To amend the Older Americans Act of 1965 to assist States in preventing, detecting, treating, intervening in, and responding to elder abuse, neglect, and exploitation, and for other purposes.

October 7, 2004

Mr. GREGG, from the Committee on Health, Education, Labor, and Pensions reported the following original bill; which was read twice and placed on the calendar

To amend the Older Americans Act of 1965 to assist States in preventing, detecting, treating, intervening in, and responding to elder abuse, neglect, and exploitation, and for other purposes.

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

SECTION 1. SHORT TITLE.

This Act may be cited as the `Act for Elder Justice'.

SEC. 2. PURPOSES.

The purposes of this Act are as follows:

(1) To assist States and Indian tribes in developing a comprehensive multi-disciplinary approach to elder justice.

(2) To promote research and data collection that will fill gaps in knowledge about elder abuse, neglect, and exploitation.

(3) To support innovative and effective activities of service providers and programs that are designed to address issues relating to elder abuse, neglect, and exploitation.

(4) To assist States, Indian tribes, and local service providers in the development of short- and long-term strategic plans for the development and coordination of elder justice research, programs, studies, training, and other efforts.

(5) To promote collaborative efforts and diminish overlap and gaps in efforts in developing the important field of elder justice.

SEC. 3. OFFICE OF ELDER ABUSE PREVENTION AND SERVICES.

Section 201 of the Older Americans Act of 1965 (42 U.S.C. 3011) is amended by adding at the end the following:

`(e)(1) In this subsection, the terms defined in section 751 shall have the meanings given those terms in that section.

`(2) The Secretary is authorized to establish or designate within the Administration (as defined in section 102) an Office of Elder Abuse Prevention and Services.

`(3) It shall be the duty of the Assistant Secretary, acting through the head of the Office of Elder Abuse Prevention and Services to--

`(A) develop objectives, priorities, policy, and a long-term plan for--

`(i) carrying out elder justice programs and activities relating to--

`(I) elder abuse prevention, detection, treatment, and intervention, and response;

`(II) training of individuals regarding the matters described in subclause (I); and

`(III) the improvement of the elder justice system in the United States;

`(ii) collecting and disseminating data annually relating to the abuse, neglect, and exploitation of elders (and, in the discretion of the Secretary, vulnerable adults) in coordination with the efforts of the Bureau of Justice Statistics of the Office of Justice Programs of the Department of Justice to collect national data;

`(iii) disseminating information concerning best practices regarding, and providing training on, carrying out activities related to abuse, neglect, and exploitation of elders (and, in the discretion of the Secretary, vulnerable adults);

`(iv) in conjunction with the necessary experts, conducting research related to abuse, neglect, and exploitation of elders (and, in the discretion of the Secretary, vulnerable adults); and

`(v) providing technical assistance to States and other eligible entities that provide or fund the provision of the services described in subtitle B of title VII;

`(B) implement the overall policy and a strategy to carry out the plan described in subparagraph (A); and

`(C) provide advice to the Secretary on elder justice issues and administer such programs relating to elder abuse, neglect, and exploitation as the Secretary determines to be appropriate.

`(4) The Secretary, acting through the Assistant Secretary, may issue such regulations as may be necessary to carry out this subsection and subtitle B of title VII.'.

SEC. 4. ELDER JUSTICE PROGRAMS.

(a) GENERAL DEFINITIONS- Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is amended--

(1) by striking paragraph (24) and inserting the following:

`(24) The term `exploitation' means the fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual, including a caregiver or fiduciary (as such terms are defined in section 751), that uses the resources of an older individual for monetary or personal benefit, profit, or gain, or that results in depriving an older individual of rightful access to, or use of, benefits, resources, belongings, or assets.'; and

(2) by striking paragraph (34) and inserting the following:

`(34) The term `neglect' means--

`(A) the intentional, deliberate, or knowing failure of a caregiver or fiduciary (as such terms are defined in section 751) to provide the goods or services that are necessary to maintain the health or safety of an older individual; or

`(B) an adult's inability, due to physical, mental, or cognitive impairment or diminished capacity, to perform essential self-care tasks including--

`(i) obtaining essential food, clothing, shelter, and medical care;

`(ii) obtaining goods and services necessary to maintain physical health, mental health, or general safety; or

`(iii) managing one's own financial affairs.'.

(b) ELDER JUSTICE DEFINITIONS AND PROGRAMS- Title VII of the Older Americans Act of 1965 (42 U.S.C. 3058 et seq.) is amended--

(1) by redesignating subtitles B and C as subtitles C and D, respectively;

(2) by redesignating sections 751, and 761 through 764, as sections 761, and 771 through 774, respectively; and

(3) by inserting after subtitle A the following:

`Subtitle B--Elder Justice Programs

`SEC. 751. DEFINITIONS.

`In this subtitle:

`(1) 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.

`(2) DIRECT CARE- The term `direct care' means care by an employee or contractor who provides assistance or long-term care services to a recipient.

`(3) ELDER- The term `elder' means an older individual, as defined in section 102.

`(4) ELDER JUSTICE- The term `elder justice' means--

`(A) efforts to prevent, detect, treat, intervene in, and respond to 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.

`(5) 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.

`(6) 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.

`(7) GRANT- The term `grant' includes a contract, cooperative agreement, or other mechanism for providing financial assistance.

`(8) 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.

`(9) 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 effectively in activities of daily living, including eating, dressing, bathing, and management of one's financial affairs.

`(10) LONG-TERM CARE FACILITY- The term `long-term care facility' means a residential care provider that arranges for, or directly provides, long-term care.

`(11) NURSING FACILITY- The term `nursing facility' has the meaning given such term under section 1919(a) of the Social Security Act (42 U.S.C. 1396r(a)).

