,,ii  #aacth ,,congress  #ast ,session  
,s4 #iih  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,may #ba1 #bjac ,mr4
 ,franken 7for himself and ,mr4         
,blumenthal7 introduced the following   
bill2 which was read twice and referred 
to the ,committee on ,health1           
,education1 ,labor1 and ,pensions  ,a   
,,bill  ,to amend the ,older ,americans 
,act of #aife to establish a ,home ,care
 ,consumer ,bill of ,rights1 to         
establish ,state ,home ,care ,ombudsman 
,programs1 and for other purposes4  #a4 
,short title ,this ,act may be cited as 
the ,home ,care ,consumer ,bill of      
,rights ,act4  ,i ,home care bill of    
rights  #aja4 ,administration on aging  
,section #bja7;e77#b7 of the ,older     
,americans ,act of #aife 7#db ,u4,s4,c4 
#cjaa7;e77#b77 is amended--  7#a7 in    
subparagraph 7,a71 by striking and at   
the end2  7#b7 in subparagraph 7,b71 by 
striking the period and inserting 2 and2
 and  7#c7 by adding at the end the     
following3  7,c7 to establish best      

practices for ,state-based enforcement  
of a ,home ,care ,consumer ,bill of     
,rights through a ,plan for             
,enforcement1 as such ,bill and ,plan   
are outlined in section #gje1 not later 
than #f months after the date of        
enactment of the ,home ,care ,consumer  
,bill of ,rights ,act1 and to make those
 best practices available to ,states1   
and to the public through the ,national 
,center on ,elder ,abuse2  7,d7 to      
assist ,states with the development of  
,home ,care ,consumer ,bills of ,rights 
and ,plans for ,enforcement1 to support 
the shift from institutional care to    
home and community-based long-term      
services and supports and ensure that   
home care consumers1 as defined in      
section #gcf1 have basic protections as 
outlined in subsections 7b7 and 7c7 of  
section #gje2  7,e7 to develop a process
 for review and approval of ,states'    
,home ,care ,consumer ,bills of ,rights 
and ,plans for ,enforcement1 not later  
than #f months after the date of        

enactment of the ,home ,care ,consumer  
,bill of ,rights ,act2 and  7,f7 to     
review and approve ,states' ,home ,care 
,consumer ,bills of ,rights and ,plans  
for ,enforcement through that process4  
4  #ajb4 ,additional ,state plan        
requirements  7a7 ,in general ,section  
#gje of the ,older ,americans ,act of   
#aife 7#db ,u4,s4,c4 #cjeh;d7 is        
amended--  7#a7 in subsection 7a7--     
7,a7 in paragraph 7#f71 by striking and 
at the end2  7,b7 in paragraph 7#g71 by 
striking the period and inserting 2 and2
 and  7,c7 by adding at the end the     
following3  7#h7 subject to section     
#ajb7;b7 of the ,home ,care ,consumer   
,bill of ,rights ,act1 an assurance--   
7,a7 that the ,state has a ,home ,care  
,consumer ,bill of ,rights and a ,plan  
for ,enforcement of such a ,bill1       
developed in accordance with the        
procedures described under paragraph    
7#b7 and as approved by the ,assistant  
,secretary1 and include a copy of the   
,bill and ,plan2 or  7,b7 at the        

discretion of the ,assistant ,secretary1
 in the event the ,state does not have  
an approved ,home ,care ,consumer ,bill 
of ,rights and ,plan for ,enforcement1  
that the ,state has an alternative such 
as a proposal for developing and        
submitting for approval a ,home ,care   
,consumer ,bill of ,rights and ,plan for
 ,enforcement4  2  7#b7 by redesignating
 subsection 7b7 as subsection 7d72  7#c7
 by inserting after subsection 7a7 the  
following3  7b7 ,home ,care ,consumer   
,bill of ,rights ,the ,home ,care       
,consumer ,bill of ,rights referred to  
in subsection 7a77#h7 shall1 at a       
minimum--  7#a7 address a home care     
consumer's right to basic safety by--   
7,a7 affirming that home care consumers 
are protected from physical1 sexual1    
mental1 and verbal abuse1 neglect1 and  
exploitation1 including financial       
exploitation2  7,b7 affirming that home 
care consumers are served by providers  
who are properly trained and are        
providing home care services within     

their scope of practice and the scope of
 their certification or licensure 7if   
such a certification or licensure is    
required by the applicable ,state72     
7,c7 affirming that such providers      
maintain the confidentiality of all     
personal1 financial1 and medical        
information of home care consumers2 and 
7,d7 affirming that providers respect   
the personal property of home care      
consumers1 and in the event of consumer 
reports of theft or loss1 investigate   
and report back to the consumer the     
results of the investigation2  7#b7     
address a home care consumer's right to 
access information by--  7,a7 affirming 
that home care consumers are informed of
 their rights under this subsection and 
subsection 7c7 within #b weeks after the
 start of home care services1 and about 
the entities the consumers may contact  
if their rights are violated1 including 
the name and contact information for    
,state and local agencies responsible   
for enforcing the ,home ,care ,consumer 

