[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 333 Introduced in Senate (IS)]







108th CONGRESS
  1st Session
                                 S. 333

           To promote elder justice, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 10, 2003

 Mr. Breaux (for himself, Mr. Hatch, Mr. Baucus, Mr. Bond, Mr. Burns, 
  Ms. Collins, Mr. Harkin, Mr. Kohl, Ms. Landrieu, Mrs. Lincoln, Mr. 
   Nelson of Florida, Mr. Rockefeller, Mr. Santorum, Mr. Smith, Mr. 
Jeffords, Mr. Miller, and Ms. Stabenow) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
           To promote elder justice, and for other purposes.

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

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.
Sec. 2. Findings.
Sec. 3. Purposes.
            TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES

Sec. 101. Amendment to the social security act.
Sec. 102. Patient abuse prevention.
Sec. 103. Increasing the number of health care professionals with 
                            geriatric training.
Sec. 104. Supporting the long-term care ombudsman program. 
Sec. 105. Establishment of office of adult protective services.
Sec. 106. Assuring safety of residents when nursing facilities close.
                    TITLE II--DEPARTMENT OF JUSTICE

Sec. 201. Definitions; rule.
Sec. 202. Model State laws and practices.
Sec. 203. Office of elder justice of the department of justice.
Sec. 204. Grants under the social security act.
Sec. 205. Victim advocacy grants.
Sec. 206. Supporting local prosecutors in elder justice matters.
Sec. 207. Supporting State prosecutors in elder justice matters.
Sec. 208. Supporting Federal cases involving elder justice.
Sec. 209. Community policing.
Sec. 210. Supporting law enforcement in elder justice matters.
Sec. 211. Evaluations.
Sec. 212. Authorization of appropriations.
Sec. 213. Cause of action for elder abuse and neglect.
Sec. 214. Civil actions for elder abuse and neglect.
                       TITLE III--TAX PROVISIONS

Sec. 301. Long-term care facility worker employment tax credit.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The proportion of the United States population age 60 
        years or older will drastically increase in the next 30 years 
        as 77,000,000 baby boomers approach retirement and old age.
            (2) Each year, anywhere between 500,000 and 5,000,000 
        elders in the United States are abused, neglected, or 
        exploited.
            (3) Elder abuse, neglect, and exploitation have no 
        boundaries, and cross all racial, social class, gender, and 
        geographic lines.
            (4) Victims of elder abuse, neglect, and exploitation are 
        not only subject to injury from mistreatment and neglect, they 
        are also 3.1 times more likely to die at an earlier age than 
        expected than elders who were not victims of elder abuse, 
        neglect, and exploitation.
            (5) There is a general dearth of data as to the nature and 
        scope of elder abuse, neglect, and exploitation.
            (6) Despite the dearth of data in the field, experts agree 
        that most cases of elder abuse, neglect, and exploitation are 
        never reported and that abuse and neglect shorten a victim's 
        life, often triggering a downward spiral of an otherwise 
        productive, self-sufficient elder's life. Programs addressing 
        other difficult issues such as domestic violence and child 
        abuse and neglect have demonstrated the need for a multi-
        faceted law, combining public health, social service, and law 
        enforcement approaches.
            (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 directly dealing with these issues.
            (10) Differences in State laws and practices in the areas 
        of elder abuse, neglect, and exploitation lead to significant 
        disparities in prevention, protective and social services, 
        treatment systems, and law enforcement, and lead to other 
        inequities.
            (11) The Federal Government has played an important role in 
        promoting research, training, public safety, data collection, 
        the identification, development, and dissemination of promising 
        health care, social, and protective services, and law 
        enforcement practices, relating to child abuse and neglect, 
        domestic violence, and violence against women. The Federal 
        Government should promote similar efforts and protections 
        relating to elder abuse, neglect, and exploitation.
            (12) The Federal Government should provide leadership and 
        assist States and communities in their efforts to protect 
        elders in the United States by--
                    (A) promoting coordinated planning among all levels 
                of government;
                    (B) generating and sharing knowledge relevant to 
                protecting elders;
                    (C) providing leadership to combat the abuse, 
                neglect, and exploitation of the Nation's elders; and
                    (D) providing resources to States and communities 
                to promote elder justice.
            (13) The problem of elder abuse, neglect, and exploitation 
        requires a comprehensive approach that--
                    (A) integrates the work of health, legal, and 
                social service agencies and organizations;
                    (B) emphasizes the need for prevention, reporting, 
                investigation, assessment, treatment, and prosecution 
                of elder abuse, neglect, and exploitation at all levels 
                of government;
                    (C) ensures that sufficient numbers of properly 
                trained personnel with specialized knowledge are in 
                place to treat, assess, and provide services relating 
                to elder abuse, neglect, and exploitation, and carry 
                out elder and vulnerable adult 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 adults' right to self-determination 
                with society's responsibility to protect elders and 
                vulnerable adults.
            (14) The human, social, and economic cost of elder abuse, 
        neglect, and exploitation is high and includes unnecessary 
        expenditures of medicare and medicaid funds.
            (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 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.
            (2) To raise the issue of elder abuse, neglect, and 
        exploitation to national attention, and to create the 
        infrastructure at the Federal, State, and local levels, to 
        assure that individuals and organizations on the front lines, 
        who are fighting elder abuse, neglect, and exploitation with 
        scarce resources and fragmented systems, have the resources and 
        information needed to carry out their fight.
            (3) To bring a comprehensive multi-disciplinary approach to 
        elder justice.
            (4) To set in motion research and data collection to fill 
        gaps in knowledge about elder abuse, neglect, and exploitation.
            (5) To supplement the activities of service providers and 
        programs, to enhance training, and to leverage scarce resources 
        efficiently to ensure that elder justice receives the attention 
        it deserves as the Nation's population ages.
            (6) To examine the many different laws and practices 
        relating to elder justice in different States and jurisdictions 
        to ascertain which among those laws and practices are the most 
        effective.
            (7) To promote the development of an effective adult 
        fiduciary system, including an adult guardianship system, that 
        protects individuals with diminished capacity, maximizes their 
        autonomy, and develops effective resources and an elder rights 
        system.
            (8) To recognize and address the role of mental health, 
        disability, dementia, substance abuse, medication 
        mismanagement, and family dysfunction problems in increasing 
        and exacerbating elder abuse, neglect and exploitation.
            (9) To create a short- and long-term strategic plan for the 
        development and coordination of elder justice research, 
        programs, studies, training, and other efforts nationwide.
            (10) To promote collaborative efforts and diminish overlap 
        and gaps in efforts in developing the important field of elder 
        justice.

            TITLE I--DEPARTMENT OF HEALTH AND HUMAN SERVICES

SEC. 101. AMENDMENT TO THE SOCIAL SECURITY ACT.

    The Social Security Act (42 U.S.C. 301 et seq.) is amended by 
adding at the end the following:

                      ``TITLE XXII--ELDER JUSTICE

``SEC. 2201. DEFINITIONS; RULE.

    ``(a) Definitions.--In this title:
            ``(1) Abuse.--The term `abuse' means the knowing infliction 
        of physical or psychological harm or the knowing deprivation of 
        goods or services that are necessary to meet essential needs or 
        to avoid physical or psychological harm.
            ``(2) Adult protective services.--The term `adult 
        protective services' means those services provided to elders 
        and to people age 18 and older with disabilities who are, or 
        who are in danger of being, abused, neglected, or exploited, 
        who are unable to protect themselves, or who have no one to 
        assist them adequately. The term includes services such as 
        disseminating reports of adult abuse, neglect or exploitation, 
        investigating those reports, case planning, monitoring, 
        evaluation, providing other case work and services, and 
        providing, arranging for, or facilitating the provision of 
        medical, social service, economic, legal, housing, law 
        enforcement, or other protective, emergency, or support 
        services.
            ``(3) Caregiver.--The term `caregiver' means an individual 
        who has the responsibility for the care of an elder, either 
        voluntarily, by contract, by receipt  of payment for care, or 
as a result of the operation of law and means a family member or other 
individual who provides (on behalf of such individual or of a public or 
private agency, organization, or institution) compensated or 
uncompensated care to an elder who needs supportive services in any 
setting.
            ``(4) Direct care.--The term `direct care' means care by an 
        employee or contractor who provides assistance or long-term 
        care services to a recipient.
            ``(5) Elder.--The term `elder' means an individual age 60 
        or older.
            ``(6) Elder justice.--The term `elder justice' means--
                    ``(A) from a societal perspective, efforts to 
                prevent, detect, treat, intervene in, and prosecute 
                elder abuse, neglect, and exploitation and to protect 
                elders with diminished capacity while maximizing their 
                autonomy; and
                    ``(B) from an individual perspective, the 
                recognition of an elder's rights, including the right 
                to be free of abuse, neglect, and exploitation.
            ``(7) Eligible entity.--The term `eligible entity' means a 
        State or local government agency, Indian tribe, or any other 
        public or private entity that is engaged in and has expertise 
        in issues relating to elder justice or in a field necessary to 
        promote elder justice efforts.
            ``(8) Exploitation.--The term `exploitation' means the 
        fraudulent or otherwise illegal, unauthorized, or improper act 
        or process of an individual, including a caregiver or 
        fiduciary, that uses the resources of an elder for monetary or 
        personal benefit, profit, 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) Granting authority.--The term `granting authority' 
        means the Secretary of Health and Human Services, the Attorney 
        General, or the Secretary of Health and Human Services and the 
        Attorney General jointly, as appropriate.
            ``(12) 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 surrogate 
                decisionmaker;
                    ``(B) the manner in which the court-appointed 
                surrogate carries out duties to the individual and the 
                court; or
                    ``(C) the manner in which the court exercises 
                oversight of the surrogate.
            ``(13) Indian.--The term `Indian' means a person who is a 
        member of an Indian tribe.
            ``(14) Indian tribe.--The term `Indian tribe' means any 
        Indian tribe, band, nation, or other organized group or 
        community, including any Alaska Native village or regional 
        corporation as defined in or established pursuant to the Alaska 
        Native Claims Settlement Act (43 U.S.C. 1601 et seq.), that is 
        recognized as eligible for the special programs and services 
        provided by the United States to Indians because of their 
        status as Indians.
            ``(15) Knowingly.--The term `knowingly' has the meaning 
        given such term in section 3729(b) of title 31, United States 
        Code.
            ``(16) 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.
            ``(17) Long-term care.--
                    ``(A) In general.--The term `long-term care' means 
                a wide range of supportive and health services for 
                individuals who need assistance because the individuals 
                have a loss of capacity for self-care due to illness, 
                disability, or vulnerability.
                    ``(B) Need for assistance.--For purposes of 
                subparagraph (A), a need for assistance is often 
                measured in terms of the capability to engage in 
                activities of daily living, including eating, dressing, 
                bathing, and management of one's financial affairs.
            ``(18) Long-term care facility.--The term `long-term care 
        facility' means a residential care provider that arranges for, 
        or directly provides, long-term care.
            ``(19) Neglect.--The term `neglect' means--
                    ``(A) the failure of a caregiver or fiduciary to 
                provide the goods or services that are necessary to 
                maintain the health or safety of an elder; or
                    ``(B) self-neglect.
            ``(20) Nursing facility.--The term `nursing facility' has 
        the meaning given such term under section 1919(a).
            ``(21) Self-neglect.--The term `self-neglect' means an 
        adult's inability, due to physical or mental impairment or 
        diminished capacity, to perform essential self-care tasks 
        including--
                    (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.
            ``(22) 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 constituting aggravated 
                sexual abuse under section 2241, or sexual abuse under 
                section 2242, of title 18, United States Code, or any 
                similar offense under State law.
            ``(23) Social.--The term `social', when used with respect 
        to a service, includes adult protective services.
            ``(24) State.--The term `State' means any of the several 
        States, the District of Columbia, the Commonwealth of Puerto 
        Rico, and any other possession or territory of the United 
        States.
            ``(25) State long-term care ombudsman.--The term `State 
        Long-Term Care Ombudsman' means the State Long-Term Care 
        Ombudsman described in section 712(a)(2) of the Older Americans 
        Act of 1965 (42 U.S.C. 3058g(a)(2)).
            ``(26) Underserved population.--The term `underserved 
        population' means the population of an area designated by the 
        Secretary as an area with a shortage of elder justice programs 
        or a population group designated by the Secretary as having a 
        shortage of such programs. Such areas or groups designated by 
        the Secretary may include--
                    ``(A) areas or groups that are geographically 
                isolated (such as isolated in a rural area);
                    ``(B) racial and ethnic minority populations; and
                    ``(C) populations underserved because of special 
                needs (such as language barriers, disabilities, alien 
                status, or age).
            ``(27) Vulnerable adult.--The term `vulnerable adult' means 
        an adult, age 18 or older, who needs protections and programs 
        that are the same as or similar to protections and programs for 
        elders, including an adult who, due to a developmental, 
        cognitive, psychological, physical, or other type of 
        disability, may be abused, neglected, or exploited.
    ``(b) Rule.--The Secretary may determine, in an appropriate case, 
that a provision of this title that applies to elders also applies to 
vulnerable adults.

               ``Subtitle A--Federal Elder Justice System

``SEC. 2211. OFFICE OF ELDER JUSTICE OF THE DEPARTMENT OF HEALTH AND 
              HUMAN SERVICES.

    ``(a) Establishment.--There is established within the Department of 
Health and Human Services under the Assistant Secretary for Aging an 
Office of Elder Justice.
    ``(b) Director.--
            ``(1) Appointment.--The President, with the advice and 
        consent of the Senate, shall appoint a Director of the Office 
        of Elder Justice, from among individuals with experience and 
        expertise in elder justice issues, to manage the Office of 
        Elder Justice established under this section.
            ``(2) Duties.--The Director of the Office of Elder Justice 
        shall--
                    ``(A)(i) develop objectives, priorities, policy, 
                and a long-term plan for elder justice programs and 
                activities relating to prevention, detection, training, 
                treatment, evaluation, intervention, research, and 
                improvement of the elder justice system in the United 
                States;
                    ``(ii) implement the overall policy and a strategy 
                to carry out the plan described in clause (i); and
                    ``(iii) hire personnel to assist the director in 
                carrying out the policy, program, and administrative 
                activities related to the duties under clauses (i) and 
                (ii);
                    ``(B) provide advice to the Secretary on elder 
                justice issues; and
                    ``(C) coordinate activities with the Senior Advisor 
                on Elder Justice.
            ``(3) Reporting relationship.--The Director of the Office 
        of Elder Justice shall report to the Assistant Secretary for 
        Aging.
            ``(4) Compensation.--The Director shall be compensated at a 
        rate that shall not exceed the rate established for level I of 
        the Executive Schedule under section 5312 of title 5, United 
        States Code.
    ``(c) Senior Advisor.--
            ``(1) Appointment.--The Secretary shall appoint a Senior 
        Advisor on Elder Justice, from among individuals with 
        experience and expertise in elder justice issues.
            ``(2) Duties.--The Senior Advisor on Elder Justice shall--
                    ``(A) coordinate elder justice activities among all 
                relevant divisions, offices, and components of the 
                Department of Health and Human Services;
                    ``(B) serve as the chairperson of the Intra-Agency 
                Elder Justice Steering Committee established under 
                section 2212; and
                    ``(C) provide advice to the Secretary on elder 
                justice issues.
            ``(3) Location.--The Senior Advisor on Elder Justice shall 
        be located in the Office of the Secretary.
            ``(4) Position.--The position of the Senior Advisor on 
        Elder Justice shall be a Senior Executive Service position, as 
defined in section 3132 of title 5, United States Code.

``SEC. 2212. HEALTH AND HUMAN SERVICES INTRA-AGENCY ELDER JUSTICE 
              STEERING COMMITTEE.

    ``(a) In General.--There is established within the Department of 
Health and Human Services an Intra-Agency Elder Justice Steering 
Committee (in this section referred to as the `steering committee') to 
coordinate the elder justice programs and policy of the Department of 
Health and Human Services.
    ``(b) Membership.--The steering committee shall be composed of 
representatives, appointed by the Secretary, from--
            ``(1) the Administration on Aging;
            ``(2) the National Institute on Aging;
            ``(3) the Centers for Medicare & Medicaid Services;
            ``(4) the Centers for Disease Control and Prevention;
            ``(5) the Agency for Healthcare Research and Quality;
            ``(6) the Administration for Children and Families, 
        including a representative who works in adult protective 
        services;
            ``(7) the Office of the Assistant Secretary for Planning 
        and Evaluation;
            ``(8) the Health Resources and Services Administration;
            ``(9) the Substance Abuse and Mental Health Services 
        Administration;
            ``(10) the Indian Health Service; and
            ``(11) such other offices or divisions within the 
        Department of Health and Human Services as the Secretary 
        determines appropriate.
    ``(c) Duties.--The steering committee shall coordinate elder 
justice matters for the Department of Health and Human Services to 
enhance programs and collaborations and to avoid unnecessary 
duplication of efforts.

``SEC. 2213. ELDER JUSTICE COORDINATING COUNCIL.