`(12) STATE LEGAL ASSISTANCE DEVELOPER- The term `State legal assistance developer' means an individual described in section 731.

`(13) 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).

`SEC. 752. STATE AND TRIBAL GRANTS TO STRENGTHEN LONG-TERM CARE AND PROVIDE ASSISTANCE FOR ELDER JUSTICE PROGRAMS.

`(a) GRANTS- The Assistant Secretary may award grants to States and Indian tribes to enable the States and tribes to strengthen long-term care and provide assistance for elder justice programs.

`(b) APPLICATION- To be eligible to receive a grant under this subtitle, a State or Indian tribe shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information as the Assistant Secretary may require.

`(c) USE OF FUNDS- A State or Indian tribe that receives a grant under this subtitle may use the funds made available through the grant to award grants--

`(1) to eligible entities for the prevention, detection, assessment, and treatment of, intervention in, investigation of, and response to elder abuse, neglect, and exploitation;

`(2) to eligible entities to examine various types of elder shelters (in this paragraph referred to as `safe havens'), and to test various safe haven models for establishing safe havens (at home or elsewhere), that--

`(A) recognize autonomy and self-determination, and fully protect the due process rights of elders; and

`(B)(i) provide a comprehensive, culturally sensitive, and multidisciplinary team response to allegations of elder abuse, neglect, or exploitation;

`(ii) provide a dedicated, elder-friendly setting;

`(iii) have the capacity to meet the needs of elders for care; and

`(iv) provide various services including--

`(I) nursing and forensic evaluation;

`(II) therapeutic intervention;

`(III) victim support and advocacy; and

`(IV) case review and assistance to make the elders 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;

`(3) to eligible entities to establish or continue volunteer programs that focus on the issues of elder abuse, neglect, and exploitation, or to provide related services;

`(4) to eligible entities to support multidisciplinary elder justice activities, such as--

`(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;

`(B) establishing a State or tribal coordinating council, which shall identify the individual State's or Indian tribe's needs and provide the Secretary with information and recommendations relating to efforts by the State or Indian tribe to combat elder abuse, neglect, and exploitation;

`(C) providing training, technical assistance, and other methods of support to groups

carrying out multidisciplinary efforts at the State or Indian tribe level (referred to in some States as `State Working Groups');

`(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, Indian tribes, and communities; or

`(E) carrying out such other interdisciplinary or multidisciplinary efforts as the Assistant Secretary determines to be appropriate;

`(5) to eligible entities to provide training for individuals with respect to issues of elder abuse, neglect, and exploitation, consisting of--

`(A) training within a discipline; or

`(B) cross-training activities that permit individuals in multiple disciplines to train together, fostering communication, coordinating efforts, and ensuring collaboration;

`(6) to eligible entities to address underserved populations of elders, such as--

`(A) elders living in rural locations;

`(B) elders in minority populations; or

`(C) low-income elders;

`(7) to eligible entities to provide incentives for individuals to train for, seek, and maintain employment providing direct care in a long-term care facility, such as--

`(A) to eligible entities to provide incentives to participants in programs carried out under part A of title IV, and section 403(a)(5), of the Social Security Act (42 U.S.C. 601 et seq., 603(a)(5)) to train for and seek employment providing direct care in a long-term care facility;

`(B) 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 professional certification, based on observed clinical care practices and the amount of time the employees spend providing direct care; and

`(ii) provide, or make arrangements with employers to provide, bonuses or other increased compensation or benefits to employees who achieve professional certification under such a program; or

`(C) to long-term care facilities to enable the facilities to provide training and technical assistance to eligible employees regarding management practices using methods that are demonstrated to promote retention of employees of the facilities, 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; or

`(ii) 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;

`(8) to encourage the establishment of eligible partnerships to develop collaborative and innovative approaches to improve the quality of, including preventing abuse, neglect, and exploitation in, long-term care; or

`(9) to eligible entities to establish multidisciplinary panels to address and develop best practices concerning methods of--

`(A) improving the quality of long-term care; and

`(B) addressing abuse, including resident-to-resident abuse, in long-term care.

`(d) ADMINISTRATIVE EXPENSES- A State or Indian tribe that receives a grant under this section shall not use more than 5 percent of the funds made available through the grant to pay for administrative expenses.

`(e) SUPPLEMENT NOT SUPPLANT- Funds made available pursuant to this section shall be used to supplement and not supplant other Federal, State, and local (including tribal) funds expended to provide activities described in subsection (c).

`(f) MAINTENANCE OF EFFORT- The State or Indian tribe, in using the proceeds of a grant received under this section, shall maintain the expenditures of the State or tribe for activities described in subsection (c) at a level equal to not less than the level of such expenditures maintained by the State or tribe for the fiscal year preceding the fiscal year for which the grant is received.

`(g) ACCOUNTABILITY MEASURES- The Assistant Secretary shall develop accountability measures to ensure

the effectiveness of the activities conducted using funds made available under this section, including accountability measures to ensure that the activities described in subsection (c)(7) benefit eligible employees and increase the stability of the long-term care workforce.

`(h) EVALUATING PROGRAMS- The Assistant Secretary shall evaluate the activities conducted using funds made available under this section and shall use the results of such evaluation to determine the activities for which funds made available under this section may be used.

`(i) COMPLIANCE WITH APPLICABLE LAWS- In order to receive funds under this section, an entity shall comply with all applicable laws, regulations, and guidelines.

`(j) ELIGIBLE PARTNERSHIPS- In subsection (c)(8), 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.

`(k) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2005 through 2008.'.

Calendar No. 780

To amend the Older Americans Act of 1965 to assist States in preventing, detecting, treating, intervening in, and responding to elder abuse, neglect, and exploitation, and for other purposes.

October 7, 2004

END