,bill of ,rights2  7,b7 affirming that  
home care consumers--  7i7 are informed 
of the cost of home care services prior 
to receiving those services1 whether the
 cost of those services are covered     
under health insurance1 long-term care  
insurance1 or other private and public  
programs1 and any charges the consumer  
will be expected to pay2 and  7ii7 are  
given advance notice of any changes to  
those costs or services2 and  7,c7      
affirming that home care consumers have 
access to information about the         
availability of the home care services  
provided in the community involved and  
have the ability to choose among home   
care services and providers of home care
 services available in the community2   
7#c7 address a home care consumer's     
right to choice1 participation1 and     
self-determination by--  7,a7 affirming 
that home care consumers can participate
 in the planning of their home care     
services1 including making choices about
 aspects of their care and services that

 are important to them1 choosing        
providers and schedules to the extent   
practicable1 receiving reasonable       
accommodation of their needs and        
preferences1 and involving anyone they  
chose to participate with them in that  
planning2  7,b7 affirming that home care
 consumers are provided with sufficient 
information to make informed decisions1 
are fully informed in advance about any 
proposed changes in care and services1  
and are involved in the decisionmaking  
process regarding those changes2 and    
7,c7 affirming that home care consumers 
can refuse services and receive an      
explanation of the consequences of doing
 so2  7#d7 address a home care          
consumer's right to receive care and    
services provided in a way that promotes
 each consumer's dignity and            
individuality2  7#e7 address a home care
 consumer's right to redress grievances 
by--  7,a7 affirming that home care     
consumers are able to voice grievances  
about the quality of their home care    

services1 the number of hours of        
service1 and violations of their rights1
 receive prompt responses to those      
concerns1 and are informed about the    
entities the consumers may contact to   
state those grievances in order to have 
the grievances addressed in an          
appropriate and timely manner1 and      
without retaliation2 and  7,b7 affirming
 that home care consumers are able to   
assert their rights under this          
subsection and subsection 7c7 without   
retaliation2  7#f7 address the role and 
responsibilities that fiduciaries may   
have in securing the rights of home care
 consumers affirmed under the ,home     
,care ,consumer ,bill of ,rights2 and   
7#g7 meet any other guidelines          
determined to be appropriate by the     
,assistant ,secretary4  7c7 ,plan for   
enforcement ,in developing the ,plan for
 ,enforcement referred to in subsection 
7a77#h71 the ,state shall take into     
account the best practices established  
under section #bja7;e77#b77;,c74 ,the   

,plan shall include a description of how
 ,state entities with a role in         
protecting older individuals1 such as   
home care services licensing agencies1  
adult protective services agencies1 the 
,office of the ,state ,long-,term ,care 
,ombudsman 7if the office has           
jurisdiction over home and              
community-based long-term care71 local  
law enforcement agencies1 and other     
entities determined to be appropriate by
 the ,assistant ,secretary1 will        
coordinate activities to enforce the    
,home ,care ,consumer ,bill of ,rights4 
2 and  7#d7 by adding at the end the    
following3  7e7 ,definition ,in this    
section1 the term home care consumer and
 home care services have the meanings   
given the terms in section #gcf4  4  7b7
 ,application of requirement ,to submit 
,state home care consumer bill of rights
 and plan for enforcement  7#a7 ,in     
general ,the requirement for a ,state to
 provide an assurance1 and either a     
,home ,care ,consumer ,bill of ,rights  

and a ,plan for ,enforcement of such    
,bill or an alternative1 under paragraph
 7#h7 of section #gje7;a7 of the ,older 
,americans ,act of #aife 7as added by   
subsection 7a77 shall apply to ,states  
beginning on the date 7referred to in   
this subsection as the application date7
 that is #a year after the date of the  
establishment of best practices under   
section #bja7;e77#b77;,c7 of such ,act  
7as added by section #aja74  7#b7 ,first
 submission after application date ,a   
,state shall comply with paragraph 7#h7 
of section #gje7;a7 of the ,older       
,americans ,act of #aife 7as added by   
subsection 7a77 in whichever of the     
following #b submissions occurs first   
with respect to such ,state after the   
application date described under        
paragraph 7#a73  7,a7 ,the submission of
 a new ,state plan under section #cjg of
 the ,older ,americans ,act of #aife    
7#db ,u4,s4,c4 #cjbg74  7,b7 ,the       
submission of an annual revision to a   
,state plan submitted under such section

 #cjg4  7#c7 ,ongoing submissions ,after
 complying with paragraph 7#h7 of       
section #gje7;a7 of the ,older          
,americans ,act of #aife 7as added by   
subsection 7a77 in a submission in      
accordance with paragraph 7#b7 of this  
subsection1 a ,state shall comply with  
such paragraph 7#h7 in each new ,state  
plan submitted under section #cjg of the
 ,older ,americans ,act of #aife 7#db   
,u4,s4,c4 #cjbg74  #ajc4 ,prevention of 
elder abuse1 neglect1 and exploitation  
,section #gba7;b7 of the ,older         
,americans ,act of #aife 7#db ,u4,s4,c4 
#cjeh;i7b77 is amended--  7#a7 in       
paragraph 7#aa71 by striking and at the 
end2  7#b7 in paragraph 7#ab71 by       
striking the period and inserting 2 and2
 and  7#c7 by adding at the end the     
following3  7#ac7 developing a ,state   
,home ,care ,consumer ,bill of ,rights  
and ,plan for ,enforcement 7as described
 in section #gje7 to protect home care  
consumers 7as defined in section #gcf7  
from abuse1 neglect1 and exploitation4  

