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S. 334 (es) To amend the Federal Power Act to remove the jurisdiction of the Federal Energy Regulatory Commission to license projects on fresh waters in the State of Hawaii. [Engrossed in Senate] ...

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  1st Session
                                 S. 333

           To promote elder justice, and for other purposes.



                           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,


    (a) Short Title.--This Act may be cited as the ``Elder Justice 
    (b) Table of Contents.--The table of contents of this Act is as 

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Purposes.

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.

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.


    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 
            (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 
            (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.


    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 
            (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 
            (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 



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

                      ``TITLE XXII--ELDER JUSTICE


    ``(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 
            ``(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 
            ``(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 
                            ``(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 

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