively, of
the Social Security Act (42 U.S.C. 1395i-3; 1395r).
(B) USE OF FUNDS- A grant awarded under subparagraph (A) shall be used
for the purpose of designing and implementing complaint investigations
systems that--
(i) promptly prioritize complaints in order to ensure a rapid response
to the most serious and urgent complaints;
(ii) respond to complaints with optimum effectiveness and timeliness;
and
(iii) optimize the collaboration between local authorities, consumers,
and providers, including--
(II) the State Long-Term Care Ombudsman;
(III) local law enforcement agencies;
(IV) advocacy and consumer organizations;
(VI) Area Agencies on Aging; and
(VII) other appropriate entities.
(C) AUTHORIZATION- There are authorized to be appropriated to carry
out this paragraph, for each of fiscal years 2008 through 2011, $5,000,000.
(3) REPORTING OF CRIMES AND ENSURING SAFETY OF RESIDENTS WHEN FEDERALLY
FUNDED LONG-TERM CARE FACILITIES CLOSE- 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 under this Act shall annually determine whether
the facility received at least $10,000 in such 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 such 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 (1).
`(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
individual who is a resident of, or is 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.
`(1) IN GENERAL- If a covered individual violates subsection (b)--
`(A) the covered individual shall be subject to a civil money penalty
of not more than $200,000; or
`(B) the Secretary shall classify the covered 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 individual--
`(A) the covered individual shall be subject to a civil money penalty
of not more than $300,000; and
`(B) the Secretary shall classify the covered individual as an excluded
individual, for a period of not more than 3 years.
`(3) EXCLUDED INDIVIDUAL- During any period for which a covered individual
is classified as an excluded individual under paragraph (1)(B) or (2)(B),
a long-term care facility that employs such individual shall be ineligible
to receive Federal funds under this Act.
`(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 or other employee
with the appropriate State professional disciplinary agency because
of lawful acts done by the nurse or employee,
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 the 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) Procedure- The provisions of section 1128A (other than subsections
(a) and (b) and the second sentence of subsection (f)) shall apply to a
civil money penalty under this section in the same manner as such provisions
apply to a penalty or proceeding under section 1128A(a).
`(f) Definitions- In this section, the terms `elder justice', `long-term
care facility', and `law enforcement' have the meanings given those terms
in section 2011.
`ENSURING SAFETY OF RESIDENTS WHEN FEDERALLY FUNDED LONG-TERM CARE FACILITIES
CLOSE
`Sec. 1150B. (a) In General-
`(1) NOTIFICATION OF FACILITY CLOSURE- Subject to paragraph (2), 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 under this Act
during the preceding year, the owner or operator of the facility shall--
`(A) 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;
`(B) include in the notice a plan for the transfer and adequate relocation
of the residents of the facility prior to closure, including assurances
that the residents will be transferred to the most appropriate facility
in terms of quality, services, and location; and
`(C) 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.
`(2) EXCEPTION WHERE THE SECRETARY HAS ISSUED A TERMINATION NOTICE- In
the case of a long-term care facility described in paragraph (1) for which
the Secretary has issued a termination notice for the facility to close
by not later than 15 days after the issuance of such notice, the Secretary
shall establish requirements for the notification, transfer, and adequate
relocation of residents within an appropriate timeframe.
`(b) Sanctions- Any person owning or operating 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- The provisions of section 1128A (other than subsections
(a) and (b) and the second sentence of subsection (f)) shall apply to a
civil money penalty or assessment under this section in the same manner
as such provisions apply to a penalty or proceeding under section 1128A(a).
`(d) Definition- In this section, the term `long-term care facility' has
the meaning given that term in section 2011.'.
(4) REPORT TO CONGRESS ON PILOT PROGRAM FOR NATIONAL AND STATE BACKGROUND
CHECKS ON DIRECT PATIENT ACCESS EMPLOYEES OF LONG-TERM CARE FACILITIES
OR PROVIDERS- Not later than the date that is 6 months after the completion
of the pilot program for national and State background checks on direct
patient access employees of long-term care facilities or providers established
under section 307 of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (42 U.S.C. 1395aa note), the Secretary shall
submit to the Committee on Finance of the Senate and the Committee on
Ways and Means and the Committee on Energy and Commerce of the House of
Representatives a report containing the results of the evaluation required
under subsection (e) of such section of such Act, together with recommendations
for such legislation and administrative action as the Secretary determines
appropriate.
(c) National Nurse Aide Registry-
(1) DEFINITION OF NURSE AIDE- In this subsection, the term `nurse aide'
has the meaning given that term in sections 1819(b)(5)(F) and 1919(b)(5)(F)
of the Social Security Act (42 U.S.C. 1395i-3(b)(5)(F); 1396r(b)(5)(F)).