    ``(a) Establishment.--There is established a committee to be known 
as the Elder Justice Coordinating Council (in this section referred to 
as the `Council').
    ``(b) Membership.--The Council shall be composed of the following:
            ``(1) The Secretary (or the Secretary's designee).
            ``(2) The Attorney General (or the Attorney General's 
        designee).
            ``(3) A representative, appointed by the head of the 
        Federal department or agency, or other entity, involved from--
                    ``(A) the Department of Housing and Urban 
                Development;
                    ``(B) the Department of Education;
                    ``(C) the Department of Labor;
                    ``(D) the Department of Transportation;
                    ``(E) the Department of the Treasury;
                    ``(F) the Office of Management and Budget;
                    ``(G) the Office of the Surgeon General;
                    ``(H) the Social Security Administration;
                    ``(I) the Food and Drug Administration;
                    ``(J) the Federal Trade Commission;
                    ``(K) the Department of Commerce;
                    ``(L) the Pension Benefit Guaranty Corporation;
                    ``(M) the Securities and Exchange Commission;
                    ``(N) the Commodity Futures Trading Commission;
                    ``(O) the Board of Governors of the Federal Reserve 
                System;
                    ``(P) the Office of the Comptroller of the 
                Currency;
                    ``(Q) the Federal Deposit Insurance Corporation;
                    ``(R) the Federal Bureau of Investigation;
                    ``(S) the Centers for Disease Control and 
                Prevention;
                    ``(T) the Secret Service;
                    ``(U) the National Institute on Aging;
                    ``(V) the Internal Revenue Service; and
                    ``(W) the United States Postal Service.
            ``(4) A representative appointed by the Board of Directors 
        of the Legal Services Corporation from the Legal Services 
        Corporation.
            ``(5) A representative appointed by the President from--
                    ``(A) the State Justice Institute;
                    ``(B) the National Research Council of the National 
                Academy of Sciences; and
                    ``(C) the Institute of Medicine of the National 
                Academy of Sciences.
            ``(6) Representatives from other Federal agencies, 
        appointed by the heads of the Federal agencies with 
        responsibilities or programs relating to elder abuse, neglect, 
        and exploitation as determined appropriate by the Secretary and 
        the Attorney General.
            ``(7) One representative from each State, representing 
        State and local governments, appointed by the President from 
        among persons designated by the Governor of such State due to 
        expertise in, and active work in, the area of elder justice.
            ``(8) The members of the advisory board established under 
        section 2214.
    ``(c) Period of Appointment; Vacancies.--Members shall be appointed 
for terms of 3 years. Any vacancy in the Council shall not affect its 
powers, but shall be filled in the same manner as the original 
appointment was made.
    ``(d) Co-Chairpersons.--The Council shall be co-chaired by the 
Secretary and the Attorney General (or their designees).
    ``(e) Meetings.--
            ``(1) In general.--The Council shall meet at least 2 times 
        per year as determined by the co-chairpersons.
            ``(2) Elder justice summit.--
                    ``(A) In general.--One of the meetings described in 
                paragraph (1) shall be an Elder Justice Summit to 
review the state of elder justice, including--
                            ``(i) a summary presentation directly to 
                        the Secretary and the Attorney General 
                        regarding--
                                    ``(I) the nature and dimension of 
                                the problems of elder abuse, neglect, 
                                and exploitation;
                                    ``(II) Federal, State, local, and 
                                private efforts in elder justice;
                                    ``(III) challenges to be faced in 
                                elder justice;
                                    ``(IV) promising practices in elder 
                                justice; and
                                    ``(V) plans and priorities for the 
                                future in elder justice;
                            ``(ii) additional presentations to address 
                        in greater detail those topics described in 
                        clause (i); and
                            ``(iii) presentations on such other topics 
                        as the Council determines appropriate.
                    ``(B) Participants.--Additional participants, in 
                addition to the members of the Council, to be invited 
                to the Elder Justice Summit shall include--
                            ``(i) experts in the fields of elder abuse, 
                        neglect, and exploitation, selected by the co-
                        chairpersons;
                            ``(ii) the chairman and ranking member of 
                        the Special Committee on Aging of the Senate;
                            ``(iii) designees of the Speaker of the 
                        House of Representatives and the minority 
                        leader of the House of Representatives; and
                            ``(iv) governmental representatives invited 
                        jointly by the co-chairpersons, including--
                                    ``(I) 1 representative from the 
                                Federal Government;
                                    ``(II) 1 representative from a 
                                State government; and
                                    ``(III) 1 representative from a 
                                local government.
                    ``(C) Additional observers.--Additional observers 
                of the Elder Justice Summit may include representatives 
                of Federal, State, and local public and private 
                entities, as well as experts and members of the public 
                designated by the Council to be observers.
            ``(3) Other meetings.--In addition to the meeting described 
        in paragraph (2), the Council shall have at least 1 additional 
        meeting per year in order to--
                    ``(A) conduct an in-depth analysis of the numerous 
                phenomena that make up elder abuse, neglect, and 
                exploitation;
                    ``(B) permit participants to highlight promising 
                practices, exchange information about addressing 
                challenges, and identify needs and priorities; and
                    ``(C) determine a procedure for examining and 
                eliciting national elder justice issues and priorities 
                in order to guide the Council.
    ``(f) Duties.--
            ``(1) In general.--The Council shall make recommendations 
        for the coordination of activities, relating to elder abuse, 
        neglect, and exploitation and other crimes against elders, to 
        the Department of Health and Human Services, the Department of 
        Justice, and other relevant Federal, State, local, and private 
        agencies and entities.
            ``(2) Report.--Not later than 2 years after the date of 
        enactment of the Elder Justice Act and every 2 years 
        thereafter, the Council shall provide to Congress a report 
        that--
                    ``(A) describes the activities of, accomplishments 
                of, and challenges faced by--
                            ``(i) the Council; and
                            ``(ii) the entities represented on the 
                        Council; and
                    ``(B) makes recommendations for legislation, model 
                laws, or other appropriate action.
    ``(g) Powers of the Council.--
            ``(1) Hearings.--The Council may hold such hearings, sit 
        and act at such times and places, take such testimony, and 
        receive such evidence as the Council considers advisable to 
        carry out this section.
            ``(2) Information from federal agencies.--The Council may 
        secure directly from any Federal department or agency such 
        information as the Council considers necessary to carry out 
        this section. Upon request of the co-chairpersons of the 
        Council, the head of such department or agency shall furnish 
        such information to the Council.
            ``(3) Postal services.--The Council may use the United 
        States mails in the same manner and under the same conditions 
        as other departments and agencies of the Federal Government.
    ``(h) Travel Expenses.--The members of the Council, and the 
participants in and observers of the Elder Justice Summit shall not 
receive compensation for the performance of services for the council. 
The members shall be allowed, and the participants may be allowed, 
travel expenses, including per diem in lieu of subsistence, at rates 
authorized for employees of agencies under subchapter I of chapter 57 
of title 5, United States Code, while away from their homes or regular 
places of business in the performance of services for the Council. 
Notwithstanding section 1342 of title 31, United States Code, the 
Secretary and the Attorney General may accept the voluntary and 
uncompensated services of the members and the participants.
    ``(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) Effective Date.--Section 14 of the Federal Advisory Committee 
Act (5 U.S.C. App.) shall not apply to the Council.

``SEC. 2214. 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 a short- and 
long-term multidisciplinary strategic plan for the development of the 
field of elder justice, and to make recommendations to the Secretary, 
the Attorney General, the Elder Justice Coordinating Council 
established under section 2213, and the appropriate committees of 
Congress.
    ``(b) Solicitation of Nominations.--The Secretary and the Attorney 
General shall jointly publish a notice in the Federal Register 
soliciting nominations for the appointment of members of the advisory 
board under subsection (c).
    ``(c) Composition.--The advisory board shall be composed of members 
appointed jointly by the Secretary and the Attorney General, from the 
general public who are individuals with experience and expertise in 
elder abuse, neglect, and exploitation prevention, intervention, 
treatment, law enforcement, or research, with due consideration to 
representation of ethnic or racial minorities and diverse geographic 
areas, including individuals who represent--
            ``(1) social service providers (including State and local 
        agencies with the statutory responsibility for adult protective 
        services);
            ``(2) health care providers (including geriatrics, 
        emergency medicine, and nursing and mental health 
        professionals);
            ``(3) legal professionals (including law enforcement and 
        the judiciary);
            ``(4) gerontologists;
            ``(5) psychologists;
            ``(6) State and local government;
            ``(7) organizations providing services to elders and 
        disabled persons;
            ``(8) volunteer groups;
            ``(9) elder rights advocates;
            ``(10) family groups;
            ``(11) experts in adult fiduciary relationships, and those 
        serving as or monitoring fiduciaries, including guardians; and
            ``(12) individuals in forensics-related positions 
        (including coroners and forensic pathologists).
    ``(d) Vacancies.--Members shall be appointed for terms of 3 years. 
Any vacancy in the advisory board shall not affect its powers, but 
shall be filled in the same manner as the original appointment was 
made.
    ``(e) Election of Officers.--The advisory board shall elect a 
chairperson and vice chairperson from among the members of the advisory 
board. The advisory board shall elect its initial chairperson and vice 
chairperson at its initial meeting.
    ``(f) Duties.--Not later than 18 months after the establishment of 
the advisory board under subsection (a), and annually thereafter, the 
advisory board shall prepare and submit to the Secretary, the Attorney 
General, and the appropriate committees of Congress a report 
containing--
            ``(1) information on the status of Federal, State, and 
        local public and private elder justice activities;
            ``(2) recommendations (including recommended priorities) 
        regarding--
                    ``(A) elder justice programs, research, training, 
                services, practice, enforcement, and coordination;
                    ``(B) coordination between entities pursuing elder 
                justice efforts and those involved in related areas 
                that may inform or overlap with elder justice efforts, 
                such as activities to combat violence against women and 
                child abuse and neglect; and
                    ``(C) activities relating to adult fiduciary 
                systems, including guardianship and other fiduciary 
                arrangements;
            ``(3) recommendations for specific modifications needed in 
        Federal and State laws (including regulations) or for programs, 
        research, and training to enhance prevention, detection, 
        diagnosis, treatment, intervention in, investigation, and 
        prosecution of elder abuse, neglect, and exploitation;
            ``(4) recommendations for the most effective coordinated 
        national data collection with respect to elder justice, and 
        elder abuse, neglect, and exploitation; and
            ``(5) recommendations for a multidisciplinary strategic 
        plan to guide the effective and efficient development of the 
        elder justice area.
    ``(g) Powers of the Advisory Board.--
            ``(1) Hearings.--The advisory board may hold such hearings, 
        sit and act at such times and places, take such testimony, and 
        receive such evidence as the advisory board considers advisable 
        to carry out this section.
            ``(2) Information from federal agencies.--The advisory 
        board may secure directly from any Federal department or agency 
        such information as the advisory board considers necessary to 
        carry out this section. Upon request of the co-chairpersons of 
        the advisory board, the head of such department or agency shall 
        furnish such information to the advisory board.
            ``(3) Sharing of data and reports.--The advisory board may 
        secure from any entity pursuing elder justice activities under 
        the Elder Justice Act or an amendment made by that Act, any 
        data, reports, or recommendations generated in connection with 
        such activities.
            ``(4)  Postal services.--The advisory board may use the 
        United States mails in the same manner and under the same 
        conditions as other departments and agencies of the Federal 
        Government.
    ``(h) Travel Expenses.--The members of the advisory board shall not 
receive compensation for the performance of services for the advisory 
board, but shall be allowed travel expenses, including per diem in lieu 
of subsistence, at rates authorized for employees of agencies under 
subchapter I of chapter 57 of title 5, United States Code, while away 
from their homes or regular places of business in the performance of 
services for the advisory board. Notwithstanding section 1342 of title 
31, United States Code, the Secretary and the Attorney General may  
accept the voluntary and uncompensated services of the members of the 
advisory board.
    ``(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) Effective Date.--Section 14 of the Federal Advisory Committee 
Act (5 U.S.C. App.) shall not apply to the advisory board.

           ``Subtitle B--Activities to Promote Elder Justice

``SEC. 2221. DATA COLLECTION AND DISSEMINATION.

    ``(a) Elder Justice Resource Center.--
            ``(1) Establishment.--The Secretary, after consultation 
        with the Attorney General, shall establish within the Office of 
        Elder Justice (established under this title), an Elder Justice 
        Resource Center (in this section referred to as the `Center') 
        to be the central repository for information regarding elder 
        abuse, neglect, and exploitation.
            ``(2) Duties.--The Center shall--
                    ``(A) develop the capacity and procedures to 
                collect, maintain, and disseminate information relevant 
                to consumers, families, providers, clinicians, 
                advocates, regulators, law enforcement, policymakers, 
                researchers, fiduciaries including guardians, judges, 
                and lawyers, relevant to the prevention, detection, 
                assessment, identification, and treatment of, 
                intervention in, and prosecution of, elder abuse, 
                neglect, and exploitation;
                    ``(B) provide, in a user-friendly manner, 
                information on--
                            ``(i) ways to promote autonomy in the face 
                        of aging or diminishing capacity and mobility;
                            ``(ii) how to avoid becoming a victim of 
                        elder abuse, neglect, or exploitation; and
                            ``(iii) advance planning and how to avoid 
                        the need for a fiduciary;
                    ``(C) provide links and references to other sources 
                of information;
                    ``(D) compile, analyze, and publish a summary of 
                research conducted on elder abuse, neglect, and 
                exploitation and information on how to obtain the 
                original research materials;
                    ``(E) solicit public comment and comment from the 
                advisory board established under section 2214 on the 
                activities of the Center;
                    ``(F) establish a toll-free number for information 
                and referrals;
                    ``(G) coordinate activities with resource centers 
                and clearinghouses on elder justice topics; and
                    ``(H) provide funding to public and private 
                agencies and entities to develop or continue the 
                efforts of specialized elder justice-related 
                clearinghouses and information repositories, to be 
                linked to the Center, that address topics such as those 
                enumerated in subparagraphs (A) and (B) and that 
                provide effective services.
            ``(3) Coordination of available resources.--In establishing 
        the Center under this subsection the Secretary, after 
        consultation with the Attorney General, shall--
                    ``(A) consult with other Federal agencies that 
                operate similar resource centers;
                    ``(B) consult with private entities that operate 
                resource centers or clearinghouses on elder justice 
                related topics;
                    ``(C) consult with the head of each agency 
                participating in the Elder Justice Coordinating Council 
                established under section 2213, as well as other 
                agencies with clearinghouses comparable to the Center, 
                such as clearinghouses relating to child abuse and 
                neglect, to determine the most efficient and effective 
                manner for collecting, maintaining, and disseminating 
                information on elder abuse, neglect, and exploitation; 
                and
                    ``(D) solicit public comment on the components of 
                such Center.
            ``(4) National elder justice library.--
                    ``(A) Establishment.--The Secretary shall establish 
                within the Center, a National Elder Justice Library (in 
                this paragraph referred to as the `Library') to serve 
                as a centralized repository for all types of 
                appropriate materials concerning training, technical 
                assistance, and promising practices relating to elder 
                justice including--
                            ``(i) brochures and pamphlets;
                            ``(ii) video and computer-based resources;
                            ``(iii) books; and
                            ``(iv) training materials.
                    ``(B) Index.--The Library shall create and maintain 
                an up-to-date index of the materials described in 
                subparagraph (A) by title, author, date, subject, and 
                type of material, and a brief description of such 
                materials. Such index shall be available on the 
                Internet as well as in printed form in order to be 
                easily accessible to the general public.
                    ``(C) Availability.--The materials held by the 
                Library shall be available for copying by individuals 
                and entities nationwide and shall be disseminated at a 
                nominal or no fee. The materials shall be copied and 
                disseminated in accordance with the applicable 
                provisions of title 17, United States Code.
                    ``(D) Duties.--
                            ``(i) Additional materials.--The Library 
                        shall--
                                    ``(I) collect data on materials 
                                that would be appropriate for such 
                                library;
                                    ``(II) make efforts to identify and 
                                obtain appropriate materials; and
                                    ``(III) identify and obtain 
                                materials relating to effective methods 
                                of conducting training and providing 
                                technical assistance relating to elder 
                                justice, including conducting 
the training and providing the assistance for underserved populations.
                            ``(ii) Information packets.--After 
                        evaluating the materials described in this 
                        paragraph, the Library shall compile and 
                        develop information packets for use by groups 
                        in various settings including groups who are 
                        underserved or have other special needs. Such 
                        information packets shall include information 
                        and materials on training, technical 
                        assistance, and promising practices targeted at 
                        specific topics, groups, and settings.
    ``(b) Collection of Uniform National Data on Elder Abuse, Neglect, 
and Exploitation.--
            ``(1) Purpose.--The purpose of this subsection is to 
        improve, streamline, and promote uniform collection, 
        maintenance, and dissemination of national data relating to 
        elder abuse, neglect, and exploitation.
            ``(2) Phase i.--
                    ``(A) In general.--Not later than 1 year after the 
                date of enactment of the Elder Justice Act, the 
                Director of the Centers for Disease Control and 
                Prevention (in this subsection referred to as the 
                `Director'), after consultation with the Attorney 
                General and working with experts in relevant 
                disciplines, shall--
                            ``(i) develop a method for collecting 
                        national data regarding elder abuse, neglect, 
                        and exploitation; and
                            ``(ii) develop uniform national data 
                        reporting forms adapted to each relevant entity 
                        or discipline (such as health, public safety, 
                        social and protective services, and law) 
                        reflecting--
                                    ``(I) the distinct manner in which 
                                each discipline receives and maintains 
                                information; and
                                    ``(II) the sequence and history of 
                                reports to or involvement of different 
                                disciplines, independently, or the 
                                sequence and history of reports from 
                                one discipline to another over time.
                    ``(B) Forms.--The national data reporting forms 
                described in subparagraph (A)(ii) shall incorporate the 
                definitions of this title, for use in determining what 
                is considered a reportable event.
            ``(3) Phase ii.--
                    ``(A) In general.--Not later than 1 year after the 
                completion of the activities described in paragraph 
                (2), the Director shall ensure that the national data 
                reporting forms and data collection methods developed 
                in accordance with such paragraph are pilot tested in 6 
                States determined by the Director.
                    ``(B) Adjustments to the form and methods.--The 
                Director, after considering the results of the pilot 
                testing described in subparagraph (A), and after 
                consultation with the Attorney General and relevant 
                experts shall adjust the national data reporting forms 
                and data collection methods as necessary.
            ``(4) Phase iii.--
                    ``(A) Distribution of national data reporting 
                forms.--After completion of the adjustment to the 
                national data reporting forms under paragraph (3)(B), 
                the Director shall submit the national data reporting 
                forms along with instructions to--
                            ``(i) the heads of the relevant components 
                        of the Department of Health and Human Services, 
                        the Department of Justice, and the Department 
                        of the Treasury, and such other Federal 
                        entities as may be appropriate; and
                            ``(ii) the Governor's office of each State 
                        for collection from all relevant State entities 
                        of data, including health care, social 
                        services, and law enforcement data.
                    ``(B) Data collection grants.--
                            ``(i) Authorization.--The Director is 
                        authorized to award grants to States to improve 
                        data collection activities relating to elder 
                        abuse, neglect, and exploitation.
                            ``(ii) Amount.--The amount of funds 
                        provided under each grant awarded to a State 
                        under this subsection shall not exceed 
                        $200,000, to be distributed in accordance with 
                        clause (v).
                            ``(iii) Application.--Each State desiring a 
                        grant under this subparagraph shall submit to 
                        the Director an application at such time, in 
                        such manner, and containing such information as 
                        the Director may require.
                            ``(iv) Requirements.--Each State receiving 
                        a grant under this subparagraph for a fiscal 
                        year is required to report data for the 
                        calendar year that begins during that fiscal 
                        year, using the national data reporting forms 
                        described in subparagraph (A).
                            ``(v) Funding.--
                                    ``(I) First year.--For the first 
                                fiscal year in which a State receives 
                                grant funds under this subsection the 
                                Director shall initially distribute 50 
                                percent of such funds. The Director 
                                shall distribute the remaining funds at 
                                the end of the calendar year that 
                                begins during that fiscal year, if the 
                                Director determines that the State has 
                                properly reported data required under 
                                this subsection for the calendar year.
                                    ``(II) Subsequent years.--Except as 
                                provided in subclause (I), the Director 
                                shall distribute grant funds to a State 
                                under this subsection for a fiscal year 
                                if the Director determines that the 
                                State properly reported data required 
                                under this subsection for the calendar 
                                year that ends during that fiscal year.
                    ``(C) Required information.--Each report submitted 
                under this paragraph shall receive an identifier 
                beginning with a 2-letter State code, and a 2-letter 
                year code, and such numbers as the Director determines 
                to be appropriate. Each individual report shall be 
                assigned a new identifier, even if a victim described 
                in the report is reported to have been victimized more 
                than once. If the State submits a report for more than 
                one discipline, the State shall submit a combined 
                report to avoid double counting. The State shall note 
                in each report whether an event was ongoing or occurred 
                in distinct separate episodes.
            ``(5) Report.--Not later than 1 year after the date of 
        enactment of the Elder Justice Act and annually thereafter, the 
        Director shall prepare and submit to the appropriate committees 
        of Congress, including to the Special Committee on Aging of the 
        Senate, a report regarding activities conducted under this 
        subsection.
            ``(6) Regulations.--The Secretary shall promulgate such 
        regulations as are necessary to carry out this subsection.

