[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 2940 Reported in Senate (RS)]






                                                       Calendar No. 780
108th CONGRESS
  2d Session
                                S. 2940

                          [Report No. 108-391]

     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.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            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

_______________________________________________________________________

                                 A BILL


 
     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

108th CONGRESS

  2d Session

                                S. 2940

                          [Report No. 108-391]

_______________________________________________________________________

                                 A BILL

     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

                 Read twice and placed on the calendar