(A) IN GENERAL- The Secretary, in consultation with appropriate government
agencies and private sector organizations, shall conduct a study on
establishing a national nurse aide registry.
(B) AREAS EVALUATED- The study conducted under this subsection shall
include an evaluation of--
(i) who should be included in the registry;
(ii) how such a registry would comply with Federal and State privacy
laws and regulations;
(iii) how data would be collected for the registry;
(iv) what entities and individuals would have access to the data collected;
(v) how the registry would provide appropriate information regarding
violations of Federal and State law by individuals included in the
registry;
(vi) how the functions of a national nurse aide registry would be
coordinated with the pilot program for national and State background
checks on direct patient access employees of long-term care facilities
or providers established under section 307 of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173);
and
(vii) how the information included in State nurse aide registries
developed and maintained under sections 1819(e)(2) and 1919(e)(2)
of the Social Security Act (42 U.S.C. 1395i-3(e)(2); 1396r(e)(2)(2))
would be provided as part of a national nurse aide registry.
(C) CONSIDERATIONS- In conducting the study and preparing the report
required under this subsection, the Secretary shall take into consideration
the findings and conclusions of relevant reports and other relevant
resources, including the following:
(i) The Department of Health and Human Services Office of Inspector
General Report, Nurse Aide Registries: State Compliance and Practices
(February 2005).
(ii) The General Accounting Office (now known as the Government Accountability
Office) Report, Nursing Homes: More Can Be Done to Protect Residents
from Abuse (March 2002).
(iii) The Department of Health and Human Services Office of the Inspector
General Report, Nurse Aide Registries: Long-Term Care Facility Compliance
and Practices (July 2005).
(iv) The Department of Health and Human Services Health Resources
and Services Administration Report, Nursing Aides, Home Health Aides,
and Related Health Care Occupations--National and Local Workforce
Shortages and Associated Data Needs (2004)(in particular with respect
to chapter 7 and appendix F).
(v) The 2001 Report to CMS from the School of Rural Public Health,
Texas A&M University, Preventing Abuse and Neglect in Nursing
Homes: The Role of Nurse Aide Registries.
(vi) Information included in State nurse aide registries developed
and maintained under sections 1819(e)(2) and 1919(e)(2) of the Social
Security Act (42 U.S.C. 1395i-3(e)(2); 1396r(e)(2)(2)).
(D) REPORT- Not later than 18 months after the date of enactment of
this Act, the Secretary shall submit a report to the Elder Justice Coordinating
Council, the Committee on Finance of the Senate, and the Committee on
Ways and Means and the Committee on Energy and Commerce of the House
of Representatives containing the findings and recommendations of the
study conducted under this paragraph.
(E) FUNDING LIMITATION- Funding for the study conducted under this subsection
shall not exceed $500,000.
(3) CONGRESSIONAL ACTION- After receiving the report submitted by the
Secretary under paragraph (2)(D), the Committee on Finance of the Senate
and the Committee on Ways and Means and the Committee on Energy and Commerce
of the House of Representatives shall, as they deem appropriate, take
action based on the recommendations contained in the report.
(4) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated
such sums as are necessary for the purpose of carrying out this subsection.
(d) Conforming Amendments-
(1) TITLE XX- Title XX of the Social Security Act (42 U.S.C. 1397 et seq.),
as amended by section 5(a), is amended--
(A) in the heading of section 2001, by striking `TITLE' and inserting
`SUBTITLE'; and
(B) in subtitle 1, by striking `this title' each place it appears and
inserting `this subtitle'.
(2) TITLE IV- Title IV of the Social Security Act (42 U.S.C. 601 et seq.)
is amended--
(i) in paragraphs (1)(A), (2)(A), and (3)(B), by inserting `subtitle
1 of' before `title XX' each place it appears;
(ii) in the heading of paragraph (2), by inserting `SUBTITLE 1 OF'
before `TITLE XX'; and
(iii) in the heading of paragraph (3)(B), by inserting `SUBTITLE 1
OF' before `TITLE XX'; and
(B) in sections 422(b), 471(a)(4), 472(h)(1), and 473(b)(2), by inserting
`subtitle 1 of' before `title XX' each place it appears.
(3) TITLE XI- Title XI of the Social Security Act (42 U.S.C. 1301 et seq.)
is amended--
(A) in section 1128(h)(3)--
(i) by inserting `subtitle 1 of' before `title XX'; and
(ii) by striking `such title' and inserting `such subtitle'; and
(B) in section 1128A(i)(1), by inserting `subtitle 1 of' before `title
XX'.
END