``SEC. 2222. ENHANCING RESEARCH AND TRAINING AND STRENGTHENING 
              SERVICES, SYSTEMS, AND PREVENTION.

    ``(a) Grants.--The Secretary may award grants to eligible entities 
for the prevention, detection, assessment, and treatment of, 
intervention in, investigation of, and prosecution of elder abuse, 
neglect, and exploitation including--
            ``(1) physical, psychological, and emotional abuse and 
        neglect by family and other in-home caregivers;
            ``(2) physical, psychological, and emotional abuse and 
        neglect of residents in institutional and other residential 
        care facilities;
            ``(3) elder sexual abuse;
            ``(4) domestic violence in later life;
            ``(5) financial fraud and exploitation; and
            ``(6) self-neglect.
    ``(b) Centers of Excellence.--
            ``(1) Grants authorized.--The Secretary, through the 
        Director of the National Institute on Aging, and after 
        consultation with the Director of the Centers for Disease 
        Control and Prevention, the Director of the Office of Elder 
        Justice in the Department of Health and Human Services, the 
        Director of the Office of Elder Justice in the Department of 
        Justice, and the members of the advisory board established 
        under section 2214, may award grants to institutions of higher 
        education and other appropriate entities to establish 5 Centers 
        of Excellence nationwide that shall specialize in research, 
        clinical practice, and training relating to elder abuse, 
        neglect, and exploitation.
            ``(2) Authorized activities.--The Centers of Excellence 
        established with funds provided under paragraph (1) shall 
        conduct the following activities:
                    ``(A) Examine potential issues relating to the 
                protection of elders who are the subjects of research 
                on elder abuse, neglect, and exploitation and provide 
                guidance to other elder abuse, neglect, or exploitation 
                researchers regarding human subjects, protections, and 
                the institutional or peer review boards at research 
                institutions.
                    ``(B) After consultation with the Director of the 
                National Institute on Aging, and the Director of the 
                Office of Human Research Protections, develop and 
                recommend to the Secretary guidelines to assist the 
                institutional or peer review boards in the review of 
                research under this title.
                    ``(C) Coordinate activities, to the extent 
                feasible, among the Centers and with other researchers 
                of elder abuse, neglect, and exploitation and related 
                areas, and designate 1 such Center to lead such 
                coordination.
            ``(3) Additional activities.--The Centers of Excellence 
        established under paragraph (1) may conduct activities 
        including the following:
                    ``(A) Carrying out a study to determine the 
                national incidence and prevalence of elder abuse, 
                neglect, and exploitation in all settings.
                    ``(B) Developing uniform, validated screening tools 
                to assist individuals, families, practitioners, 
                institutions, and communities in detecting ongoing or 
                potential elder abuse, neglect, and exploitation. The 
                tools that may be developed include--
                            ``(i) a screening tool to determine whether 
                        a particular elder is at risk for becoming, or 
                        is, a victim;
                            ``(ii) a screening tool to measure whether 
                        caregivers are at risk of committing elder 
                        abuse, neglect, or exploitation;
                            ``(iii) a screening tool to measure whether 
                        families are at risk for elder abuse, neglect, 
                        and exploitation; and
                            ``(iv) a screening tool to assess 
                        communities, evaluating how each individual 
                        agency or system relating to elder abuse, 
                        neglect, or exploitation operates in such a 
                        community and how all of such agencies or 
                        systems communicate and operate in relationship 
                        to each other within such community.
                    ``(C) Carrying out various types of intervention 
                research.
                    ``(D) Identifying steps that can be taken (and 
                replicated) to make homes, neighborhoods, communities, 
                and facilities safer for elders, and to enhance their 
                sense of security in all kinds of environments.
                    ``(E) Researching successful fiduciary practices 
                and systems to enhance the well-being of persons with 
                diminished capacity.
            ``(4) Collaboration and access to records.--In awarding a 
        grant under this subsection the Secretary shall--
                    ``(A) consider the potential for collaboration 
                among researchers and other relevant entities, such as 
                State agencies with statutory responsibility for adult 
                protective services and State Long-Term Care Ombudsmen, 
                that receive reports of elder abuse, neglect, and 
                exploitation, but that may be restricted from 
                participating in research as a result of State law, 
                confidentiality requirements, or other provisions; and
                    ``(B) require that each institution of higher 
                education desiring a grant under this subsection ensure 
                that the researchers working at such institution will 
                have access to records necessary to conduct research in 
                accordance with this subsection.
            ``(5) Excellence advisory committee.--
                    ``(A) Committee established.--There is established 
                in the Department of Health and Human Services an 
                Excellence Advisory Committee (in this subsection 
                referred to as the `Committee').
                    ``(B) Membership.--The Committee shall be composed 
                of individuals appointed by the Secretary with a 
                demonstrated interest and expertise in research, 
                education, and clinical activities related to elder 
                abuse, neglect, and exploitation, or individuals with 
                related experience in essential fields such as 
                epidemiology or forensic pathology, including--
                            ``(i) representatives from private 
                        entities; and
                            ``(ii) representatives from Federal and 
                        State agencies, including--
                                    ``(I) researchers;
                                    ``(II) health care practitioners;
                                    ``(III) policy experts; and
                                    ``(IV) other individuals 
                                appropriate to promote useful research, 
                                training, and clinical practice.
                    ``(C) Period of appointment; vacancies.--Members 
                shall be appointed for terms of 3 years. Any vacancy in 
                the Committee shall not affect its powers, but shall be 
                filled in the same manner as the original appointment 
                was made.
                    ``(D) Duties.--The Committee shall coordinate with 
                the Advisory Board established under section 2214 and 
                shall make recommendations to the Secretary, the 
                Attorney General, the Elder Justice Coordinating 
Council established under section 2213, and the Centers of Excellence 
established under this subsection concerning--
                            ``(i) facilitating the coordination of the 
                        activities of the Centers of Excellence 
                        established under this subsection;
                            ``(ii) developing procedures and mechanisms 
                        for data sharing between such Centers of 
                        Excellence; and
                            ``(iii) ensuring that such Centers of 
                        Excellence have similar systems and research 
                        and reporting procedures in order to facilitate 
                        the sharing of data.
                    ``(E) Travel expenses.--The members of the 
                Committee shall not receive compensation for the 
                performance of services for the committee, but shall be 
                allowed travel expenses, including per diem in lieu of 
                subsistence, at rates authorized for employees of 
                agencies under subchapter I of chapter 57 of title 5, 
                United States Code, while away from their homes or 
                regular places of business in the performance of 
                services for the Committee. Notwithstanding section 
                1342 of title 31, United States Code, the Secretary may 
                accept the voluntary and uncompensated services of 
                members of the Committee.
                    ``(F) Detail of government employees.--Any Federal 
                Government employee may be detailed to the Committee 
                without reimbursement, and such detail shall be without 
                interruption or loss of civil service status or 
                privilege.
                    ``(G) Termination.--Section 14 of the Federal 
                Advisory Committee Act (5 U.S.C. App.) shall not apply 
                to the Committee.
    ``(c) Safe Haven and Legal Advocacy Grants.--
            ``(1) Safe haven grants.--
                    ``(A) Grants authorized.--The Secretary may award 
                grants to 6 diverse communities to examine various 
                types of elder shelters (in this paragraph referred to 
                as `safe havens') and to test various models for 
                establishing safe havens at home or elsewhere.
                    ``(B) Authorized activities.--Grant funds awarded 
                pursuant to subparagraph (A) shall be used to establish 
                safe havens that--
                            ``(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 elder safer at home or to 
                                find appropriate placement in safer 
                                environments, including shelters, and, 
                                in some circumstances long-term care 
                                facilities, other residential care 
                                facilities, and hospitals.
            ``(2) Legal advocacy grants.--
                    ``(A) Grants authorized.--The Secretary, after 
                consultation with the Attorney General, may award 
                grants--
                            ``(i) to study the need for community 
                        resources in order to provide assistance for 
                        legal and related services for victims of elder 
                        abuse, neglect, or exploitation; and
                            ``(ii) to provide assistance for such 
                        services by awarding grants for demonstration 
                        projects in diverse communities.
                    ``(B) Authorized activities.--Grant funds awarded 
                pursuant to subparagraph (A) shall be used to provide--
                            ``(i) court-appointed advocates;
                            ``(ii) authorized fiduciaries, including 
                        public guardians;
                            ``(iii) monitoring and oversight of 
                        fiduciaries;
                            ``(iv) legal services; and
                            ``(v) such other services as the Secretary, 
                        after consultation with the Attorney General, 
                        determines appropriate.
    ``(d) Grants To Enhance Volunteer Services.--The Secretary, after 
consultation with the Attorney General, may award grants to nonprofit 
organizations and faith-based organizations to encourage such 
organizations to establish or continue volunteer programs that focus on 
the issues of elder abuse, neglect, and exploitation, or that provide 
related services.
    ``(e) Multidisciplinary Efforts.--
            ``(1) Grants.--The Secretary may award grants to fund 
        various multidisciplinary elder justice activities, including 
        the following:
                    ``(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 State coordinating councils 
                modeled after the national Elder Justice Coordinating 
                Council established under section 2213. Such State 
                coordinating councils shall identify the individual 
                States' needs and provide the national Elder Justice 
                Coordinating Council with information and 
                recommendations relating to State efforts to combat 
                elder abuse, neglect, and exploitation.
                    ``(C) Providing training, technical assistance, and 
                other methods of support to groups carrying out 
multidisciplinary efforts at the State level (referred to in some 
States as `State Working Groups').
                    ``(D) Broadening and studying various models for 
                elder fatality and serious injury review teams, to make 
                recommendations about their composition, protocols, 
                functions, timing, roles, and responsibilities, with a 
                goal of producing models and information that will 
                allow for replication based on the needs of other 
                States and communities.
                    ``(E) Carrying out other interdisciplinary or 
                multidisciplinary efforts as determined by the 
                Secretary to be appropriate.
            ``(2) Intradisciplinary review.--
                    ``(A) In general.--The Director of the Centers for 
                Disease Control and Prevention, after consultation with 
                the Director of the Office of Elder Justice in the 
                Department of Health and Human Services and the 
                Director of the Office of Elder Justice in the 
                Department of Justice, shall conduct an intensive 
                intradisciplinary review of entities that conduct elder 
                justice activities in several different communities, 
                examining how the entities address elder abuse, 
                neglect, and exploitation issues (such as an assessment 
                of various types of health care and social service 
                providers, public safety agencies, law enforcement 
                agencies, prosecutor offices, and the judiciary).
                    ``(B) Goal.--The goals of the study described in 
                subparagraph (A) include--
                            ``(i) making an assessment of the 
                        functioning and effectiveness of each entity in 
                        a community that conducts elder justice 
                        activities, and the interdisciplinary 
                        communications and collaborations among such 
                        entities; and
                            ``(ii) developing a procedure for 
                        communities to conduct a self-assessment to 
                        assist them in identifying the manner in which 
                        the entities described in clause (i) in such 
                        communities respond to elder justice issues, 
                        the needs of such communities relating to elder 
                        justice issues, and ways to improve the 
                        response systems of such communities for elder 
                        abuse, neglect, and exploitation.
    ``(f) Training Grants.--
            ``(1) Grants authorized.--The Secretary may award grants to 
        groups representing the targeted disciplines described in 
        paragraph (2)(B) to train individuals with respect to issues of 
        elder abuse, neglect, and exploitation.
            ``(2) Authorized activities.--
                    ``(A) In general.--Grant funds awarded under 
                paragraph (1) shall be used for training within a 
                discipline as well as cross-training activities that 
                permit individuals in multiple disciplines to train 
                together, fostering communication, coordinating 
                efforts, and ensuring collaboration.
                    ``(B) Targeted disciplines.--Groups representing 
                disciplines that will be targeted for training through 
                grants awarded under paragraph (1) include--
                            ``(i) physicians (geriatricians, family 
                        physicians, internists, emergency physicians, 
                        forensic pathologists and medical examiners, 
                        psychiatrists, and other specialists), and 
                        medical residents, interns, and fellows;
                            ``(ii) nurses and nurse's aides, including 
                        geriatric nurse practitioners, directors of 
                        nursing, and Sexual Abuse Nurse Examiners 
                        (SANE) nurses;
                            ``(iii) social workers;
                            ``(iv) public health and safety 
                        professionals including Emergency Medical 
                        Services professionals;
                            ``(v) therapists, including creative arts, 
                        occupational, speech, and physical therapists;
                            ``(vi) State surveyors (who survey nursing 
                        facilities and other long-term care 
                        facilities);
                            ``(vii) long-term care facility and 
                        hospital staff;
                            ``(viii) coroners and funeral home 
                        operators;
                            ``(ix) Federal, State, and local offices 
                        with responsibility for elder justice or long-
                        term care matters;
                            ``(x) employees or contractors of State and 
                        local agencies with responsibility for training 
                        persons who provide adult protective services;
                            ``(xi) State Long-Term Care Ombudsmen;
                            ``(xii) victim advocates and advocates for 
                        elders and individuals with disabilities;
                            ``(xiii) individuals involved in volunteer 
                        organizations (including faith-based 
                        organizations) who are involved in issues of 
                        elder abuse, neglect, and exploitation;
                            ``(xiv) police officers, sheriffs, 
                        detectives, firefighters, Federal and State 
                        investigators, public safety officers, and 
                        corrections personnel;
                            ``(xv) Federal, State, and local 
                        prosecutors, attorneys in private practice 
                        involved in elder justice issues, and judges 
                        and court employees;
                            ``(xvi) TRIADs (federally recognized 
                        partnerships of elders, sheriff departments, 
                        and the American Association of Retired 
                        Persons);
                            ``(xvii) elder service officers;
                            ``(xviii) individuals who work with the 
                        public, including bank personnel, postal 
                        workers, utility workers, providers of home-
                        delivered meals, and others who may work with 
                        elders;
                            ``(xix) students in professional and 
                        paraprofessional schools, internships, 
                        fellowships, and other training programs in a 
                        relevant profession;
                            ``(xx) fiduciaries, including guardians, 
                        conservators, and agents under powers of 
                        attorney; and
                            ``(xxi) staff and volunteers of domestic 
                        violence and child abuse and neglect programs.
    ``(g) Pilot Project To Evaluate Utility of Services to Elders in 
Need.--The Secretary, acting through the Director of the Office of 
Elder Justice in the Department of Health and Human Services, and after 
consultation with the Director of the Office of Elder Justice in the 
Department of Justice, is authorized to award grants to develop and 
implement pilot projects designed to ameliorate gaps in basic elder 
justice-related health, social, or protective services, with the goal 
of identifying what types of services are most useful to elders in 
need, and in what contexts the services are useful.
    ``(h) Increasing the Number of Health Care Professionals With 
Geriatric Training.--The Secretary shall establish programs to 
increase--
            ``(1) the number of health care professionals (including 
        physicians, nurses, nursing personnel, social workers, and 
        therapists) and students in the health care professions, who 
        receive education and training related to geriatrics; and
            ``(2) the number of such professionals who provide health 
        care related to geriatrics.
    ``(i) Special Needs Grants.--
            ``(1) Grants authorized.--The Secretary may award grants to 
        eligible entities to identify, address, and make 
        recommendations on meeting the special needs of underserved 
        populations of elders.
            ``(2) Populations included.--The grant funds awarded 
        pursuant to paragraph (1) shall be used to fund programs 
        including the following:
                    ``(A) Rural settings.--Programs designed to meet 
                the needs of elders living in rural locations, 
                including the needs of their informal caregivers and 
                fiduciaries. The programs shall include--
                            ``(i) strategies to decrease isolation;
                            ``(ii) training for informal caregivers and 
                        fiduciaries;
                            ``(iii) activities involving collaboration 
                        between the entities and local secondary 
                        schools and institutions of higher education to 
                        offer classes for credit, focusing on training 
                        individuals to work with elders and caregivers;
                            ``(iv) training for volunteers to serve in 
                        rural communities; and
                            ``(v) strategies on the use of advance 
                        planning to avoid the need for a guardian or 
                        other fiduciary.
                    ``(B) Minority populations.--Programs designed to 
                meet the needs of elders in minority populations, 
                including culturally and linguistically appropriate 
                programs.
                    ``(C) Indian tribes.--Programs designed to provide 
                necessary services to elders who are members of Indian 
                tribes including successful programs in elder abuse, 
                neglect, and exploitation prevention and treatment that 
                target Indian populations. The entities carrying out 
                the programs shall deliver services and distribute 
                educational information on elder abuse, neglect, and 
                exploitation to Indian tribes and other policymakers, 
                health and social service providers, law enforcement, 
                and researchers with a particular interest in elders 
                who are members of Indian tribes.
    ``(j) Public Awareness Grants.--
            ``(1) Grants authorized.--The Secretary and the Attorney 
        General, after consultation with the advisory board established 
        under section 2214 and the coordinating council established 
        under section 2213, shall jointly award 1 grant to a national 
        organization, or 1 or more grants to eligible entities, to 
        conduct a national multimedia campaign designed to raise 
        awareness about elder abuse, neglect, and exploitation.
            ``(2) Authorized activities.--Grant funds awarded under 
        paragraph (1) shall be used for activities including the 
        following:
                    ``(A) Raising public awareness regarding financial 
                schemes that target elders.
                    ``(B) Pilot testing of the effectiveness of various 
                types of multimedia campaigns in raising awareness 
                about--
                            ``(i) the types of elder abuse, neglect, 
                        and exploitation;
                            ``(ii) steps to take if an individual 
                        suspects elder abuse, neglect, or exploitation 
                        has occurred; and
                            ``(iii) ways to prevent elder abuse, 
                        neglect, or exploitation.
    ``(k) Elder Justice Innovation Fund.--The Secretary and the 
Attorney General are authorized to jointly award grants to individuals 
or entities working in the elder justice field or related fields for 
research, a demonstration project, development or implementation of a 
promising program or practice, or another innovative effort, that might 
not otherwise be funded or pursued in the absence of a grant under this 
subsection.