4  #ajd4 ,national adult protective     
services resource center ,section #bja  
of the ,older ,americans ,act of #aife  
7#db ,u4,s4,c4 #cjaa7 is amended by     
adding at the end the following3  7g7   
7#a7 ,the ,assistant ,secretary shall1  
by grant or contract with a national    
nonprofit entity1 establish a ,national 
,adult ,protective ,services ,resource  
,center 7referred to in this subsection 
as the ,center74 ,the purposes of the   
,center are to improve the capacity of  
,state and local adult protective       
services programs to respond effectively
 to abuse1 neglect1 and exploitation of 
vulnerable adults1 including home care  
consumers and residents of long-term    
care facilities1 and to coordinate with 
the ,home ,care ,ombudsman ,program and 
,long-,term ,care ,ombudsman ,program to
 protect home care consumers and        
residents most effectively4  7#b7 ,the  
nonprofit entity awarded a grant or     
contract under this subsection shall    
have expertise in1 and representation   

by1 ,state and local adult protective   
services programs4  7#c7 ,the ,center   
shall--  7,a7 collect and disseminate   
information regarding1 and increase     
public awareness of1 the role of adult  
protective services programs in         
investigating the abuse1 neglect        
7including self-neglect71 and           
exploitation of vulnerable adults1      
including home care consumers and       
residents of long-term care facilities1 
and in intervening to protect the       
consumers and residents from abuse2     
7,b7 develop1 distribute1 and provide   
training and technical assistance for   
adult protective services program       
investigators and supervisors           
investigating the abuse1 neglect        
7including self-neglect71 and           
exploitation of vulnerable adults1      
including home care consumers and       
residents of long-term care facilities1 
and intervening to protect the consumers
 and residents from further abuse2  7,c7
 develop1 distribute1 and provide       

training to home care and long-term care
 professionals and others on            
recognizing1 reporting 7including       
regarding mandatory reporting           
requirements71 and responding to the    
abuse1 neglect 7including self-neglect71
 and financial exploitation of          
vulnerable adults1 including home care  
consumers and residents of long-term    
care facilities2  7,d7 compile and      
disseminate reports on research and best
 practices for adult protective services
 programs and other programs on         
effective responses to the abuse1       
neglect 7including self-neglect71 and   
exploitation of vulnerable adults1      
including home care consumers and       
residents of long-term care facilities2 
7,e7 work with the ,national ,ombudsman 
,resource ,center and ,state and local  
home care ombudsman programs and        
long-term care ombudsman programs to    
develop and disseminate training1       
practice standards1 and policies        
regarding--  7i7 the roles and          

responsibilities of adult protective    
services and ombudsman programs2  7ii7  
confidentiality and abuse reporting     
issues and protocols2 and  7iii7        
effective ways to maximize the resources
 of adult protective services programs  
for the benefit of home care consumers  
and residents of long-term care         
facilities2 and  7,f7 establish a data  
system to collect information on the    
abuse1 neglect 7including self-neglect71
 and exploitation of home care consumers
 and residents of long-term care        
facilities and to measure the           
effectiveness of the activities carried 
out by the ,center4  7#d7 ,in this      
subsection1 the terms home care consumer
 and home care ombudsman program have   
the meanings given the terms in section 
#gcf4  4  ,,ii ,state home care         
ombudsman programs  #bja4 ,program      
,section #gja of the ,older ,americans  
,act of #aife 7#db ,u4,s4,c4 #cjeh7 is  
amended by inserting and grants after   
allotments4  #bjb4 ,authorization of    

appropriations ,chapter #a of subtitle  
,a of title ,,vii of the ,older         
,americans ,act of #aife is amended by  
inserting after section #gjb 7#db       
,u4,s4,c4 #cjeh;a7 the following3       
#gjb;,a4 ,authorization of              
appropriations for ,state home care     
ombudsman program ,there are authorized 
to be appropriated to carry out chapter 
#e such sums as may be necessary for    
fiscal year #bjad and each subsequent   
fiscal year4  4  #bjc4 ,grants ,section 
#gjc of the ,older ,americans ,act of   
#aife 7#db ,u4,s4,c4 #cjeh;b7 is amended
 by adding at the end the following3    
7d7 ,grants for ,state home care        
ombudsman programs  7#a7 ,in general    
,the ,assistant ,secretary shall use    
funds made available under section      
#gjb;,a to award grants1 on a           
competitive basis1 to ,states for ,state
 ,home ,care ,ombudsman ,programs4  7#b7
 ,considerations ,in selecting ,states  
to receive the grants1 the ,assistant   
,secretary shall consider--  7,a7 a     

,state's current financial support 7as  
of the date of consideration7 for home  
care ombudsman services2  7,b7 a        
,state's commitment to preventing       
conflict of interest between providers  
of home care services and providers of  
home care ombudsman services2 and  7,c7 
other criteria determined by the        
,assistant ,secretary4  7#c7 ,priorities
 ,in selecting ,states to receive the   
grants1 the ,assistant ,secretary may   
give first priority to ,states that are 
providing home care ombudsman services  
to home care consumers on the date of   
enactment of section #gcg1 and seek to  
enhance the home care ombudsman programs
 through which the ,states provide the  
services4  4  #bjd4 ,eligibility  7a7   
,organization ,section #gjd of the      
,older ,americans ,act of #aife 7#db    
,u4,s4,c4 #cjeh;c7 is amended1 in the   
matter preceding paragraph 7#a71 by     
inserting or grants after allotments4   
7b7 ,additional requirements ,section   
#gje7;a7 of the ,older ,americans ,act  

of #aife 7#db ,u4,s4,c4 #cjeh;d7a77 is  
amended--  7#a7 in the matter preceding 
paragraph 7#a71 by inserting or grant   
after allotment2 and  7#b7 in paragraph 
7#d71 by striking enactment of this     
subtitle and inserting enactment of the 
chapter4  #bje4 ,state ,home ,care      
,ombudsman ,programs ,subtitle ,a of    
title ,,vii of the ,older ,americans    
,act of #aife 7#db ,u4,s4,c4 #cjeh et   
seq47 is amended by adding at the end   
the following3  #e ,state ,home ,care   
,ombudsman ,programs  #gcf4 ,definitions
 ,in this chapter3  7#a7 ,home care     
consumer ,the term home care consumer   
means a person who receives services in 
the person's home or community to       
promote independence and reduce the     
necessity for residence in a long-term  
care facility1 which may include--  7,a7
 home care services provided through    
this ,act1 the ,medicare program under  
title ,,xviii of the ,social ,security  
,act 7#db ,u4,s4,c4 #acie et seq471 the 
,medicaid program under title ,,xix of  