``SEC. 2223. STUDIES.

    ``(a) Roles of Entities Responding to Elder Abuse, Neglect, and 
Exploitation.--
            ``(1) In general.--The Secretary of Health and Human 
        Services and the Attorney General shall jointly sponsor or 
        conduct a study of the roles and responsibilities of government 
        and government-funded entities responsible for responding to, 
        investigating, and taking other actions in response to reports 
        of elder abuse, neglect, and exploitation including--
                    ``(A) State and local agencies with the 
                responsibility for adult protective services;
                    ``(B) the State Long-Term Care Ombudsmen;
                    ``(C) law enforcement (including prosecutors);
                    ``(D) fiduciaries;
                    ``(E) judges and other court personnel; and
                    ``(F) such other social and protective service, 
                advocacy, and protection organizations as the Secretary 
                and the Attorney General determine to be appropriate.
            ``(2) Goals.--The goals of the study authorized in 
        paragraph (1) (which may be conducted in distinct sections, if 
        there is overall coordination) are--
                    ``(A) to identify gaps in detection of, 
                investigation of, and intervention in elder abuse, 
                neglect, and exploitation;
                    ``(B) to improve the response to elder abuse, 
                neglect, and exploitation; and
                    ``(C) to reduce elder victimization and its 
                consequences by assessing and improving the systems 
                created to address reports of the problems.
            ``(3) Authorized activities.--In conducting the study 
        authorized in paragraph (1), the Director shall--
                    ``(A) conduct an evaluation of--
                            ``(i) how the social and protective 
                        service, advocacy, protection, judicial, and 
                        law enforcement entities and systems are 
                        operating;
                            ``(ii) the interplay and allocation of 
                        responsibilities among those entities;
                            ``(iii) how that allocation differs from 
                        community to community and State to State; and
                            ``(iv) how those differences impact the 
                        population intended to be protected by the 
                        entities and systems;
                    ``(B) make recommendations on how to clarify the 
                roles (at the national level) of entities such as State 
                agencies with responsibility for adult protective 
                services, the State Long-Term Care Ombudsmen, and other 
                protection and advocacy entities to enhance efficiency, 
                eliminate gaps in service, and identify conflicting 
                mandates and duplication of efforts; and
                    ``(C) evaluate how various communities delineate 
                the roles and responsibilities of the types of entities 
                described in subparagraph (A) in order to identify and 
                recommend effective models and methods to duplicate the 
                delineation efforts (such as duplication through 
                memoranda of understanding).
    ``(b) Family Elder Abuse, Neglect, and Exploitation Study.--
            ``(1) In general.--The Director of the Centers for Disease 
        Control and Prevention (in this subsection referred to as the 
        `Director'), after consultation with the Director of the Office 
        of Elder Justice in the Department of Health and Human Services 
        and the Director of the Office of Elder Justice in the 
        Department of Justice, shall conduct a study to determine the 
        best method to address elder abuse, neglect, and exploitation 
        from a public health perspective, including examining methods 
        to reduce elder abuse, neglect, and exploitation committed by 
        family members.
            ``(2) Collaboration.--The Director, in carrying out 
        activities under this subsection, shall collaborate with the 
        Director of the National Institute on Aging, the Director of 
        the Office of Elder Justice in the Department of Health and 
        Human Services, the Director of the Office of Elder Justice in 
        the Department of Justice, the heads of State agencies with 
        responsibility for adult protective services, and the heads of 
        such other entities as the Director determines appropriate.

``SEC. 2224. FORENSIC MARKERS, METHODOLOGIES, AND TRAINING.

    ``(a) Forensic Centers.--
            ``(1) Grants.--The Secretary shall make grants to 
        appropriate entities to establish and operate stationary and 
        mobile forensic centers, to develop forensic expertise 
        regarding, and provide services relating to, elder abuse, 
        neglect, and exploitation.
            ``(2) Coordination among forensic centers and centers of 
        excellence.--The entities establishing and operating the 
        forensic centers shall coordinate activities on an ongoing 
        basis with the Centers of Excellence described in section 
        2222(b)(1) and with the Excellence Advisory Committee described 
        in section 2222(b)(5). Such coordination shall include ongoing 
        communication among the entities, the Centers of Excellence, 
        and the Excellence Advisory Committee. The entities shall 
        adhere to the procedures and mechanisms developed by the 
        Excellence Advisory Committee including procedures and 
        mechanisms relating to the sharing of data.
            ``(3) Stationary forensic centers.--The Secretary shall 
        make 4 of the grants described in paragraph (1) to institutions 
        of higher education with demonstrated expertise in forensics or 
        commitment to preventing or treating elder abuse, neglect, or 
        exploitation, to establish and operate stationary forensic 
        centers. The Secretary shall make at least 2 of the 4 grants to 
        an entity operating a Center of Excellence described in section 
        2222(b)(1) at an institution of higher education.
            ``(4) Mobile centers.--The Secretary shall make 6 of the 
        grants described in paragraph (1) to appropriate entities to 
        establish and operate mobile forensic centers.
            ``(5) Use of funds.--
                    ``(A) Development of forensic markers and 
                methodologies.--An entity that receives a grant under 
                this subsection shall use funds made available through 
                the grant to assist in the determination of whether 
                abuse or neglect occurred, a crime was committed, to 
                conduct research to describe and disseminate 
                information on--
                            ``(i) forensic markers that indicate a case 
                        in which elder abuse, neglect, or exploitation 
                        may have occurred; and
                            ``(ii) methodologies for determining, in 
                        such a case, when and how health care, 
                        emergency service, social and protective 
                        service, and legal service providers should 
                        intervene and when the providers should report 
                        the case to law enforcement authorities.
                    ``(B) Applications.--An entity that receives a 
                grant under this subsection shall use funds made 
                available through the grant to develop forensic 
                expertise regarding elder abuse, neglect, and 
                exploitation, in order to provide medical and forensic 
                evaluation, therapeutic intervention, victim support 
                and advocacy, case review, and case tracking.
                    ``(C) Collection of evidence.--An entity operating 
                a Center of Excellence described in section 2222(b)(1) 
                that receives a grant under this subsection shall use 
                funds made available through the grant to develop the 
                capacity to collect forensic evidence, including 
                collecting forensic evidence relating to a potential  
determination of elder abuse, neglect, or exploitation.
    ``(b) Training To Develop Expertise in Geriatric Forensics.--
            ``(1) Fellowship programs.--
                    ``(A) In general.--The Secretary shall provide 
                fellowships to eligible individuals, to enable the 
                individuals to obtain training through a standard 
                forensic science training program.
                    ``(B) Eligible individuals.--To be eligible to 
                receive a fellowship under this paragraph, an 
                individual shall be a physician who--
                            ``(i) is board certified or board eligible 
                        in internal medicine or family practice;
                            ``(ii) has completed a program in 
                        geriatrics that meets such criteria as the 
                        Secretary may prescribe; and
                            ``(iii) has entered into an agreement with 
                        the Secretary to provide the team training 
                        described in subparagraph (C), after receiving 
                        the training described in subparagraph (A).
                    ``(C) Team training.--An individual who receives a 
                fellowship under this paragraph shall provide training 
                in forensic geriatrics to interdisciplinary teams of 
                health care professionals.
            ``(2) Other programs.--The Secretary shall establish 
        programs, and make grants to carry out the programs, to provide 
        forensic training to experienced geriatricians.

 ``Subtitle C--Increasing Security, Quality, and Consumer Information 
                           for Long-Term Care

          ``CHAPTER 1--INCREASING SECURITY FOR LONG-TERM CARE

``SEC. 2231. REPORTING TO LAW ENFORCEMENT OF CRIMES OCCURRING IN 
              FEDERALLY FUNDED LONG-TERM CARE FACILITIES.

    ``(a) Determination and Notification.--
            ``(1) Determination.--Except as provided in paragraph (2), 
        the owner or operator of each long-term care facility that 
        receives Federal funds shall annually determine if the facility 
        received an amount of Federal funds that was not less than 
        $10,000 during the past year.
            ``(2) Single positive determination.--The owner or operator 
        shall make the determination for a year unless the owner or 
        operator determined that the facility received that amount 
        during any previous year.
            ``(3) Notification.--If the owner or operator determines 
        that the facility received that amount during any year, the 
        owner or operator shall annually notify each individual 
        described in subsection (b) of the obligation to comply with 
        subsection (b).
    ``(b) Reporting Requirement.--
            ``(1) In general.--Each individual who is an owner, 
        operator, employee, manager, agent, or contractor of a long-
        term care facility that is the subject of a determination 
        described in subsection (a)(3) shall report to 1 or more law 
        enforcement entities for the jurisdiction in which the facility 
        is located, any reasonable suspicion of a crime (as defined by 
        the law of the applicable political subdivision) against any 
        person who is a resident of or receiving care from the 
        facility.
            ``(2) Timing.--If the events that cause the suspicion--
                    ``(A) result in serious bodily injury, the 
                individual shall report the suspicion immediately, but 
                not later than 2 hours after forming the suspicion; and
                    ``(B) do not result in serious bodily injury, the 
                individual shall report the suspicion not later than 24 
                hours after forming the suspicion.
    ``(c) Penalty.--
            ``(1) In general.--If an individual described in subsection 
        (b) violates subsection (b)--
                    ``(A) the individual shall be fined not more than 
                $200,000 or subject to a civil money penalty of not 
                more than $200,000; or
                    ``(B) the Secretary shall classify the individual 
                as an excluded individual, for a period of not more 
                than 3 years.
            ``(2) Increased harm.--If an individual described in 
        subsection (b) violates subsection (b), and the violation 
        exacerbates the harm to the victim of the crime or results in 
        harm to another person--
                    ``(A) the individual shall be fined not more than 
                $200,000 or subject to a civil money penalty of not 
                more than $200,000; and
                    ``(B) the Secretary shall classify the individual 
                as an excluded individual, for a period of not more 
                than 3 years.
            ``(3) Excluded individual.--During any period for which an 
        individual is classified as an excluded individual under this 
        paragraph, an entity that employs the individual shall be 
        ineligible to receive funds under the medicare program under 
        title XVIII or the medicaid program under title XIX.
            ``(4) Extenuating circumstances.--The Secretary may take 
        into account the financial burden on providers with underserved 
        populations in determining the penalty.
    ``(d) Regulations.--The Secretary, after consulting with the 
Attorney General, shall issue regulations to carry out this section.

          ``CHAPTER 2--IMPROVING THE QUALITY OF LONG-TERM CARE

``SEC. 2241. GRANTS AND INCENTIVES TO ENHANCE LONG-TERM CARE STAFFING.

    ``(a) General Authority.--The Administrator of the Centers for 
Medicare & Medicaid Services (in this section referred to as the 
`Administrator') shall carry out activities, including activities 
described in subsection (b) and (c), to provide incentives for 
individuals to train for, seek, and maintain employment providing 
direct care in a long-term care facility.
    ``(b) Specific Programs To Enhance Training, Recruitment, and 
Retention of Staff.--
            ``(1) Coordination with other programs to recruit and train 
        long-term care staff.--The Administrator shall coordinate 
        activities with the Secretary of Labor and the Assistant 
        Secretary for the Administration for Children and Families, in 
        order to provide incentives to participants in programs carried 
        out under section 403(a)(5) and part A of title IV to train for 
        and seek employment providing direct care in a long-term care 
        facility.
            ``(2) Career ladders and wage or benefit increases to 
        increase staffing in long-term care facilities.--
                    ``(A) In general.--The Administrator shall make 
                grants to eligible entities to carry out programs 
                through which the entities--
                            ``(i) offer, to employees who provide 
                        direct care in a long-term care facility, 
                        continuing training and varying levels of 
                        certification, based on observed clinical care 
                        practices and the amount of time the employees 
                        spend providing direct care; and
                            ``(ii) provide, or make arrangements with 
                        employers to provide, bonuses or other 
                        increased compensation or benefits to employees 
                        who achieve certification under such a program.
                    ``(B) Application.--To be eligible to receive a 
                grant under this paragraph, an entity shall submit an 
                application to the Administrator at such time, in such 
                manner, and containing such information as the 
                Administrator may require.
    ``(c) Specific Programs To Improve Management Practices.--
            ``(1) In general.--The Administrator shall make grants to 
        eligible organizations to enable the organizations to provide 
        training and technical assistance to eligible persons 
        (including administrators, directors of nursing, staff 
        developers, and charge nurses) who establish or implement 
        management practices for long-term care facilities.
            ``(2) Use of funds.--An organization that receives a grant 
        under paragraph (1) shall use funds made available through the 
        grant--
                    ``(A) to provide training and technical assistance 
                regarding management practices, that are for employees 
                that provide direct care in a long-term care facility, 
                and that are demonstrated to promote retention of those 
                employees, such as--
                            ``(i) the establishment of basic human 
                        resource policies that reward high performance, 
                        including policies that provide for improved 
                        wages and benefits on the basis of job reviews;
                            ``(ii) the establishment of motivational 
                        and thoughtful work organization practices;
                            ``(iii) the creation of a workplace culture 
                        that respects and values caregivers and their 
                        needs;
                            ``(iv) the promotion of a workplace culture 
                        that respects the rights of residents of a 
                        long-term care facility and results in improved 
                        care for the residents; and
                            ``(v) the establishment of other programs 
                        that promote the provision of high quality 
                        care, such as a continuing education program 
                        that provides additional hours of training, 
                        including on-the-job training, for employees 
                        who are certified nurse aides; or
                    ``(B) to disseminate training materials for the 
                training described in subparagraph (A), and to provide 
                the materials to the National Elder Justice Library 
                established in section 2221(a)(4), so that the 
                materials are available to other providers of such 
                training.
            ``(3) Application.--To be eligible to receive a grant under 
        this subsection, an organization shall submit an application to 
        the Administrator at such time, in such manner, and containing 
        such information as the Administrator may require.
    ``(d) Evaluating Programs.--After the first programs developed 
under this section have been completed, the Administrator shall 
evaluate the outcomes of such programs in determining which future 
applications to fund.
    ``(e) Accountability Measures.--The Administrator shall develop 
accountability measures to assure that funds made available under this 
section benefit the staff who are the intended beneficiaries of the 
programs provided under this section, to promote increases and 
stability in the long-term care workforce.
    ``(f) Compliance With Applicable Laws.--In order to receive funds 
under this section, an eligible entity shall comply with all applicable 
laws, regulations, and guidelines.

``SEC. 2242. COLLABORATIVE EFFORTS TO ENHANCE COMMUNICATION ON 
              PROMOTING QUALITY OF AND PREVENTING ABUSE AND NEGLECT IN 
              LONG-TERM CARE.

    ``(a) In General.--The Director of the Agency for Healthcare 
Research and Quality (in this section referred to as the `Director'), 
after consultation with the Attorney General, may establish pilot 
projects to improve long-term care. In carrying out the projects, the 
Director shall make grants to eligible partnerships to develop 
collaborative and innovative approaches to improve the quality of, 
including preventing abuse and neglect in, long-term care.
    ``(b) Eligible Partnerships.--To be eligible to receive a grant 
under this section, a partnership shall be a multidisciplinary 
community partnership, such as a partnership consisting of 
representatives in a community of nursing facility providers, advocates 
for residents of long-term care facilities, State Long-Term Care 
Ombudsmen, surveyors, the State agency with responsibility for adult 
protective services, the State agency with responsibility for licensing 
long-term care facilities, law enforcement agencies, courts, family 
councils, residents, certified nurse aides, registered nurses, 
physicians, and other appropriate entities and individuals.
    ``(c) Application.--To be eligible to receive a grant under this 
section, a partnership shall submit an application to the Director at 
such time, in such manner, and containing such information as the 
Director may require.

``SEC. 2243. COLLABORATIVE EFFORTS TO DEVELOP CONSENSUS AROUND THE 
              MANAGEMENT OF CERTAIN QUALITY-RELATED FACTORS.

    ``(a) In General.--The Director of the Agency for Healthcare 
Research and Quality (in this section referred to as the `Director'), 
after consultation with the Attorney General and the Advisory Board 
established under section 2214, may make grants to eligible entities to 
establish multidisciplinary panels to address, and develop consensus 
on, subjects relating to improving the quality of long-term care. The 
Director shall make a limited number of such grants, including at least 
1 grant for the establishment of such a panel to address, and develop 
consensus on, methods of managing resident-to-resident abuse in long-
term care.
    ``(b) Use of Funds.--An entity that receives a grant under this 
section shall--
            ``(1) establish a multidisciplinary panel to address a 
        specific subject; and
            ``(2) ensure that the panel uses the funds made available 
        through the grant to establish a goal with respect to the 
        subject, examine relevant research and data, identify best 
        practices with respect to the subject, determine the best way 
        to carry out those best practices in a practical and feasible 
        manner, and determine an effective manner of distributing 
        information on the subject.
    ``(c) Application.--To be eligible to receive a grant under this 
section, an entity shall submit an application to the Director at such 
time, in such manner, and containing such information as the Director 
may require.

   ``CHAPTER 3--INCREASING CONSUMER INFORMATION ABOUT LONG-TERM CARE

``SEC. 2251. LONG-TERM CARE CONSUMER CLEARINGHOUSE.

    ``(a) In General.--The Director of the Office of Elder Justice in 
the Department of Health and Human Services, in coordination with the 
Director of the Agency for Healthcare Research and Quality and the 
Administrator of the Centers for Medicare & Medicaid Services, shall 
establish a long-term care consumer clearinghouse in the Department of 
Health and Human Services.
    ``(b) Information.--The clearinghouse shall be established as part 
of the Elder Justice Resource Center (established under section 2221) 
and shall provide comprehensive detailed information, in a consumer-
friendly form, to consumers about choices relating to long-term care 
providers, such as information (including links to websites and other 
resources that provide information) about--
            ``(1) obtaining the services of, and employing, caregivers 
        who provide long-term care at an individual's home; and
            ``(2) options for residential long-term care, such as--
                    ``(A)(i) the type of care provided by nursing 
                facilities; and
                    ``(ii) the type of care provided by group homes and 
                other residential long-term care facilities that are 
                not nursing facilities;
                    ``(B) the benefits available through the programs 
                carried out under titles XVIII and XIX of the Social 
                Security Act (42 U.S.C. 1395 et seq. and 1396 et seq.); 
                and
                    ``(C) the care available through specific long-term 
                care facilities, including data on the satisfaction 
                level of residents of, and families of residents of, 
                the facilities.
    ``(c) Providers.--In providing information on long-term care 
providers under this section, the clearinghouse shall provide 
information (from States and other sources) on assisted living 
facilities, board and care facilities, congregate care facilities, home 
health care providers, and other long-term care providers.

``SEC. 2252. CONSUMER INFORMATION ABOUT THE CONTINUUM OF RESIDENTIAL 
              LONG-TERM CARE FACILITIES.

    ``(a) Study.--
            ``(1) In general.--The Director of the Agency for 
        Healthcare Research and Quality, after consultation with the 
        Director of the Office of Elder Justice in the Department of 
        Health and Human Services and the Director of the Office of 
        Elder Justice in the Department of Justice shall, directly or 
        through a grant, conduct a study on consumer concerns relating 
        to residential long-term care facilities, other than nursing 
        facilities.
            ``(2) Specific topics.--The entity conducting the study 
        shall--
                    ``(A) develop definitions for classes of the 
                residential long-term care facilities described in 
                paragraph (1); and
                    ``(B) collect information on the prices of, level 
                of services provided by, oversight and enforcement 
                provisions of, and admission and discharge criteria of, 
                the facilities.
    ``(b) Report.--The Director of the Agency for Healthcare Research 
and Quality shall prepare a report containing the results of the study, 
and submit the report to the Elder Justice Coordinating Council 
established under section 2213, the Committee on Ways and Means of the 
House of Representatives, and the Special Committee on Aging of the 
Senate.

                      ``Subtitle D--Administration

``SEC. 2261. EVALUATIONS.

    ``(a) Grants.--
            ``(1) In general.--In making a grant under a provision of 
        this title (other than this section), the granting authority 
        shall--
                    ``(A) require the recipient of the grant to--
                            ``(i) reserve a portion of the funds made 
                        available through the grant; and
                            ``(ii) use the reserved funds to conduct an 
                        evaluation of the other activities carried out 
                        through the grant; or
                    ``(B)(i) reserve a portion of the funds available 
                for the grant; and
                    ``(ii) use the reserved funds to provide assistance 
                to an eligible entity to conduct an evaluation of the 
                activities carried out through the grant.
            ``(2) Use of funds.--A recipient of a grant described in 
        paragraph (1)(A), or assistance described in paragraph 
        (1)(B)(ii), shall use the funds made available through the 
        grant, or the assistance, respectively, to conduct a validated 
        evaluation of the effectiveness of the activities described in 
        subparagraph (A) or (B), respectively, of paragraph (1).
            ``(3) Applications.--
                    ``(A) Submission.--
                            ``(i) Grants for projects containing 
                        evaluations.--To be eligible to receive a grant 
                        for which the granting authority requires the 
                        reservation described in paragraph (1)(A)(i), 
                        an entity shall include a proposal for the 
                        evaluation in the application submitted for the 
                        grant.
                            ``(ii) Assistance for evaluations.--To be 
                        eligible to receive assistance under paragraph 
                        (1)(B)(ii), an entity shall submit an 
                        application to the granting authority at such 
                        time, in such manner, and containing such 
                        information as the granting authority may 
                        require, including a proposal for the 
                        evaluation.
                    ``(B) Review and assistance.--An employee of the 
                National Institute on Aging, and a private expert, with 
                expertise in evaluation methodology shall review each 
                proposal described in clause (i) or (ii) of 
                subparagraph (A), and determine whether the methodology 
                described in the proposal is adequate to gather 
                meaningful information. If the employee and expert 
                determine that the methodology is inadequate, the 
                employee and expert shall recommend that the granting 
                authority deny the application for the grant described 
                in subparagraph (A)(i), or the assistance described in 
                subparagraph (B)(ii), as appropriate, or make 
                recommendations for how the application should be 
                amended. If the granting authority denies the 
                application on the basis of the proposal, the granting 
                authority shall inform the applicant why the 
                application was denied, and offer assistance to the 
                applicant in modifying the proposal.
    ``(b) Other Grants.--The granting authority shall make grants to 
appropriate entities to conduct validated evaluations of activities, to 
reduce elder abuse, neglect, and exploitation, that are not funded 
under this title.
    ``(c) Condition of Participation.--As a condition of participation 
in any grant under this title, individuals, facilities, and other 
entities shall agree to be subject to sections 3729 through 3733 of 
title 31, United States Code and other applicable laws.

``SEC. 2262. HUMAN SUBJECT RESEARCH.

    ``(a) In General.--For purposes of the application of subpart A of 
part 46 of title 45, Code of Federal Regulations to research conducted 
under this title, the term `legally authorized representative' means, 
unless otherwise provided by law, the individual, or judicial or other 
body authorized under the applicable law to consent to medical 
treatment on behalf of another person.
    ``(b) Guidelines.--The Secretary of Health and Human Services, 
through the Director of the National Institute on Aging, after 
consultation with the Director of the Office for Human Research 
Protections and the Excellence Advisory Committee established under 
section 2222(b)(5), shall promulgate guidelines to assist researchers 
working in the area of elder abuse, neglect, and exploitation, with 
issues relating to human subject protections.

``SEC. 2263. REGULATIONS.

    ``The Secretary may issue such regulations as may be necessary to 
carry out this title.

``SEC. 2264. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out this title 
such sums as may be necessary for each of fiscal years 2004 through 
2010.''.

SEC. 102. PATIENT ABUSE PREVENTION.