the ,social ,security ,act 7#db         
,u4,s4,c4 #acif et seq471 or another    
public or private funding source2 or    
7,b7 home care services determined to be
 appropriate by a ,state operating a    
,state ,home ,care ,ombudsman ,program4 
7#b7 ,home care ombudsman program ,the  
term home care ombudsman program means a
 ,state ,home ,care ,ombudsman ,program 
described in section #gcg7;a77#a74  7#c7
 ,home care ombudsman representative    
,the term home care ombudsman           
representative includes an employee or  
volunteer who represents an entity      
designated under section                
#gcg7;a77#e77;,a7 and who is            
individually designated by the          
,ombudsman4  7#d7 ,home care services   
,the term home care services means home 
and community-based services to promote 
independence and reduce the necessity   
for residence in a long-term care       
facility1 including personal care       
services designed to assist an          
individual in the activities of daily   

living such as bathing1 exercising1     
personal grooming1 and getting in and   
out of bed4  7#e7 ,local home care      
,ombudsman entity ,the term local home  
care ,ombudsman entity means an entity  
designated under section                
#gcg7;a77#e77;,a7 to carry out the      
duties described in section             
#gcg7;a77#e77;,b7 with respect to a     
planning and service area or other      
substate area4  7#f7 ,office2 ,ombudsman
 ,the terms ,office and ,ombudsman1 used
 without further modification1 have the 
meanings given the terms in section     
#gaa4  #gcg4 ,program  7a7              
,establishment  7#a7 ,in general ,in    
order to be eligible to receive a grant 
under section #gjc7;d7 from funds       
appropriated under section #gjb;,a and  
made available to carry out this        
chapter1 a ,state agency shall1 in      
accordance with this section1 agree to  
carry out a ,state ,home ,care          
,ombudsman ,program within the ,office  
of the ,state ,long-,term ,care         

,ombudsman4  7#b7 ,home care ombudsman  
program ,the home care ombudsman program
 shall be carried out by the ,ombudsman4
  7#c7 ,functions ,in carrying out the  
home care ombudsman program1 the        
,ombudsman1 personally or through       
representatives of the home care        
ombudsman program--  7,a7 shall         
identify1 investigate1 and resolve      
complaints that--  7i7 are made by1 or  
on behalf of1 home care consumers2  7ii7
 relate to action1 inaction1 or         
decisions1 that may adversely affect the
 health1 safety1 welfare1 or rights of  
home care consumers 7including the      
welfare and rights of home care         
consumers with respect to the           
appointment and activities of guardians 
and representative payees71 of--  7,i7  
entities responsible for determining    
eligibility for home care services1 such
 as ,state and local governments2 and   
7,,ii7 entities responsible for         
determining availability of home care   
services1 such as managed care          

organizations2 or  7iii7 relate to      
action1 inaction1 or decisions1         
regarding informing home care consumers 
about their eligibility for1 or the     
availability of1 home care services1    
of--  7,i7 providers1 or representatives
 of providers1 of home care services2   
7,,ii7 public agencies2  7,,iii7 health 
and social service agencies2 and  7,,iv7
 entities providing consumer-directed   
services under a consumer-directed      
program2  7,b7 shall provide services to
 protect the health1 safety1 welfare1   
and rights of home care consumers2  7,c7
 shall inform home care consumers about 
means of obtaining services provided by 
providers or agencies described in      
subparagraph 7,a77ii7 or services       
described in subparagraph 7,b72  7,d7   
shall1 in conjunction with other        
entities1 such as area agencies on      
aging1 conduct public education about   
the home care ombudsman program and its 
services1 including the rights of home  
care workers to report concerns to the  

ombudsman in order to protect the       
health1 safety1 welfare1 and rights of  
home care consumers2  7,e7 shall ensure 
that home care consumers and            
complainants receive timely responses   
from representatives of the home care   
ombudsman program to complaints2  7,f7  
shall represent the interests of home   
care consumers before governmental      
agencies and seek administrative1 legal1
 and other remedies to protect the      
health1 safety1 welfare1 and rights of  
the home care consumers1 including      
issues related to the sufficiency of the
 home care workforce and its            
availability to meet the needs of home  
care consumers2  7,g7 shall provide     
administrative and technical assistance 
to entities designated under paragraph  
7#e7 to assist the entities in          
participating in the home care ombudsman
 program2  7,h7 shall provide for       
training representatives of the home    
care ombudsman program2  7,i7 shall--   
7i7 promote the development of citizen  

organizations1 to participate in the    
home care ombudsman program2  7ii7      
analyze1 comment on1 and monitor the    
development and implementation of       
,federal1 ,state1 and local laws1       
regulations1 and other governmental     
policies and actions1 that pertain to   
the health1 safety1 welfare1 and rights 
of home care consumers1 with respect to 
the adequacy of home care services in   
the ,state1 including issues related to 
the sufficiency of the home care        
workforce and its availability to meet  
the needs of home care consumers2  7iii7
 recommend any changes in such laws1    
regulations1 policies1 and actions as   
the ,ombudsman determines to be         
appropriate2 and  7iv7 facilitate public
 comment on the laws1 regulations1      
policies1 and actions2 and  7,j7 shall  
carry out other activities as the       
,assistant ,secretary determines to be  
appropriate4  7#d7 ,contracts and       
arrangements  7,a7 ,in general  7i7     
,agencies and organizations ,except as  