    (a) Establishment of Program To Prevent Abuse of Nursing Facility 
Residents.--
            (1) Screening of Skilled Nursing Facility and Nursing 
        Facility Employee Applicants.--
                    (A) Medicare program.--Section 1819(b) of the 
                Social Security Act (42 U.S.C. 1395i-3(b)) is amended 
                by adding at the end the following:
            ``(8) Screening of skilled nursing facility workers.--
                    ``(A) Background checks on applicants.--Subject to 
                subparagraph (B)(ii), before hiring a skilled nursing 
                facility worker, a skilled nursing facility shall--
                            ``(i) give the worker written notice that 
                        the facility is required to perform background 
checks with respect to applicants;
                            ``(ii) require, as a condition of 
                        employment, that such worker--
                                    ``(I) provide a written statement 
                                disclosing any conviction for a 
                                relevant crime;
                                    ``(II) provide a statement signed 
                                by the worker authorizing the facility 
                                to request the search and exchange of 
                                criminal records;
                                    ``(III) provide in person to the 
                                facility a copy of the worker's 
                                fingerprints or thumb print, depending 
                                upon available technology; and
                                    ``(IV) provide any other 
                                identification information the 
                                Secretary may specify in regulation; 
                                and
                            ``(iii) request through the appropriate 
                        State agency that the State initiate a State 
                        and national criminal background check on such 
                        worker in accordance with the provisions of 
                        subsection (e)(6) and submit to such State 
                        agency the information described in subclauses 
                        (II) through (IV) of clause (ii).
                    ``(B) Prohibition on hiring of abusive workers.--
                            ``(i) In general.--A skilled nursing 
                        facility may not knowingly employ any skilled 
                        nursing facility worker who has any conviction 
                        for a relevant crime.
                            ``(ii) Provisional employment.--After 
                        complying with the requirements of clauses (i) 
                        and (ii) of subparagraph (A), a skilled nursing 
                        facility may provide for a provisional period 
                        of employment for a skilled nursing facility 
                        worker pending completion of the check against 
                        the background check described under 
                        subparagraph (A)(iii). Subject to clause (iii), 
                        such facility shall maintain direct supervision 
                        of the covered individual during the worker's 
                        provisional period of employment.
                            ``(iii) Exception for small rural skilled 
                        nursing facilities.--In the case of a small 
                        rural skilled nursing facility (as defined by 
                        the Secretary), the Secretary shall provide, by 
                        regulation after consultation with providers of 
                        skilled nursing facility services and entities 
                        representing beneficiaries of such services, 
                        for an appropriate level of supervision with 
                        respect to any provisional employees employed 
                        by the facility in accordance with clause (ii). 
                        Such regulation should encourage the provision 
                        of direct supervision of such employees 
                        whenever practicable with respect to such a 
                        facility and if such supervision would not 
                        impose an unreasonable cost or other burden on 
                        the facility.
                    ``(C) Reporting requirements.--A skilled nursing 
                facility shall report to the State any instance in 
                which the facility determines that a skilled nursing 
                facility worker has committed an act of resident 
                neglect or abuse or misappropriation of resident 
                property in the course of employment by the facility.
                    ``(D) Use of information.--
                            ``(i) In general.--A skilled nursing 
                        facility that obtains information about a 
                        skilled nursing facility worker pursuant to 
                        subparagraph (A)(iii) may use such information 
                        only for the purpose of determining the 
                        suitability of the worker for employment.
                            ``(ii) Immunity from liability.--A skilled 
                        nursing facility that, in denying employment 
                        for an applicant (including during the period 
                        described in subparagraph (B)(ii)), reasonably 
                        relies upon information about such applicant 
                        provided by the State pursuant to subsection 
                        (e)(6) shall not be liable in any action 
                        brought by such applicant based on the 
                        employment determination resulting from the 
                        information.
                            ``(iii) Criminal penalty.--Whoever 
                        knowingly violates the provisions of clause (i) 
                        shall be fined in accordance with title 18, 
                        United States Code, imprisoned for not more 
                        than 2 years, or both.
                    ``(E) Civil penalty.--
                            ``(i) In general.--A skilled nursing 
                        facility that violates the provisions of this 
                        paragraph shall be subject to a civil penalty 
                        in an amount not to exceed--
                                    ``(I) for the first such violation, 
                                $2,000; and
                                    ``(II) for the second and each 
                                subsequent violation within any 5-year 
                                period, $5,000.
                            ``(ii) Knowing retention of worker.--In 
                        addition to any civil penalty under clause (i), 
                        a skilled nursing facility that--
                                    ``(I) knowingly continues to employ 
                                a skilled nursing facility worker in 
                                violation of subparagraph (A) or (B); 
                                or
                                    ``(II) knowingly fails to report a 
                                skilled nursing facility worker under 
                                subparagraph (C),
                        shall be subject to a civil penalty in an 
                        amount not to exceed $5,000 for the first such 
                        violation, and $10,000 for the second and each 
                        subsequent violation within any 5-year period.
                    ``(F) Definitions.--In this paragraph:
                            ``(i) Conviction for a relevant crime.--The 
                        term `conviction for a relevant crime' means 
                        any Federal or State criminal conviction for--
                                    ``(I) any offense described in 
                                paragraphs (1) through (4) of section 
                                1128(a); and
                                    ``(II) such other types of offenses 
                                as the Secretary may specify in 
                                regulations, taking into account the 
                                severity and relevance of such 
                                offenses, and after consultation with 
                                representatives of long-term care 
                                providers, representatives of long-term 
                                care employees, consumer advocates, and 
                                appropriate Federal and State 
                                officials.
                            ``(ii) Disqualifying information.--The term 
                        `disqualifying information' means information 
                        about a conviction for a relevant crime.
                            ``(iii) Skilled nursing facility worker.--
                        The term `skilled nursing facility worker' 
                        means any individual (other than a volunteer) 
                        that has access to a patient of a skilled 
                        nursing facility under an employment or other 
                        contract, or both, with such facility. Such 
                        term includes individuals who are licensed or 
                        certified by the State to provide such 
                        services, and nonlicensed individuals providing 
                        such services, as defined by the Secretary, 
                        including nurse assistants, nurse aides, home 
                        health aides, and personal care workers and 
                        attendants.''.
                    (B) Medicaid program.--Section 1919(b) of the 
                Social Security Act (42 U.S.C. 1396r(b)) is amended by 
                adding at the end the following new paragraph:
            ``(8) Screening of nursing facility workers.--
                    ``(A) Background checks on applicants.--Subject to 
                subparagraph (B)(ii), before hiring a nursing facility 
                worker, a nursing facility shall--
                            ``(i) give the worker written notice that 
                        the facility is required to perform background 
                        checks with respect to applicants;
                            ``(ii) require, as a condition of 
                        employment, that such worker--
                                    ``(I) provide a written statement 
                                disclosing any conviction for a 
                                relevant crime;
                                    ``(II) provide a statement signed 
                                by the worker authorizing the facility 
                                to request the search and exchange of 
                                criminal records;
                                    ``(III) provide in person to the 
                                facility a copy of the worker's 
                                fingerprints or thumb print, depending 
                                upon available technology; and
                                    ``(IV) provide any other 
                                identification information the 
                                Secretary may specify in regulation; 
                                and
                            ``(iii) request through the appropriate 
                        State agency that the State initiate a State 
                        and national criminal background check on such 
                        worker in accordance with the provisions of 
                        subsection (e)(8) and submit to such State 
                        agency the information described in subclauses 
                        (II) through (IV) of clause (ii).
                    ``(B) Prohibition on hiring.--
                            ``(i) In general.--A nursing facility may 
                        not knowingly employ any nursing facility 
                        worker who has any conviction for a relevant 
                        crime.
                            ``(ii) Provisional employment.--After 
                        complying with the requirements of clauses (i) 
                        and (ii) of subparagraph (A), a nursing 
                        facility may provide for a provisional period 
                        of employment for a nursing facility worker 
                        pending completion of the check against the 
                        background check described under subparagraph 
                        (A)(iii). Subject to clause (iii), such 
                        facility shall maintain direct supervision of 
                        the worker during the worker's provisional 
                        period of employment.
                            ``(iii) Exception for small rural nursing 
                        facilities.--In the case of a small rural 
                        nursing facility (as defined by the Secretary), 
                        the Secretary shall provide, by regulation 
                        after consultation with providers of nursing 
                        facility services and entities representing 
                        beneficiaries of such services, for an 
                        appropriate level of supervision with respect 
                        to any provisional employees employed by the 
                        facility in accordance with clause (ii). Such 
                        regulation should encourage the provision of 
                        direct supervision of such employees whenever 
                        practicable with respect to such a facility and 
                        if such supervision would not impose an 
                        unreasonable cost or other burden on the 
                        facility.
                    ``(C) Reporting requirements.--A nursing facility 
                shall report to the State any instance in which the 
                facility determines that a nursing facility worker has 
                committed an act of resident neglect or abuse or 
                misappropriation of resident property in the course of 
                employment by the facility.
                    ``(D) Use of information.--
                            ``(i) In general.--A nursing facility that 
                        obtains information about a nursing facility 
                        worker pursuant to subparagraph (A)(iii) may 
                        use such information only for the purpose of 
                        determining the suitability of the worker for 
                        employment.
                            ``(ii) Immunity from liability.--A nursing 
                        facility that, in denying employment for an 
                        applicant (including during the period 
                        described in subparagraph (B)(ii)), reasonably 
                        relies upon information about such applicant 
                        provided by the State pursuant to subsection 
                        (e)(8) shall not be liable in any action 
                        brought by such applicant based on the 
                        employment determination resulting from the 
                        information.
                            ``(iii) Criminal penalty.--Whoever 
                        knowingly violates the provisions of clause (i) 
                        shall be fined in accordance with title 18, 
                        United States Code, imprisoned for not more 
                        than 2 years, or both.
                    ``(E) Civil penalty.--
                            ``(i) In general.--A nursing facility that 
                        violates the provisions of this paragraph shall 
                        be subject to a civil penalty in an amount not 
                        to exceed--
                                    ``(I) for the first such violation, 
                                $2,000; and
                                    ``(II) for the second and each 
                                subsequent violation within any 5-year 
                                period, $5,000.
                            ``(ii) Knowing retention of worker.--In 
                        addition to any civil penalty under clause (i), 
                        a nursing facility that--
                                    ``(I) knowingly continues to employ 
                                a nursing facility worker in violation 
                                of subparagraph (A) or (B); or
                                    ``(II) knowingly fails to report a 
                                nursing facility worker under 
                                subparagraph (C),
                        shall be subject to a civil penalty in an 
                        amount not to exceed $5,000 for the first such 
                        violation, and $10,000 for the second and each 
                        subsequent violation within any 5-year period.
                    ``(F) Definitions.--In this paragraph:
                            ``(i) Conviction for a relevant crime.--The 
                        term `conviction for a relevant crime' means 
                        any Federal or State criminal conviction for--
                                    ``(I) any offense described in 
                                paragraphs (1) through (4) of section 
                                1128(a); and
                                    ``(II) such other types of offenses 
                                as the Secretary may specify in 
                                regulations, taking into account the 
                                severity and relevance of such 
                                offenses, and after consultation with 
                                representatives of long-term care 
                                providers, representatives of long-term 
                                care employees, consumer advocates, and 
                                appropriate Federal and State 
                                officials.
                            ``(ii) Disqualifying information.--The term 
                        `disqualifying information' means information 
                        about a conviction for a relevant crime.
                            ``(iii) Nursing facility worker.--The term 
                        `nursing facility worker' means any individual 
                        (other than a volunteer) that has access to a 
                        patient of a nursing facility under an 
                        employment or other contract, or both, with 
                        such facility. Such term includes individuals 
                        who are licensed or certified by the State to 
                        provide such services, and nonlicensed 
                        individuals providing such services, as defined 
                        by the Secretary, including nurse assistants, 
                        nurse aides, home health aides, and personal 
                        care workers and attendants.''.
                    (C) Federal responsibilities.--
                            (i) Development of standard federal and 
                        state background check form.--The Secretary of 
                        Health and Human Services, after consultation 
                        with the Attorney General and representatives 
                        of appropriate State agencies, shall develop a 
                        model form that an applicant for employment at 
                        a nursing facility may complete and Federal and 
                        State agencies may use to conduct the criminal 
                        background checks required under sections 
                        1819(b)(8) and 1919(b)(8) of the Social 
                        Security Act (42 U.S.C. 1395i-3(b), 1396r(b)) 
                        (as added by this section).
                            (ii) Periodic evaluation.--The Secretary of 
                        Health and Human Services, after consultation 
                        with the Attorney General, periodically shall 
                        evaluate the background check system imposed 
                        under sections 1819(b)(8) and 1919(b)(8) of the 
                        Social Security Act (42 U.S.C. 1395i-3(b), 
                        1396r(b)) (as added by this section) and shall 
                        implement changes, as necessary, based on 
                        available technology, to make the background 
                        check system more efficient and able to provide 
                        a more immediate response to long-term care 
                        providers using the system.
                    (D) No preemption of stricter state laws.--Nothing 
                in section 1819(b)(8) or 1919(b)(8) of the Social 
                Security Act (42 U.S.C. 1395i-3(b)(8), 1396r(b)(8)) (as 
                so added) shall be construed to supersede any provision 
                of State law that--
                            (i) specifies a relevant crime for purposes 
                        of prohibiting the employment of an individual 
                        at a long-term care facility that is not 
                        included in the list of such crimes specified 
                        in such sections or in regulations promulgated 
                        by the Secretary of Health and Human Services 
                        to carry out such sections; or
                            (ii) requires a long-term care facility (as 
                        so defined) to conduct a background check prior 
                        to employing an individual in an employment 
                        position that is not included in the positions 
                        for which a background check is required under 
                        such sections.
                    (E) Technical amendments.--Effective as if included 
                in the enactment of section 941 of the Medicare, 
                Medicaid, and SCHIP Benefits Improvement and Protection 
                Act of 2000 (114 Stat. 2763A-585), as enacted into law 
                by section 1(a)(6) of Public Law 106-554, sections 
                1819(b) and 1919(b) of the Social Security Act (42 
                U.S.C. 1395i-3(b), 1396r(b)), as amended by such 
                section 941 (as so enacted into law) are each amended 
                by redesignating the paragraph (8) added by such 
                section as paragraph (9).
            (2) Federal and state requirements concerning background 
        checks.--
                    (A) Medicare.--Section 1819(e) of the Social 
                Security Act (42 U.S.C. 1395i-3(e)) is amended by 
                adding at the end the following:
            ``(6) Federal and state requirements concerning criminal 
        background checks on skilled nursing facility employees.--
                    ``(A) In general.--Upon receipt of a request by a 
                skilled nursing facility pursuant to subsection (b)(8) 
                that is accompanied by the information described in 
                subclauses (II) through (IV) of subsection 
                (b)(8)(A)(ii), a State, after checking appropriate 
                State records and finding no disqualifying information 
                (as defined in subsection (b)(8)(F)(ii)), shall 
                immediately submit such request and information to the 
                Attorney General and shall request the Attorney General 
                to conduct a search and exchange of records with 
                respect to the individual as described in subparagraph 
                (B).
                    ``(B) Search and exchange of records by attorney 
                general.--Upon receipt of a submission pursuant to 
                subparagraph (A), the Attorney General shall direct a 
                search of the records of the Federal Bureau of 
                Investigation for any criminal history records 
                corresponding to the fingerprints and other positive 
                identification information submitted. The Attorney 
                General shall provide any corresponding information 
                resulting from the search to the State.
                    ``(C) State reporting of information to skilled 
                nursing facility.--Upon receipt of the information 
                provided by the Attorney General pursuant to 
                subparagraph (B), the State shall--
                            ``(i) review the information to determine 
                        whether the individual has any conviction for a 
                        relevant crime (as defined in subsection 
                        (b)(8)(F)(i)); and
                            ``(ii) immediately report to the skilled 
                        nursing facility in writing the results of such 
                        review.
                    ``(D) Fees for performance of criminal background 
                checks.--
                            ``(i) Authority to charge fees.--
                                    ``(I) Attorney general.--The 
                                Attorney General may charge a fee to 
                                any State requesting a search and 
                                exchange of records pursuant to this 
                                paragraph and subsection (b)(8) for 
                                conducting the search and providing the 
                                records. The amount of such fee shall 
                                not exceed the lesser of the actual 
                                cost of such activities or $50. Such 
                                fees shall be available to the Attorney 
                                General, or, in the Attorney General's 
                                discretion, to the Federal Bureau of 
                                Investigation until expended.
                                    ``(II) State.--A State may charge a 
                                skilled nursing facility a fee for 
                                initiating the criminal background 
                                check under this paragraph and 
                                subsection (b)(8), including fees 
                                charged by the Attorney General, and 
                                for performing the review and report 
                                required by subparagraph (C). The 
                                amount of such fee shall not exceed the 
                                actual cost of such activities.
                            ``(ii) Prohibition on charging applicants 
                        or employees.--An entity may not impose on an 
                        applicant for employment or an employee any 
                        charges relating to the performance of a 
                        background check under this paragraph.
                    ``(E) Regulations.--
                            ``(i) In general.--In addition to the 
                        Secretary's authority to promulgate regulations 
                        under this title, the Attorney General, after 
                        consultation with the Secretary, may promulgate 
                        such regulations as are necessary to carry out 
                        the Attorney General's responsibilities under 
                        this paragraph and subsection (b)(9), including 
                        regulations regarding the security 
                        confidentiality, accuracy, use, destruction, 
                        and dissemination of information, audits and 
                        recordkeeping, and the imposition of fees.
                            ``(ii) Appeal procedures.--The Attorney 
                        General, after consultation with the Secretary, 
                        shall promulgate such regulations as are 
                        necessary to establish procedures by which an 
                        applicant or employee may appeal or dispute the 
                        accuracy of the information obtained in a 
                        background check conducted under this 
                        paragraph. Appeals shall be limited to 
                        instances in which an applicant or employee is 
                        incorrectly identified as the subject of the 
                        background check, or when information about the 
                        applicant or employee has not been updated to 
                        reflect changes in the applicant's or 
                        employee's criminal record.
                    ``(F) Report.--Not later than 2 years after the 
                date of enactment of this paragraph, the Attorney 
                General shall submit a report to Congress on--
                            ``(i) the number of requests for searches 
                        and exchanges of records made under this 
                        section;
                            ``(ii) the disposition of such requests; 
                        and
                            ``(iii) the cost of responding to such 
                        requests.''.
                    (B) Medicaid.--Section 1919(e) of the Social 
                Security Act (42 U.S.C. 1396r(e)) is amended by adding 
                at the end the following:
            ``(8) Federal and state requirements concerning criminal 
        background checks on nursing facility employees.--
                    ``(A) In general.--Upon receipt of a request by a 
                nursing facility pursuant to subsection (b)(8) that is 
                accompanied by the information described in subclauses 
                (II) through (IV) of subsection (b)(8)(A)(ii), a State, 
                after checking appropriate State records and finding no 
                disqualifying information (as defined in subsection 
                (b)(8)(F)(ii)), shall immediately submit such request 
                and information to the Attorney General and shall 
                request the Attorney General to conduct a search and 
                exchange of records with respect to the individual as 
                described in subparagraph (B).
                    ``(B) Search and exchange of records by attorney 
                general.--Upon receipt of a submission pursuant to 
                subparagraph (A), the Attorney General shall direct a 
                search of the records of the Federal Bureau of 
                Investigation for any criminal history records 
                corresponding to the fingerprints and other positive 
                identification information submitted. The Attorney 
                General shall provide any corresponding information 
                resulting from the search to the State.
                    ``(C) State reporting of information to nursing 
                facility.--Upon receipt of the information provided by 
                the Attorney General pursuant to subparagraph (B), the 
                State shall--
                            ``(i) review the information to determine 
                        whether the individual has any conviction for a 
                        relevant crime (as defined in subsection 
                        (b)(8)(F)(i)); and
                            ``(ii) immediately report to the nursing 
                        facility in writing the results of such review.
                    ``(D) Fees for performance of criminal background 
                checks.--
                            ``(i) Authority to charge fees.--
                                    ``(I) Attorney general.--The 
                                Attorney General may charge a fee to 
                                any State requesting a search and 
                                exchange of records pursuant to this 
                                paragraph and subsection (b)(8) for 
                                conducting the search and providing the 
                                records. The amount of such fee shall 
                                not exceed the lesser of the actual 
                                cost of such activities or $50. Such 
                                fees shall be available to the Attorney 
                                General, or, in the Attorney General's 
                                discretion, to the Federal Bureau of 
                                Investigation, until expended.
                                    ``(II) State.--A State may charge a 
                                nursing facility a fee for initiating 
                                the criminal background check under 
                                this paragraph and subsection (b)(8), 
                                including fees charged by the Attorney 
                                General, and for performing the review 
                                and report required by subparagraph 
                                (C). The amount of such fee shall not 
                                exceed the actual cost of such 
                                activities.
                            ``(ii) Prohibition on charging applicants 
                        or employees.--An entity may not impose on an 
                        applicant for employment or an employee any 
                        charges relating to the performance of a 
                        background check under this paragraph.
                    ``(E) Regulations.--
                            ``(i) In general.--In addition to the 
                        Secretary's authority to promulgate regulations 
                        under this title, the Attorney General, after 
                        consultation with the Secretary, may promulgate 
                        such regulations as are necessary to carry out 
                        the Attorney General's responsibilities under 
                        this paragraph and subsection (b)(8), including 
                        regulations regarding the security, 
                        confidentiality, accuracy, use, destruction, 
                        and dissemination of information, audits and 
                        recordkeeping, and the imposition of fees.
                            ``(ii) Appeal procedures.--The Attorney 
                        General, after consultation with the Secretary, 
                        shall promulgate such regulations as are 
                        necessary to establish procedures by which an 
                        applicant or employee may appeal or dispute the 
                        accuracy of the information obtained in a 
                        background check conducted under this 
                        paragraph. Appeals shall be limited to 
                        instances in which an applicant or employee is 
                        incorrectly identified as the subject of the 
                        background check, or when information about the 
                        applicant or employee has not been updated to 
                        reflect changes in the applicant's or 
                        employee's criminal record.
                    ``(F) Report.--Not later than 2 years after the 
                date of enactment of this paragraph, the Attorney 
                General shall submit a report to Congress on--
                            ``(i) the number of requests for searches 
                        and exchanges of records made under this 
                        section;
                            ``(ii) the disposition of such requests; 
                        and
                            ``(iii) the cost of responding to such 
                        requests.''.
            (3) Application to other entities providing home health or 
        long-term care services.--
                    (A) Medicare.--Part D of title XVIII of the Social 
                Security Act (42 U.S.C. 1395x et seq.) is amended by 
                adding at the end the following:

 ``application of skilled nursing facility preventive abuse provisions 
 to any provider of services or other entity providing home health or 
                        long-term care services

    ``Sec. 1897. (a) In General.--The requirements of subsections 
(b)(8) and (e)(6) of section 1819 shall apply to any provider of 
services or any other entity that is eligible to be paid under this 
title for providing home health services, hospice care (including 
routine home care and other services included in hospice care under 
this title), or long-term care services to an individual entitled to 
benefits under part A or enrolled under part B, including an individual 
provided with a Medicare+Choice plan offered by a Medicare+Choice 
organization under part C (in this section referred to as a `medicare 
beneficiary').
    ``(b) Supervision of Provisional Employees.--
            ``(1) In general.--With respect to an entity that provides 
        home health services, such entity shall be considered to have 
        satisfied the requirements of section 1819(b)(8)(B)(ii) or 
        1919(b)(8)(B)(ii) if the entity meets such requirements for 
        supervision of provisional employees of the entity as the 
        Secretary shall, by regulation, specify in accordance with 
        paragraph (2).
            ``(2) Requirements.--The regulations required under 
        paragraph (1) shall provide the following:
                    ``(A) Supervision of a provisional employee shall 
                consist of ongoing, good faith, verifiable efforts by 
                the supervisor of the provisional employee to conduct 
                monitoring and oversight activities to ensure the 
                safety of a medicare beneficiary.
                    ``(B) For purposes of subparagraph (A), monitoring 
                and oversight activities may include (but are not 
                limited to) the following:
                            ``(i) Follow-up telephone calls to the 
                        medicare beneficiary.
                            ``(ii) Unannounced visits to the medicare 
                        beneficiary's home while the provisional 
                        employee is serving the medicare beneficiary.
                            ``(iii) To the extent practicable, limiting 
                        the provisional employee's duties to serving 
                        only those medicare beneficiaries in a home or 
                        setting where another family member or resident 
                        of the home or setting of the medicare 
                        beneficiary is present.
                    ``(C) In promulgating such regulations, the 
                Secretary shall take into account the staffing and 
                geographic issues faced by small rural entities (as 
                defined by the Secretary) that provide home health 
                services, hospice care (including routine home care and 
                other services included in hospice care under this 
                title), or other long-term care services. Such 
                regulations should encourage the provision of 
                monitoring and oversight activities whenever 
                practicable with respect to such an entity, and if such 
                activities would not impose an unreasonable cost or 
                other burden on the entity.''.
                    (B) Medicaid.--Section 1902(a) of the Social 
                Security Act (42 U.S.C. 1396a) is amended--
                            (i) in paragraph (64), by striking ``and'' 
                        at the end;
                            (ii) in paragraph (65), by striking the 
                        period and inserting ``; and''; and
                            (iii) by inserting after paragraph (65) the 
                        following:
            ``(66) provide that any entity that is eligible to be paid 
        under the State plan for providing home health services, 
        hospice care (including routine home care and other services 
        included in hospice care under title XVIII), or long-term care 
        services for which medical assistance is available under the 
        State plan to individuals requiring long-term care complies 
        with the requirements of subsections (b)(8) and (e)(8) of 
        section 1919 and section 1897(b) (in the same manner as such 
        section applies to a medicare beneficiary).''.
    (b) Prevention and Training Demonstration Project.--
            (1) Establishment.--The Secretary of Health and Human 
        Services shall establish a demonstration program to provide 
        grants to develop information on best practices in patient 
        abuse prevention training (including behavior training and 
        interventions) for managers and staff of hospital and health 
        care facilities.
            (2) Eligibility.--To be eligible to receive a grant under 
        paragraph (1), an entity shall be a public or private nonprofit 
        entity and prepare and submit to the Secretary of Health and 
        Human Services an application at such time, in such manner, and 
        containing such information as the Secretary may require.
            (3) Use of funds.--Amounts received under a grant under 
        this subsection shall be used to--
                    (A) examine ways to improve collaboration between 
                State health care survey and provider certification 
                agencies, long-term care ombudsman programs, the long-
                term care industry, and local community members;
                    (B) examine patient care issues relating to 
                regulatory oversight, community involvement, and 
                facility staffing and management with a focus on staff 
                training, staff stress management, and staff 
                supervision;
                    (C) examine the use of patient abuse prevention 
                training programs by long-term care entities, including 
                the training program developed by the National 
                Association of Attorneys General, and the extent to 
                which such programs are used; and
                    (D) identify and disseminate best practices for 
                preventing and reducing patient abuse.
            (4) Authorization of appropriations.--There are authorized 
        to be appropriated to carry out this subsection such sums as 
        may be necessary.
    (c) Sense of the Senate Regarding the Establishment of a National 
Background Check System for Long-Term Care Employees.--
            (1) Findings.--The Senate makes the following findings:
                    (A) Nearly 1,500,000 Americans reside in 17,000 
                nursing homes throughout the Nation, and the vast 
                majority of nursing homes participate in the medicare 
                and medicaid programs.
                    (B) The Federal Government spent $82,100,000,000 
                through the medicare and medicaid programs in fiscal 
year 2000 for long-term care services.
                    (C) The impending retirement of the baby boom 
                generation will greatly increase the demand and need 
                for quality long-term care, and it is incumbent on 
                Congress and the President to ensure that medicare and 
                medicaid beneficiaries are protected from abuse, 
                neglect, and mistreatment.
                    (D) On July 30, 2001, the minority staff of the 
                special investigations division of the Committee on 
                Government Reform of the House of Representatives 
                issued a report which found that in the past 2 years, 
                over 30 percent of nursing homes in the United States 
                were cited for a physical, sexual, or verbal abuse 
                violation that had the potential to harm residents, and 
                nearly 10 percent of nursing homes had violations that 
                caused actual harm to residents.
                    (E) Although the majority of long-term care 
                facilities do an excellent job in caring for elderly 
                and disabled patients, incidents of abuse and neglect 
                and mistreatment do occur at an unacceptable rate and 
                are not limited to nursing homes alone.
                    (F) Without a national background check system to 
                screen applicants for employment, all long-term care 
                providers, including nursing facilities, home health, 
                home care, and hospice providers, are at risk for 
                hiring workers with a history of abuse and violence.
                    (G) A March 2002 report by the General Accounting 
                Office found that few prosecutions and criminal 
                convictions result from allegations of abuse in nursing 
                homes.
                    (H) Federal law requires all States to maintain a 
                nurse aide registry which includes any substantiated 
                findings of abuse committed by nurse aides in nursing 
                homes.
                    (I) In March 2002, the General Accounting Office 
                testified before the Special Committee on Aging of the 
                Senate that the existing State registries contained 
                significant gaps because many nursing home employees 
                are not included in the registries and the registries 
                do not track abuses committed in other States.
                    (J) A 1998 report from the Office of the Inspector 
                General of the Department of Health and Human Services 
                entitled ``Safeguarding Long-Term Care Residents'' 
                recommended establishing a national registry of abusive 
                long-term care workers to be checked by all long-term 
                care facilities before hiring an employee.
            (2) Sense of the senate.--It is the Sense of the Senate 
        that Congress should pass legislation that will--
                    (A) require the Secretary of Health and Human 
                Services to establish a national registry of abusive 
                long-term care workers that will incorporate abuse 
                information from all existing State nurse aide 
                registries, and expand information included in the 
                State registries and the national registry to include 
                abuse information about all employees of all long-term 
                care providers that receive funding through the 
                medicare or medicaid programs (42 U.S.C. 1395 et seq.; 
                1396 et seq.);
                    (B) require all long-term care providers, before 
                hiring a potential employee, to conduct checks of both 
                the national registry and criminal conviction records 
                maintained by the Federal Bureau of Investigation, and 
                prohibit long-term care providers from hiring potential 
                employees with relevant abuse and criminal histories;
                    (C) require the Secretary of Health and Human 
                Services and the Attorney General to develop an 
                efficient system for long-term care providers to use to 
                check both the national registry and the criminal 
                conviction records maintained by the Federal Bureau of 
                Investigation before hiring an employee; and
                    (D) ensure adequate safeguards to protect the 
                privacy and accuracy of information regarding 
                applicants for employment being checked through the 
                national registry and the criminal conviction records 
                maintained by the Federal Bureau of Investigation.
    (d) Effective Date.--
            (1) In general.--Except as provided in paragraph (2), this 
        section and the amendments made by this section shall take 
        effect on the date that is 6 months after the effective date of 
        final regulations promulgated to carry out this section and 
        such amendments.
            (2) Sense of the senate.--Subsection (c) shall take effect 
        on the date of enactment of this section.

SEC. 103. INCREASING THE NUMBER OF HEALTH CARE PROFESSIONALS WITH 
              GERIATRIC TRAINING.

    Section 338C of the Public Health Service Act (42 U.S.C. 254m) is 
amended by adding at the end the following:
    ``(f) For purposes of this section and section 338B, the term 
`obligated service', with respect to an individual who has entered into 
a written contract with the Secretary under section 338B, includes any 
period in which the individual is enrolled and participating in an 
accredited (as determined by the Secretary) educational program that 
provides geriatric training. Upon the completion of such training, such 
individual, after consultation with the Secretary, shall provide 
geriatric services as appropriate during the remainder of such 
individual's period of obligated service.''.

SEC. 104. SUPPORTING THE LONG-TERM CARE OMBUDSMAN PROGRAM.

    Section 712(h) of the Older Americans Act of 1965 (42 U.S.C. 
3058g(h)) is amended--
            (1) in paragraph (8), by striking ``; and'' and inserting a 
        semicolon;
            (2) in paragraph (9), by striking the period and inserting 
        ``; and''; and
            (3) by adding at the end the following:
            ``(10) make grants, in consultation with the Director of 
        the Office of Elder Justice in the Department of Health and 
        Human Services and the Director of the Office of Elder Justice 
        in the Department of Justice, to eligible entities with 
        relevant expertise and experience to conduct evaluations and 
        pilot studies relating to various programs and methods carried 
        out by the Office of the State Long-Term Care Ombudsman or a 
        local Ombudsman entity under section 307(a)(9) or this chapter, 
        or to provide support (such as an ombudsman resource 
        center).''.

SEC. 105. ESTABLISHMENT OF OFFICE OF ADULT PROTECTIVE SERVICES.

    (a) In General.--Part A of title XI of the Social Security Act (42 
U.S.C. 1301 et seq.) is amended by adding at the end the following:

                 ``office of adult protective services

    ``Sec. 1150A. (a) In General.--There is established within the 
Department of Health and Human Services, within the Administration on 
Children and Families, the Office of Adult Protective Services (in this 
section referred to as the `Office'). The Office shall be headed by a 
Director, who shall be appointed by the Secretary.
    ``(b) Duties.--The Office shall--
            ``(1) provide necessary funding and support to State and 
        local adult protective services offices that investigate 
        reports of abuse, neglect, and exploitation of elders;
            ``(2) annually collect and disseminate data relating to the 
        abuse, exploitation, and neglect of elderly individuals in 
        coordination with the Centers for Disease Control and 
        Prevention efforts to collect national data under section 
        2221(b);
            ``(3) develop and disseminate best practices regarding, and 
        provide training on, carrying out protective services for 
        elders;
            ``(4) in conjunction with the necessary experts, conduct 
        research related to the provision of such protective services;
            ``(5) provide technical assistance to States and other 
        entities that provide or fund the provision of such protective 
        services, including through grants made under title XX;
            ``(6) participate in the Intra-Agency Elder Justice 
        Steering Committee established under section 2212; and
            ``(7) coordinate activities with the Office of Elder 
        Justice established under section 2211 and with other Federal 
        and State agencies that have responsibility for issues related 
        to elder justice.
    ``(c) Appropriations.--There are appropriated such sums as may be 
necessary to carry out this section.''.
    (b) Effective Date.--The amendments made by this section take 
effect 90 days after the date of enactment of the Elder Justice Act.

SEC. 106. ASSURING SAFETY OF RESIDENTS WHEN NURSING FACILITIES CLOSE.

    (a) Medicare.--Section 1819(c)(2) of the Social Security Act (42 
U.S.C. 1395i-3(c)(2)) is amended by adding at the end the following:
                    ``(D) Notification of facility closure.--
                            ``(i) In general.--A skilled nursing 
                        facility shall--
                                    ``(I) submit to the Secretary and 
                                the appropriate State regulatory agency 
                                written notification of an impending 
                                closure not later than the date that is 
                                60 days prior to the date of such 
                                closure;
                                    ``(II) include in the notice a plan 
                                for the transfer and adequate 
                                relocation of the residents prior to 
                                closure, including assurances that 
                                residents will not be transferred to 
                                facilities providing substandard care 
                                for which administrative or law 
                                enforcement action is pending; and
                                    ``(III) not later than 10 days 
                                after the facility closure, submit to 
                                the Secretary and the appropriate State 
                                agency information identifying where 
                                residents of the closed facility were 
                                transferred and on what date.
                            ``(ii) Sanctions.--Any person owning a 
                        skilled nursing facility that fails to comply 
                        with the requirements of clause (i) shall be 
                        subject to--
                                    ``(I) a civil monetary penalty of 
                                up to $1,000,000;
                                    ``(II) exclusion from participation 
                                in the programs under this Act (in 
                                accordance with the procedures of 
                                section 1128); and
                                    ``(III) any other applicable civil 
                                monetary penalties and assessments.
                            ``(iii) Procedure.--A civil monetary 
                        penalty or assessment authorized under clause 
                        (ii) shall be imposed against a person in the 
                        same manner as a civil monetary penalty, 
                        assessment, or exclusion is imposed under 
                        section 1128A.''.
    (b) Medicaid.--Section 1919(c)(2) of the Social Security Act (42 
U.S.C. 1396r(c)(2)) is amended by adding at the end the following:
                    ``(G) Notification of facility closure.--
                            ``(i) In general.--A nursing facility 
                        shall--
                                    ``(I) submit to the Secretary and 
                                the appropriate State regulatory agency 
                                written notification of an impending 
                                closure not later than the date that is 
                                60 days prior to the date of such 
                                closure;
                                    ``(II) include in the notice a plan 
                                for the transfer and adequate 
                                relocation of the residents prior to 
                                closure, including assurances that 
                                residents will not be transferred to 
                                facilities providing substandard care 
                                for which administrative or law 
                                enforcement action is pending; and
                                    ``(III) not later than 10 days 
                                after the facility closure submit to 
                                the Secretary and the appropriate State 
                                agency information identifying where 
                                residents of the closed facility were 
                                transferred and on what date.
                            ``(ii) Sanctions.--Any person owning a 
                        nursing facility that fails to comply with the 
                        requirements of clause (i) shall be subject 
                        to--
                                    ``(I) a civil monetary penalty of 
                                up to $1,000,000;
                                    ``(II) exclusion from participation 
                                in the programs under this Act (in 
                                accordance with the procedures of 
                                section 1128); and
                                    ``(III) any other applicable civil 
                                monetary penalties and assessments.
                            ``(iii) Procedure.--A civil monetary 
                        penalty or assessment authorized under clause 
                        (ii) shall be imposed against a person in the 
                        same manner as a civil monetary penalty, 
                        assessment, or exclusion is imposed under 
                        section 1128A.''.
    (c) Regulations.--The Secretary, after consulting with the Attorney 
General, shall issue regulations to carry out this section.

                    TITLE II--DEPARTMENT OF JUSTICE

SEC. 201. DEFINITIONS; RULE.

    (a) Definitions.--In this title the terms ``abuse'', ``elder'', 
``elder justice'', ``exploitation'', ``fiduciary'', ``grant'', 
``granting authority'', ``guardianship'', ``knowingly'', ``law 
enforcement'', ``neglect'', ``serious bodily injury'', ``social'', 
``State'', and ``vulnerable adult'' have the meanings given such terms 
in title XXII of the Social Security Act.
    (b) Rule.--The Attorney General may determine, in an appropriate 
case, that a provision of this title that applies to elders also 
applies to vulnerable adults.

SEC. 202. MODEL STATE LAWS AND PRACTICES.

    (a) In General.--The Attorney General, after consultation with the 
Secretary of Health and Human Services, shall--
            (1) conduct a study and prepare a report of the findings of 
        that study of State laws and practices relating to elder abuse, 
        neglect, and exploitation and provide such report or periodic 
        reports to the Elder Justice Resource Center established under 
        section 2221 of the Social Security Act, to be made available 
        to the public; and
            (2) not later than 2 years after the date of enactment of 
        this Act, submit to the Chairman and Ranking Member of the 
        Special Committee on Aging of the Senate, and the Speaker and 
        Minority leader of the House of Representatives a report that--
                    (A) provides recommendations on a comprehensive 
                description and comparative analysis of the State laws 
                and practices; and
                    (B) provides recommended models for State laws and 
                practices based on an analysis of the most effective 
                State laws and practices, including recommendations 
                with respect to the definitions referred to in 
                subsection (b)(1).
    (b) State Laws and Practices.--The Attorney General shall examine 
State laws and practices under subsection (a) on issues including--
            (1) definitions of ``elder'', ``abuse'', ``neglect'', and 
        ``exploitation'', and related terms;
            (2) mandatory reporting laws, with respect to--
                    (A) who is a mandated reporter;
                    (B) to whom must they report and within what 
                timeframe; and
                    (C) any consequences for nonreporting;
            (3) evidentiary, procedural, sentencing, choice of 
        remedies, and data retention issues relating to pursuing cases 
        relating to elder abuse, neglect, and exploitation;
            (4) laws requiring immediate reporting of all nursing home 
        deaths to the county coroner or to some other individual or 
        entity;
            (5) fiduciary laws, including guardianship and power of 
        attorney laws;
            (6) laws that permit or encourage banks and bank employees 
        to prevent and report suspected elder abuse, neglect, and 
        exploitation;
            (7) laws that may impede research on elder abuse, neglect, 
        and exploitation;
            (8) practices relating to the enforcement of laws relating 
        to elder abuse, neglect, and exploitation; and
            (9) practices relating to other aspects of elder justice.

SEC. 203. OFFICE OF ELDER JUSTICE OF THE DEPARTMENT OF JUSTICE.

    (a) Establishment.--There is established within the Department of 
Justice under the Assistant Attorney General, Office of Justice 
Programs, an Office of Elder Justice.
    (b) Director.--
            (1) Appointment.--The President, with the advice and 
        consent of the Senate, shall appoint a Director of the Office 
        of Elder Justice, from among individuals with experience and 
        expertise in elder justice issues, to manage the Office of 
        Elder Justice established under this section.
            (2) Duties.--The Director of the Office of Elder Justice 
        shall--
                    (A)(i) develop objectives, priorities, policy, and 
                a long-term plan for elder justice programs and 
                activities relating to prevention, detection, training, 
                treatment, evaluation, intervention, research, and 
                improvement of the elder justice system in the United 
                States;
                    (ii) implement the overall policy and a strategy to 
                carry out the plan described in clause (i); and
                    (iii) hire personnel to assist the director in 
                carrying out the policy, program, and administrative 
                activities related to the duties under clauses (i) and 
                (ii);
                    (B) provide advice to the Attorney General on elder 
                justice issues; and
                    (C) coordinate activities with the Senior Counsel 
                on Elder Justice.
            (3) Reporting relationship.--The Director of the Office of 
        Elder Justice shall have the same reporting relationship with 
        the Attorney General and the Assistant Attorney General, Office 
        of Justice Programs, as the directors of the other offices 
        headed by presidential appointees within the Office of Justice 
        Programs.
            (4) Compensation.--The Director shall be compensated at a 
        rate that shall not exceed the rate established for level I of 
        the Executive Schedule under section 5312 of title 5, United 
        States Code.
    (c) Senior Counsel.--
            (1) Appointment.--The Attorney General shall appoint a 
        Senior Counsel on Elder Justice, from among individuals with 
        experience and expertise in elder justice issues.
            (2) Duties.--The Senior Counsel on Elder Justice shall--
                    (A) coordinate elder justice activities among--
                            (i) the Office of Elder Justice;
                            (ii) other offices (including bureaus) 
                        within the Office of Justice Programs that are 
                        involved with elder justice issues;
                            (iii) litigating divisions with cases 
                        relating to elder justice matters;
                            (iv) the Executive Office of United States 
                        Attorneys and the United States Attorneys' 
                        offices; and
                            (v) any other office or division of the 
                        Department of Justice that the Attorney General 
                        considers appropriate for such coordination; 
                        and
                    (B) provide advice to the Attorney General on elder 
                justice issues.
            (3) Location.--The Senior Counsel on Elder Justice shall be 
        located in--
                    (A) the Office of the Attorney General;
                    (B) the Office of the Deputy Attorney General; or
                    (C) the Office of the Associate Attorney General.
            (4) Position.--The position of the Senior Counsel on Elder 
        Justice shall be a Senior Executive Service position, as 
        defined in section 3132 of title 5, United States Code.
            (5) Staff.--The Senior Counsel on Elder Justice may appoint 
        and terminate 1 full-time employee to enable the Senior Counsel 
        to perform the duties described in paragraph (2). The Senior 
        Counsel on Elder Justice may fix the compensation of the 
        employee in accord with chapter 51 and subchapter III of 
        chapter 53 of title 5, United States Code, relating to 
        classification of positions and General Schedule pay rates.
            (6) Relation to other law.--The positions described in 
        paragraphs (4) and (5), and the salary for the positions, shall 
        be in addition to the total number of positions and the total 
        amount of salary provided for in Public Law 107-77.