provided in subparagraph 7,b71 the      
,state agency shall carry out the home  
care ombudsman program1 directly1 or by 
contract or other arrangement with any  
public agency or nonprofit private      
organization4  7ii7 ,area agencies on   
aging ,the ,state agency shall determine
 whether to enter into contracts or     
arrangements with area agencies on aging
 to carry out the home care ombudsman   
program1 based on the structure of the  
,state's existing 7as of the date of the
 determination7 long-term care ombudsman
 program and the potential for conflicts
 of interest in the home and            
community-based services system in the  
,state4 ,a ,state agency may carry out a
 home care ombudsman program through    
area agencies on aging in the ,state1 if
 the area agencies on aging--  7,i7 have
 existing 7as of the date of the        
determination7 consumer protection      
systems in place to prevent such        
conflicts of interest2 or  7,,ii7       
establish adequate procedures to prevent

 conflicts of interest under the        
program4  7,b7 ,licensing and           
certification organizations2            
associations ,the ,state agency may not 
enter into the contract or other        
arrangement described in subparagraph   
7,a7 with--  7i7 an agency or           
organization that is responsible for    
licensing or certifying home care       
services in the ,state2 or  7ii7 an     
association 7or an affiliate of such an 
association7 of providers of home care  
services4  7#e7 ,designation of local   
home care ombudsman entities and home   
care ombudsman representatives  7,a7    
,designation ,in carrying out the duties
 of the ,office1 the ,ombudsman may     
designate an entity as a local home care
 ,ombudsman entity 7and1 in doing so1   
the ,ombudsman shall1 if a local        
,ombudsman entity has already been      
designated1 designate such local        
,ombudsman entity as the local home care
 ,ombudsman entity71 and may designate  
an employee or volunteer to represent   

the entity4  7,b7 ,duties ,an individual
 so designated1 in accordance with the  
policies and procedures established by  
the ,ombudsman and the ,state agency--  
7i7 shall provide services to protect   
the health1 safety1 welfare1 and rights 
of home care consumers2  7ii7 shall     
ensure that home care consumers in the  
service area of the entity have timely  
responses to complaints and requests for
 assistance2  7iii7 shall identify1     
investigate1 and resolve complaints made
 by or on behalf of home care consumers 
that relate to action1 inaction1 or     
decisions1 that may adversely affect the
 health1 safety1 welfare1 or rights of  
home care consumers2  7iv7 shall        
represent the interests of home care    
consumers before government agencies and
 seek administrative1 legal1 and other  
remedies to protect the health1 safety1 
welfare1 and rights of home care        
consumers2  7v7 shall--  7,i7 review1   
and if necessary1 comment on any        
existing and proposed laws1 regulations1

 and other government policies and      
actions1 that pertain to the rights and 
well-being of home care consumers2 and  
7,,ii7 facilitate the ability of the    
public to comment on the laws1          
regulations1 policies1 and actions2     
7vi7 shall make referrals for services  
to protect and provide for the health1  
safety1 educational needs1 welfare1 and 
rights of family or household members   
7including children7 of home care       
consumers2 and  7vii7 shall carry out   
other activities that the ,ombudsman    
determines to be appropriate4  7,c7     
,eligibility for designation ,entities  
eligible to be designated as local home 
care ,ombudsman entities1 and           
individuals eligible to be designated as
 home care ombudsman representatives of 
such entities1 shall--  7i7 have        
demonstrated capability to carry out the
 duties established in section          
#gab7;a77#e77;,b72  7ii7 be free of     
conflicts of interest and not stand to  
gain financially through an action or   

potential action brought on behalf of   
individuals the ,ombudsman serves2 and  
7iii7 meet such additional requirements 
as the ,ombudsman may specify4  7,d7    
,policies and procedures  7i7 ,in       
general ,the ,state agency shall        
establish1 in accordance with the       
,ombudsman1 policies and procedures for 
monitoring local home care ,ombudsman   
entities designated to carry out the    
duties established in section           
#gab7;a77#e77;,b74  7ii7 ,policies ,in a
 case in which the entities are grantees
 or the home care ombudsman             
representatives are employees1 of area  
agencies on aging1 the ,state agency    
shall develop the policies in           
consultation with the area agencies on  
aging4 ,the policies shall provide for  
participation and comment by the        
agencies and for resolution of concerns 
with respect to case activity4  7iii7   
,confidentiality and disclosure ,the    
,state agency shall develop the policies
 and procedures in accordance with all  

provisions of this subtitle regarding   
confidentiality and conflict of interest
 for providers of home care services4   
7b7 ,procedures for access  7#a7 ,in    
general ,the ,state shall ensure that   
representatives of the home care        
ombudsman program shall have--  7,a7    
access to home care consumers and their 
homes with permission of the home care  
consumer involved or a legal            
representative2  7,b7 7i7 appropriate   
access to review all records of a home  
care consumer1 if--  7,i7 the           
representative of the home care         
ombudsman program has the permission of 
the home care consumer1 or the legal    
representative of the home care         
consumer2 or  7,,ii7 the home care      
consumer is unable to consent to the    
review and has no legal representative2 
or  7ii7 such access to the records as  
is necessary to investigate a complaint 
if--  7,i7 a legal guardian of the home 
care consumer refuses to give the       
permission2  7,,ii7 a representative of 

the home care ombudsman program has     
reasonable cause to believe that the    
guardian is not acting in the best      
interests of the home care consumer2 and
  7,,iii7 the representative obtains the
 approval of the ,ombudsman2  7,c7      
access to the administrative records1   
policies1 and documents1 to which home  
care consumers have1 or the general     
public has access1 of the provider of   
home care services2 and  7,d7 access to 
and1 on request1 copies of all licensing
 and certification records maintained by
 the ,state with respect to the provider
 of home care services4  7#b7           
,procedures ,the ,state agency shall    
establish procedures to ensure the      
access described in paragraph 7#a74  7c7
 ,reporting system ,the ,state agency   
shall ensure that the reporting system  
established in section #gab7;c7 is      
equipped to--  7#a7 collect and analyze 
data relating to complaints and         
conditions concerning home care services
 and to home care consumers for the     