SEC. 204. GRANTS UNDER THE SOCIAL SECURITY ACT.

    The Attorney General is authorized to award grants under 
subsections (a), (c)(1), (c)(2), (d), (e)(1), (f), (h), and (i) of 
section 2222 and under section 2224 of the Social Security Act in 
accordance with such subsections.

SEC. 205. VICTIM ADVOCACY GRANTS.

    (a) Grants Authorized.--The Attorney General, after consultation 
with the Secretary of Health and Human Services, may award grants to 
eligible entities to study the special needs of victims of elder abuse, 
neglect, and exploitation.
    (b) Authorized Activities.--Funds awarded pursuant to subsection 
(a) shall be used for pilot programs that develop programs, provide 
training to health care, social and protective services providers, law 
enforcement, fiduciaries including guardians, judges and court 
personnel, and victim advocates, and examine special approaches 
designed to meet the needs of victims of elder abuse, neglect, and 
exploitation.

SEC. 206. SUPPORTING LOCAL PROSECUTORS IN ELDER JUSTICE MATTERS.

    (a) Grant Authorized.--The Attorney General, after consultation 
with the Director of Office of Elder Justice in the Department of 
Health and Human Services, shall award grants to provide training, 
technical assistance, policy development, multidisciplinary 
coordination, and other types of support to local prosecutors, handling 
elder justice-related cases, including the funding of specially 
designated elder justice positions or units, or funding the creation of 
a Center for the Prosecution of Elder Abuse, Neglect, and Exploitation 
by the American Prosecutor Research Institute of the National District 
Attorneys Association, or other similarly situated entity to advise and 
support local prosecutors nationwide in their pursuit of cases 
involving elder abuse, neglect, and exploitation.
    (b) Duties.--The Center created under subsection (a) shall, among 
other things--
            (1) collaborate with experts in elder abuse, neglect, and 
        exploitation;
            (2) collaborate with the Advisory Board created by section 
        2214 of the Social Security Act; and
            (3) provide local prosecutors and personnel assisting such 
        prosecutors with training, technical assistance, 
        multidisciplinary teams and input, in the handling, prevention 
        and prosecution of, and special circumstances surrounding elder 
        abuse, neglect, and exploitation.

SEC. 207. SUPPORTING STATE PROSECUTORS IN ELDER JUSTICE MATTERS.

    (a) In General.--The Attorney General shall, after consultation 
with the Secretary of Health and Human Services, award grants to 
provide training, technical assistance, multidisciplinary coordination, 
policy development, and other types of support to State prosecutors, 
including employees of State Attorneys General and Medicaid Fraud 
Control Units, handling elder justice-related matters.
    (b) Creating Specialized Positions.--Grants under this section may 
be made for--
            (1) the establishment of specially designated elder justice 
        positions or units; or
            (2) the creation of a position to coordinate elder justice-
        related cases, training, technical assistance, and policy 
        development for State prosecutors, by the National Association 
        of Attorneys General (NAAG) or other similarly situated entity.

SEC. 208. SUPPORTING FEDERAL CASES INVOLVING ELDER JUSTICE.

    (a) Support and Assistance.--
            (1) In general.--The Attorney General shall support cases 
        relating to elder justice.
            (2) Additional staff.--The Attorney General shall have 
        additional Federal prosecutors and make funding available to 
        Federal prosecutors to hire nurse-investigators or other 
        experts needed to identify, assist with, or pursue cases 
        relating to elder justice.
            (3) Resource group.--The Attorney General may fund through 
        the Executive Office of United States Attorneys for a Resource 
        Group to assist prosecutors throughout the Nation in pursuing 
        failure of care and other cases relating to elder justice 
        matters.
    (b) Office of Inspector General.--The Office of Inspector General 
of the Department of Health and Human Services shall hire nurse 
investigators and other  experts to investigate and pursue failure of 
care allegations.

SEC. 209. COMMUNITY POLICING.

    (a) Grant Authorized.--The Attorney General, after consultation 
with the Secretary of the Department of Health and Human Services, 
shall establish a grant program to develop community policing and other 
law enforcement efforts to make communities safer for elders living in 
all settings.
    (b) Special Elder Units.--The Attorney General, after consultation 
with the Secretary of Health and Human Services, shall establish a 
grant program to support--
            (1) special elder units and officers;
            (2) in rural areas with fewer law enforcement personnel, a 
        specially trained elder officer;
            (3) programs, including the Alzheimer Association's ``Safe 
        Return Program'' or other similar program; and
            (4) training, technical assistance, policy development, 
        multidisciplinary coordination, and other support and programs 
        relating to elder justice.

SEC. 210. SUPPORTING LAW ENFORCEMENT IN ELDER JUSTICE MATTERS.

    The Attorney General shall, after consultation with the Secretary 
of Health and Human Services, award grants to provide training, 
technical assistance, multidisciplinary coordination, policy 
development, and other types of support to police, sheriffs, 
detectives, public safety officers, corrections personnel, and other 
front line law enforcement responders who handle elder justice-related 
matters, to fund specially designated elder justice positions or units, 
designed to support front line law enforcement in elder justice 
matters.

SEC. 211. EVALUATIONS.

    (a) Grants.--
            (1) In general.--In making a grant under a provision of 
        this title (other than this section), the granting authority 
        shall--
                    (A) require the recipient of the grant to--
                            (i) reserve a portion of the funds made 
                        available through the grant; and
                            (ii) use the reserved funds to conduct an 
                        evaluation of the other activities carried out 
                        through the grant; or
                    (B)(i) reserve a portion of the funds available for 
                the grant; and
                    (ii) use the reserved funds to provide assistance 
                to an eligible entity to conduct an evaluation of the 
                activities carried out through the grant.
            (2) Use of funds.--A recipient of a grant described in 
        paragraph (1)(A), or assistance described in paragraph 
        (1)(B)(ii), shall use the funds made available through the 
        grant, or the assistance, respectively, to conduct a validated 
        evaluation of the effectiveness of the activities described in 
        subparagraph (A) or (B), respectively, of paragraph (1).
            (3) Applications.--
                    (A) Submission.--
                            (i) Grants for projects containing 
                        evaluations.--To be eligible to receive a grant 
                        for which the granting authority requires the 
                        reservation described in paragraph (1)(A)(i), 
                        an entity shall include a proposal for the 
                        evaluation in the application submitted for the 
                        grant.
                            (ii) Assistance for evaluations.--To be 
                        eligible to receive assistance under paragraph 
                        (1)(B)(ii), an entity shall submit an 
                        application to the granting authority at such 
                        time, in such manner, and containing such 
                        information as the granting authority may 
                        require, including a proposal for the 
                        evaluation.
                    (B) Review and assistance.--An employee of the 
                Department of Justice, after consultation with an 
                employee of the Department of Health and Human Services 
                and a nongovernmental member of the advisory board 
                established under section 2214 of the Social Security 
                Act, with expertise in evaluation methodology shall 
                review each proposal described in clause (i) or (ii) of 
                subparagraph (A), and determine whether the methodology 
                described in the proposal is adequate to gather 
                meaningful information. If the reviewers determine that 
                the methodology is inadequate, they shall recommend 
                that the granting authority deny the application for 
                the grant described in subparagraph (A)(i), or the 
                assistance described in subparagraph (B)(ii), as 
                appropriate, or make recommendations for how the 
                application should be amended. If the granting 
                authority denies the application on the basis of the 
                proposal, the granting authority shall inform the 
                applicant why the application was denied, and offer 
                assistance to the applicant in modifying the proposal.
    (b) Other Grants.--The granting authority shall make grants to 
appropriate entities to conduct validated evaluations of activities, to 
reduce elder abuse, neglect, and exploitation, that are not funded 
under this title.
    (c) Condition of Participation.--As a condition of participation in 
any grant under this title, individuals, facilities, and other entities 
shall agree to be subject to the provisions of section 571 of title 18, 
United States Code, as added by this Act.

SEC. 212. AUTHORIZATION OF APPROPRIATIONS.

    There are authorized to be appropriated such sums as are necessary 
for fiscal years 2004 through 2010 to carry out this title.

SEC. 213. CAUSE OF ACTION FOR ELDER ABUSE AND NEGLECT.

    (a) In General.--Part I of title 18, United States Code, is amended 
by adding after chapter 27 the following:

                 ``CHAPTER 28--ELDER ABUSE AND NEGLECT

``Sec.
``571. Harm to residents of nursing facilities.
``Sec. 571. Harm to residents of nursing facilities
    ``(a) Definitions.--In this section:
            ``(1) Entity.--The term `entity' means--
                    ``(A) any nursing facility (including facilities 
                that do not exclusively provide nursing care);
                    ``(B) any entity that manages a nursing facility; 
                or
                    ``(C) any entity that owns, directly or indirectly, 
                a controlling interest or a 50 percent or greater 
                interest in 1 or more nursing facilities.
            ``(2) Neglect.--The term `neglect' means the failure of a 
        caregiver (as defined in section 2201 of the Social Security 
        Act) to provide the goods or services that are necessary to 
        avoid physical harm, disability, mental anguish, or mental 
        illness.
            ``(3) Nursing facility.--The term `nursing facility' means 
        both a nursing facility (as defined in section 1919(a) of the 
        Social Security Act) and a skilled nursing facility as defined 
        in section 1819(a) of the Social Security Act (42 U.S.C. 1395i-
        3(a).
            ``(4) Person.--The term `person' has the same meaning as in 
        section 921(a)(1) of this title.
    ``(b) Offense.--
            ``(1) In general.--It shall be unlawful for any person or 
        entity to, with the intent to cause injury or with reckless 
        disregard for the safety of human life, act or fail to act, if 
        such act or omission results in--
                    ``(A) serious bodily injury to 1 or more residents 
                of a nursing facility; and
                    ``(B) abuse or neglect of an additional 2 or more 
                residents of the same nursing facility.
            ``(2) Penalty for individual.--Any individual who violates 
        paragraph (1) shall be--
                    ``(A) imprisoned for not more than 20 years and, if 
                death results, shall be imprisoned for any term of 
                years or for life; and
                    ``(B) fined in accordance with section 3571.
            ``(3) Other penalty.--Any entity or person, other than an 
        individual, that violates paragraph (1) shall be fined not more 
        than $3,000,000 per nursing facility involved.''.
    (b) Health Care Offense.--Section 24(a)(1) of title 18, United 
States Code, is amended by inserting ``571,'' before ``669,''.
    (c) Technical and Conforming Amendment.--The table of chapters for 
part I of title 18, United States Code, is amended by inserting after 
the item relating to chapter 27 the following:

``28. Elder Abuse and Neglect...............................     571''.

SEC. 214. CIVIL ACTIONS FOR ELDER ABUSE AND NEGLECT.

    (a) Definitions.--In this section:
            (1) Entity.--
                    (A) In general.--The term ``entity'' means--
                            (i) any nursing facility (including 
                        facilities that do not exclusively provide 
                        nursing care);
                            (ii) any entity that manages a nursing 
                        facility; or
                            (iii) any entity that owns, directly or 
                        indirectly, a controlling interest or a 50 
                        percent or greater interest in 1 or more 
                        nursing facilities.
                    (B) Additional entities.--The term shall include 
                States, localities, and political subdivisions thereof.
            (2) Neglect.--The term ``neglect'' means the failure of a 
        caregiver (as defined in section 2201 of the Social Security 
        Act, as added by this Act) to provide the goods or services 
        that are necessary to avoid physical harm, disability, mental 
        anguish, or mental illness.
            (3) Nursing facility.--The term ``nursing facility'' means 
        both a nursing facility (as defined in section 1919(a) of the 
        Social Security Act (42 U.S.C. 1396r(a))) and a skilled nursing 
        facility as defined in section 1819(a) of the Social Security 
        Act.
            (4) Person.--The term ``person'' has the same meaning as in 
        section 921(a)(1) of title 18, United States Code.
            (5) Other terms.--The terms ``abuse'', ``State'', and 
        ``serious bodily injury'' shall have the meanings given those 
        terms in section 2201 of the Social Security Act.
    (b) Civil Actions Brought by the Attorney General.--
            (1) In general.--The Attorney General may bring an action 
        under this subsection against any person or entity that 
        knowingly, or in reckless disregard for the safety of human 
        life, acts or fails to act, if such act or omission results in 
        serious bodily injury to 1 or more residents of a nursing 
        facility and in abuse or neglect of an additional 2 or more 
        residents of the same nursing facility.
            (2) Civil penalty.--A person or entity that acts or fails 
        to act as described in paragraph (1) shall be liable to the 
        United States for a civil penalty of--
                    (A) in the case of an individual (other than an 
                owner, operator, officer, or manager of such a nursing 
                facility, such as a nurse or a certified nurse's aide) 
                up to $50,000 for each violation of this subsection;
                    (B) in the case of an individual who is an owner, 
                operator, officer, or manager of such a nursing 
                facility, up to $500,000 for each violation of this 
                subsection;
                    (C) in the case of a violation of this subsection 
                involving a single nursing facility, that facility, or 
                its management company, up to $3,000,000 for that 
                facility for such violation; and
                    (D) in the case of a violation of this subsection 
                at 2 or more nursing facilities with common ownership 
                or under common management, up to $6,000,000 for each 
                entity that owns such facilities where there were such 
                violations.
        The amount shall be set by the district court, depending on the 
        number of residents who suffered abuse or neglect, the severity 
        of the injury to residents relating to abuse or neglect, and 
        the number of resident deaths relating to abuse or neglect at 
        the facilities in violation of this subsection.
            (3) Other appropriate relief.--If the Attorney General has 
        reason to believe that a person or entity is engaging in or is 
        about to engage in an act or omission that results in or has 
        the potential for resulting in serious bodily injury to 1 or 
        more residents of a nursing facility and in abuse or neglect of 
        an additional 2 or more residents of the same nursing facility, 
        the Attorney General may petition an appropriate United States 
        district court for appropriate equitable and declaratory relief 
        to eliminate the circumstances giving rise to the actual or 
        potential harm.
            (3) Procedures.--
                    (A) In general.--A subpoena requiring the 
                attendance of a witness at a trial or hearing conducted 
                under this subsection may be served at any place in the 
                United States.
                    (B) Limitation.--An action brought under paragraph 
                (1) may not be brought more than 6 years after the date 
                on which the violation of this subsection occurred, 
                except that the time for filing is tolled during the 
                period when the right of action was not known and 
                reasonably could not have been known by an official of 
                the United States charged with responsibility to act in 
                the circumstances.
                    (C) Standard of proof.--The United States shall be 
                required to prove all actions under this subsection by 
                a preponderance of the evidence.
                    (D) Civil investigative demand procedures.--The 
                civil investigative demand procedures set forth in The 
                Antitrust Civil Process Act (15 U.S.C. 1511 et seq.) 
                may be used in investigations and actions pursued under 
                this subsection.
    (d) Relationship to Other Laws.--This section is not intended to 
supplant or otherwise bar any existing equitable, common law, or 
criminal or civil statutory remedies possessed by the United States, 
including under the False Claims Act (31 U.S.C. 33729-3733). The 
Federal Rules of Civil Procedure shall apply to actions brought under 
subsection (b).
    (e) No Private Cause of Action.--Nothing in this title creates a 
private cause of action or in any other way increases the liability of 
any person under any other law.

                       TITLE III--TAX PROVISIONS

SEC. 301. LONG-TERM CARE FACILITY WORKER EMPLOYMENT TAX CREDIT.

    (a) Work Opportunity Tax Credit.--
            (1) In general.--Section 51(d)(1) of the Internal Revenue 
        Code of 1986 (relating to members of targeted groups) is 
        amended by striking ``or'' at the end of subparagraph (G), by 
        striking the period at the end of subparagraph (H) and 
        inserting ``, or'', and by adding at the end the following:
                    ``(I) a qualified long-term care facility 
                worker.''.
            (2) Qualified long-term care facility worker.--Section 
        51(d) of such Code is amended by redesignating paragraphs (10) 
        through (12) as paragraphs (11) through (13), respectively, and 
        by inserting after paragraph (9) the following:
            ``(10) Qualified long-term care facility worker.--The term 
        `qualified long-term care facility worker' means any individual 
        who--
                    ``(A) is hired by a long-term care facility (as 
                defined in section 2201 of the Social Security Act, and
                    ``(B) is certified by the designated local agency 
                as being qualified to provide long-term care (as 
                defined in section 2201 of such Act) at such 
                facility.''.
    (b) Effective Date.--The amendments made by this section shall 
apply to individuals who begin work for the employer after the date of 
enactment of this Act.
                                 <all>