purpose of identifying and resolving    
significant problems1 including         
complaints concerning--  7,a7 quality of
 services2  7,b7 quantity of services2  
7,c7 availability of services2 and  7,d7
 denial1 reduction1 and termination of  
services2 and  7#b7 submit the data1 on 
a regular basis1 to--  7,a7 the agency  
of the ,state responsible for licensing 
or certifying providers of home care    
services in the ,state2  7,b7 other     
,state and ,federal entities that the   
,ombudsman determines to be appropriate2
  7,c7 the ,assistant ,secretary2 and   
7,d7 the ,national ,ombudsman ,resource 
,center established in section          
#bjb7;a77#ah77;,a74  7d7 ,disclosure    
7#a7 ,in general ,the ,state agency     
shall establish procedures for the      
disclosure by the ,ombudsman or local   
home care ,ombudsman entities of files  
maintained by the home care ombudsman   
program1 including records described in 
subsection 7b77#a7 or 7c74  7#b7        
,identity of complainant or home care   

consumer ,the procedures described in   
paragraph 7#a7 shall--  7,a7 provide    
that1 subject to subparagraph 7,b71 the 
files and records described in paragraph
 7#a7 may be disclosed only at the      
discretion of the ,ombudsman 7or the    
person designated by the ,ombudsman to  
disclose the files and records72 and    
7,b7 prohibit the disclosure of the     
identity of any complainant or home care
 consumer with respect to whom the      
,office maintains such files or records 
unless--  7i7 the complainant or home   
care consumer1 or the legal             
representative of the complainant or    
home care consumer1 consents to the     
disclosure and the consent is given in  
writing2  7ii7 7,i7 the complainant or  
home care consumer gives consent orally2
 and  7,,ii7 the consent is documented  
contemporaneously in a writing made by a
 representative of the home care        
ombudsman program in accordance with    
such requirements as the ,state agency  
shall establish2 or  7iii7 the          

disclosure is required by court order4  
7e7 ,consultation ,in planning and      
carrying out the home care ombudsman    
program1 the ,state agency shall        
consider the views of area agencies on  
aging1 older individuals1 and providers 
of home care services and demonstrate   
how the ,state agency has taken their   
views into consideration4  7f7 ,conflict
 of interest ,the ,state agency shall-- 
7#a7 ensure that no individual1 or      
member of the immediate family of an    
individual1 involved in the designation 
of the ,ombudsman 7whether by           
appointment or otherwise7 or the        
designation of an entity designated     
under subsection 7a77#e71 is subject to 
a conflict of interest2  7#b7 ensure    
that no officer or employee of the      
,office1 home care ombudsman            
representative of a local home care     
,ombudsman entity1 or member of the     
immediate family of the officer1        
employee1 or home care ombudsman        
representative1 is subject to a conflict

 of interest2  7#c7 ensure that the     
,ombudsman--  7,a7 does not have a      
direct involvement in the licensing or  
certification of a provider of home care
 services2  7,b7 does not have an       
ownership or investment interest        
7represented by equity1 debt1 contract1 
or other financial relationship7 in a   
provider of home care services2  7,c7 is
 not employed by1 or participating in   
the management of1 a provider of home   
care services2 and  7,d7 does not       
receive1 or have the right to receive1  
directly or indirectly1 remuneration 7in
 cash or in-kind7 under a compensation  
arrangement with an owner or operator of
 a provider of home care services2 and  
7#d7 establish1 and specify in writing1 
mechanisms to identify and remove       
conflicts of interest referred to in    
paragraphs 7#a7 and 7#b71 and to        
identify and eliminate the relationships
 described in subparagraphs 7,a7 through
 7,d7 of paragraph 7#c71 including such 
mechanisms as--  7,a7 the methods by    

which the ,state agency will examine    
individuals1 and immediate family       
members1 to identify the conflicts2 and 
7,b7 the actions that the ,state agency 
will require the individuals and such   
family members to take to remove such   
conflicts4  7g7 ,legal counsel ,the     
,state agency shall ensure that--  7#a7 
7,a7 adequate legal counsel is          
available1 and is able1 without conflict
 of interest1 to--  7i7 provide advice  
and consultation needed to protect the  
health1 safety1 welfare1 and rights of  
home care consumers2 and  7ii7 assist   
the ,ombudsman and representatives of   
the home care ombudsman program in the  
performance of the official duties of   
the ,ombudsman and representatives2 and 
7,b7 legal representation is provided to
 any representative of the home care    
ombudsman program against whom suit or  
other legal action is brought or        
threatened to be brought in connection  
with the performance of the official    
duties of the ,ombudsman or such a      

representative2 and  7#b7 the ,ombudsman
 pursues administrative1 legal1 and     
other appropriate remedies on behalf of 
home care consumers4  7h7               
,administration  7#a7 ,requirements ,the
 ,state agency shall require the ,office
 to--  7,a7 include in its annual report
 required in section #gab7;h77#a7--  7i7
 a description of the activities carried
 out by the ,office as they related to  
the home care ombudsman program in the  
year for which the report is prepared2  
7ii7 the data and an analysis of the    
data collected under subsection 7c72    
7iii7 an evaluation of the problems     
experienced by1 and the complaints made 
by or on behalf of1 home care consumers2
  7iv7 recommendations for--  7,i7      
improving quality of the care and life  
of the home care consumers2 and  7,,ii7 
protecting the health1 safety1 welfare1 
and rights of the home care consumers2  
7v7 7,i7 an analysis of the success of  
the home care ombudsman program         
including success in providing services 

to home care consumers in communities   
with high percentages of racial or      
ethnic minorities2 and  7,,ii7          
identification of barriers that prevent 
the optimal operation of the home care  
ombudsman program2 and  7vi7 policy1    
regulatory1 and legislative             
recommendations to solve identified     
problems1 to resolve the complaints1 to 
improve the quality of care and life of 
home care consumers1 to protect the     
health1 safety1 welfare1 and rights of  
home care consumers1 and to remove the  
barriers2  7,b7 not later than #b years 
after the date of the enactment of this 
chapter1 establish procedures for the   
training of the representatives of the  
home care ombudsman program1 including  
unpaid volunteers1 based on best        
practices outlined by the ,assistant    
,secretary in the most recent report    
submitted under subsection 7m77#a71 in  
consultation with representatives of    
citizen groups1 providers of home care  
services1 and the home care ombudsman   

program1 that--  7i7 specify a minimum  
number of hours of initial training2    
7ii7 specify the content of the         
training1 including training relating   
to--  7,i7 ,federal1 ,state1 and local  
laws1 regulations1 and policies1 with   
respect to providers of home care       
services in the ,state2  7,,ii7         
investigative techniques2 and  7,,iii7  
such other matters as the ,state        
determines to be appropriate2 and  7iii7
 specify an annual number of hours of   
in-service training for all designated  
representatives2  7,c7 prohibit any     
representative of the home care         
ombudsman program 7other than the       
,ombudsman7 from carrying out any       
activity described in subparagraphs 7,a7
 through 7,h7 of subsection 7a77#c7     
unless the representative--  7i7 has    
received the training required under    
subparagraph 7,b72 and  7ii7 has been   
approved by the ,ombudsman as qualified 
to carry out the activity on behalf of  
the ,office2  7,d7 coordinate home care 

ombudsman services with the protection  
and advocacy systems for individuals    
with developmental disabilities and     
mental illnesses established under--    
7i7 subtitle ,c of the ,developmental   
,disabilities ,assistance and ,bill of  
,rights ,act of #bjjj 7#db ,u4,s4,c4    
#aejda et seq472 and  7ii7 the          
,protection and ,advocacy for           
,individuals with ,mental ,illness ,act 
7#db ,u4,s4,c4 #ajhja et seq472  7,e7   
coordinate1 to the greatest extent      
possible1 home care ombudsman services  
with legal assistance provided under    
section #cjf7;a77#b77;,c71 through      
adoption of memoranda of understanding  
and other means2  7,f7 coordinate       
services with ,state and local law      
enforcement agencies and courts of      
competent jurisdiction2 and  7,g7 permit
 any local home care ,ombudsman entity  
to carry out the responsibilities       
described in subparagraph 7,a71 7,d71 or
 7,e74  7#b7 ,authorities ,the ,state   
agency shall require the ,office to--   

7,a7 analyze1 comment on1 and monitor   
the development and implementation of   
,federal1 ,state1 and local laws1       
regulations1 and other government       
policies and actions that pertain to    
providers of home care services and     
those services1 and to the health1      
safety1 welfare1 and rights of home care
 consumers1 in the ,state1 and recommend
 any changes in such laws1 regulations1 
and policies as the ,ombudsman          
determines to be appropriate2  7,b7 7i7 
provide such information as the         
,ombudsman determines to be necessary to
 public and private agencies1           
legislators1 and other persons1         
regarding--  7,i7 the problems and      
concerns of older individuals receiving 
home care services2 and  7,,ii7         
recommendations related to the problems 
and concerns2 and  7ii7 make available  
to the public1 and submit to the        
,assistant ,secretary1 the chief        
executive officer of the ,state1 the    
,state legislature1 the ,state agency   

responsible for licensing or certifying 
providers of home care services1 and    
other appropriate governmental entities1
 each report prepared under paragraph   
7#a77;,a72 and  7,c7 permit any local   
home care ,ombudsman entity to carry out
 the responsibilities described in      
subparagraph 7,a7 or 7,b74  7i7         
,liability ,the ,state shall ensure that
 no representative of the home care     
ombudsman program will be liable under  
,state law for the good faith           
performance of official duties4  7j7    
,noninterference ,the ,state shall--    
7#a7 ensure that willful interference   
with representatives of the home care   
ombudsman program in the performance of 
the official duties of the              
representatives 7as defined by the      
,assistant ,secretary7 shall be         
unlawful2  7#b7 prohibit retaliation and
 reprisals by a provider of home care   
services or other entity with respect to
 any recipient of home and              
community-based services1 employee1     

exclusive representative of an employee1
 or other person for filing a complaint 
with1 providing information to1 or      
otherwise cooperating with any          
representative of1 the home care        
ombudsman program2 and  7#c7 provide for
 appropriate sanctions with respect to  
the interference1 retaliation1 and      
reprisals4  7k7 ,coordination with      
,adult ,protective ,services  7#a7 ,in  
general ,the ,ombudsman1 in carrying out
 the ,state ,home ,care ,ombudsman      
,program1 shall coordinate activities   
with the ,national ,adult ,protective   
,services ,resource ,center and the head
 of the ,state's adult protective       
services program in a manner that is    
consistent with the ,state's existing   
7as of the date of the coordination7    
protocols for coordination of activities
 between the ,ombudsman1 in carrying out
 the ,state ,long-,term ,care ,ombudsman
 ,program4  7#b7 ,establishment of      
protocols ,if the protocols described in
 paragraph 7#a7 do not exist in the     

,state1 the ,ombudsman1 in conjunction  
with the head of the ,state's adult     
protective services program1 shall      
establish protocols to coordinate       
activities with the intent of better    
serving vulnerable adults1 which        
protocols shall--  7,a7 clarify the     
roles of each program2  7,b7 establish  
procedures for maintaining a working    
relationship2  7,c7 outline mutual      
expectations2 and  7,d7 establish       
procedures for coordinating activities  
with law enforcement4  7l7 ,maintenance 
of effort ,a ,state1 in using the funds 
made available for a fiscal year through
 a grant received under section         
#gjc7;d71 shall maintain the            
expenditures of the ,state for home care
 ombudsman services at a level that is  
not less than the level of such         
expenditures maintained by the ,state   
for the preceding fiscal year4  7m7     
,evaluation ,the ,assistant ,secretary  
shall--  7#a7 in conjunction with the   
,director of the ,office of ,long-,term 

,care ,ombudsman ,programs and the heads
 of other entities determined to be     
necessary by the ,assistant ,secretary1 
collect and analyze the data required to
 be submitted under subsection 7c7 by   
the ,states and within #a year after    
receipt of the data1 submit a report to 
,congress outlining best practices for  
carrying out a home care ombudsman      
program2 and  7#b7 make the report      
available to ,states4  4  ,,iii ,quality
 measures for home and community-based  
services  #cja4 ,functions of ,assistant
 ,secretary ,section #bjb7;b7 of the    
,older ,americans ,act of #aife 7#db    
,u4,s4,c4 #cjab7;b77 is amended--  7#a7 
in paragraph 7#h7--  7,a7 in            
subparagraph 7,d71 by striking and at   
the end2  7,b7 in subparagraph 7,e7 by  
adding and at the end2 and  7,c7 by     
adding at the end the following3  7,f7  
to provide information1 relating to the 
quality measures identified under       
paragraph 7#aa77;,a71 using the methods 
described in paragraph 7#aa77;,b71 about

 home and community-based long-term care
 programs1 service providers1 and       
resources1 when referring consumers to  
those programs1 providers1 or resources2
  2  7#b7 in paragraph 7#i7--  7,a7 in  
the matter preceding subparagraph 7,a71 
by striking and community-based service 
providers and inserting community-based 
service providers1 and1 for purposes of 
subparagraph 7,c71 ,aging and           
,disability ,resource ,centers12  7,b7  
in subparagraph 7,a71 by striking and at
 the end2  7,c7 subparagraph 7,b71 by   
adding and at the end2 and  7,d7 by     
adding at the end the following3  7,c7  
methods1 consistent with the methods    
described in paragraph 7#aa77;,b71 to   
communicate to consumers quality        
information1 relating to the measures   
identified under paragraph 7#aa77;,a71  
about home and community-based long-term
 care programs1 service providers1 and  
resources2  2  7#c7 in paragraph 7#aj71 
by striking and at the end2  7#d7 by    
redesignating paragraph 7#aa7 as        

paragraph 7#ab72 and  7#e7 by inserting 
after paragraph 7#aj7 the following3    
7#aa7 7,a7 identify1 in consultation    
with ,states 7either directly or by     
entering into a contract under this     
subparagraph and considering the        
recommendation of the contract          
recipient7 measures of quality for home 
and community-based long-term care      
programs1 service providers1 and        
resources that--  7i7 shall be designed 
to ensure the health1 safety1 and       
welfare of consumers who are referred to
 such programs1 service providers1 and  
resources by area agencies on aging1    
,aging and ,disability ,resource        
,centers1 and such other entities as the
 ,assistant ,secretary determines to be 
appropriate2 and  7ii7 shall be         
identified after the ,assistant         
,secretary takes into account1 at a     
minimum1 information regarding--  7,i7  
background checks of service providers2 
7,,ii7 licensure of agencies and        
certification and training of service   

providers2  7,,iii7 consumer            
satisfaction regarding programs1 service
 providers1 and resources1 in cases in  
which consumer satisfaction information 
is available2 and  7,,iv7 such          
additional matters as the ,assistant    
,secretary determines to be appropriate2
 and  7,b7 taking into account the      
variation in communication              
infrastructure development among ,aging 
and ,disability ,resource ,centers1     
establish consumer-friendly methods for 
communicating to consumers1 consistently
 throughout a ,state--  7i7 quality     
information relating to the measures    
identified under subparagraph 7,a7 about
 home and community-based long-term care
 programs1 service providers1 and       
resources to which such consumers are   
referred to by area agencies on aging1  
,aging and ,disability ,resource        
,centers1 and such other entities as the
 ,assistant ,secretary determines to be 
appropriate2 and  7ii7 7,i7 the content 
of the ,state certification or licensure

 requirements applicable to such home   
and community-based long-term care      
programs1 service providers1 or         
resources2 or  7,,ii7 an explanation    
that the ,state does not have           
certification or licensure requirements 
applicable to such home and             
community-based long-term care programs1
 service providers1 or resources2 and  4
  #cjb4 ,organization ,section          
#cje7;a77#c77;,e7 of the ,older         
,americans ,act of #aife 7#db ,u4,s4,c4 
#cjbe7;a77#c77;,e77 is amended--  7#a7  
in the matter before clause 7i71 by     
striking information relating to2  7#b7 
in clause 7i7--  7,a7 by inserting      
information relating to after 7i72 and  
7,b7 by striking and at the end2  7#c7  
in clause 7ii7--  7,a7 by inserting     
information relating to after 7ii72 and 
7,b7 by striking the period and         
inserting 2 and2 and  7#d7 by adding at 
the end the following3  7iii7 quality   
information1 relating to the measures   
identified under section                

#bjb7;b77#aa77;,a71 about home and      
community-based long-term care programs1
 service providers1 and resources1      
provided through methods described in   
section #bjb7;b77#aa77;,b71 when the    
,aging and ,disability ,resource        
,centers1 area agencies on aging1 and   
such other entities as the ,assistant   
,secretary determines to be appropriate1
 refer consumers to those programs1     
providers1 and resources in the ,state4 
4