,,ii #aafth ,,congress #b;d ,session ,s4 #dahb ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,july #b1 #bjbj,mr4 ,grassley 7for himself1 ,mr4 ,daines1 and ,ms4 ,mc,sally7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to provide nursing homes with resources for responding to the ,,covid-#ai public health emergency to protect the health and safety of residents and workers1 to reauthorize funding for programs under the ,elder ,justice ,act of #bjji1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,emergency ,support for ,nursing ,homes and ,elder ,justice ,reform ,act of #bjbj4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,sec4 #b4 ,definitions4,sec4 #c4 ,providing resources for personal protective equipment and testing4,sec4 #d4 ,promoting transparency about ,,covid-#ai-related cases and fatalities and staffing levels in long-term care facilities4,sec4 #e4 ,establishing strike teams4,sec4 #f4 ,promoting identification and reporting of potential abuse or neglect in long-term care facilities4,sec4 #g4 ,promoting quality of life of long-term care facility residents through televisitation4,sec4 #h4 ,upgrading nursing home compare and the ,five-,star rating system4,sec4 #i4 ,enhancing ,federal oversight of nursing homes participating in ,medicare or ,medicaid4,sec4 #aj4 ,continuing funding for programs to prevent and prosecute elder abuse and neglect4,sec4 #aa4 ,increasing resources to investigate abuse or neglect and extend services to victims4,sec4 #ab4 ,protecting ,americans with dementia4,sec4 #ac4 ,reducing racial and ethnic disparities in long-term care facilities4,sec4 #ad4 ,establishing reciprocity with ,drug ,enforcement ,administration to address improper prescribing of controlled substances4 #b4 ,definitions ,in this ,act3 7#a7 ,,covid-#ai public health emergency period ,the term ,,covid-#ai public health emergency period means the period beginning on the first day of the emergency period defined in paragraph 7#a77;,b7 of section #aace7;g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#e7;g77 and ending on the last day of the calendar quarter in which the last day of such emergency period occurs4 7#b7 ,indian tribe ,the term ,indian tribe has the meaning given that term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#c7 ,long-term care facility ,the term long-term care facility has the meaning given that term in section #bjaa7ae7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;j7#ae774 7#d7 ,nursing facility ,the term nursing facility has the meaning given that term in section #aiai7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr7a774 7#e7 ,participating provider ,the term participating provider means a skilled nursing facility or a nursing facility that has been assigned a national provider identifier number by the ,secretary and has executed an agreement to participate in the ,medicare program established under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq47 or the ,medicaid program established under title ,,xix of such ,act 7#db ,u4,s4,c4 #acif et seq474 7#f7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#g7 ,skilled nursing facility ,the term skilled nursing facility has the meaning given that term in section #ahai7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#c7;a774 7#h7 ,state ,except as otherwise provided1 the term ,state has the meaning given such term for purposes of title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#i7 ,tribal organization ,the term tribal organization has the meaning given that term in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd74 7#aj7 ,other terms ,each other term has the meaning given the term for purposes of subtitle ,b of title ,,xx of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;j et seq474 #c4 ,providing resources for personal protective equipment and testing 7a7 ,in general ,a portion of any payments received or funds made available on or after ,july #a1 #bjbj1 for responding to the public health or fiscal impacts related to the ,coronavirus ,disease 7,,covid-#ai7 under ,federal legislation enacted on or after that date which primarily makes appropriations for the coronavirus response and related activities1 shall be used for the purposes described in subsection 7b71 notwithstanding the original purpose for which the amounts were appropriated to make such payments or funds available1 or any other provision of law restricting the use of such payments or funds4 7b7 ,purposes described ,the purposes described in this subsection are the following3 7#a7 ,to establish and maintain a supply of personal protective equipment at a level that is sufficient1 as determined by the ,centers for ,disease ,control and ,prevention1 in collaboration with the ,secretary and the ,administrator of the ,federal ,emergency ,management ,agency1 to provide for the safety of-- 7,a7 personnel employed by participating providers and long-term care facilities1 including licensed assisted living or residential care facilities1 during the ,,covid-#ai public health emergency period2 and 7,b7 ,state survey agency personnel who conduct audits or investigations of participating providers and long-term care facilities1 including licensed assisted living or residential care facilities1 during the ,,covid-#ai public health emergency period4 7#b7 ,to provide regular ,,covid-#ai testing for personnel and residents of participating providers and long-term care facilities1 including licensed assisted living or residential care facilities 7at no cost to such personnel and residents71 at a level that is sufficient1 based on the needs of the locality and its circumstances1 as determined by the ,director of the ,centers for ,disease ,control and ,prevention1 in collaboration with the ,secretary and the ,administrator of the ,federal ,emergency ,management ,agency1 to provide for the safety of such personnel and residents4 ,a ,state shall provide such testing during the #ij-;day period that begins on the date on which the ,secretary1 after consultation with the ,director of the ,centers for ,disease ,control and ,prevention1 determines the ,state is able to conduct such testing at such level and notifies the ,state of the date on which the testing period is to start4 7c7 ,standards and guidance ,not later than #cj days after the date of enactment of this ,act1 the ,director of the ,centers for ,disease ,control and ,prevention1 in collaboration with the ,secretary and the ,administrator of the ,federal ,emergency ,management ,agency1 shall issue detailed guidance to ,states on compliance with the requirements of this section as it relates to participating providers and long-term care facilities1 including licensed assisted living or residential care facilities4 #d4 ,promoting transparency about ,,covid-#ai-related cases and fatalities and staffing levels in long-term care facilities 7a7 ,collection and reporting of staffing data by participating providers ,the ,secretary shall develop a plan for ensuring that participating providers shall resume compliance with the requirement1 under section #aabh;,i7g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;j7g771 to electronically submit direct care staffing information based on payroll and other auditable data 7including measures to ensure that the submitted data includes direct care staffing information for the entire duration of the emergency period74 7b7 ,collection and reporting of data related to ,,covid-#ai by participating providers and long-,term care facilities 7#a7 ,in general 7,a7 ,reporting of ,,covid-#ai cases and fatalities by participating providers and long-term care facilities ,the ,secretary shall ensure that participating providers and long-term care facilities report all suspected and confirmed cases of ,,covid-#ai among personnel and residents of the provider or facility1 all ,,covid-#ai-related fatalities among personnel and residents of the provider or facility1 and all fatalities among personnel and residents of the provider or facility1 whether related to ,,covid-#ai or unrelated to ,,covid-#ai1 for the period beginning on ,january #a1 #bjbj1 to the ,secretary4 7,b7 ,timing and manner of reporting ,such data shall be reported to the ,secretary by participating providers and long-term care facilities in a format and manner that is consistent with any data that the ,secretary has directed participating providers to furnish to the ,centers for ,disease ,control and ,prevention on or after ,may #h1 #bjbj1 and1 beginning on the date that is #ae days after the date of enactment of this ,act1 shall be collected and reported to the ,secretary by participating providers and long-term care facilities on a daily basis4 7,c7 ,publication of data ,not later than #ae days after the date of enactment of this ,act1 the ,secretary shall make the data collected under this paragraph publicly available and shall update such data on a daily basis4 7#b7 ,collection and reporting of demographic data ,the ,secretary shall post the following information with respect to participating providers and long-term care facilities on the official internet website of the ,federal ,government for ,medicare beneficiaries 7commonly referred to as the ,nursing ,home ,compare ,medicare website7 7or a successor website7 aggregated by ,state3 7,a7 ,the age1 gender1 race1 ethnicity1 disability1 and preferred language of the residents of participating providers with suspected or confirmed ,,covid-#ai infections4 7,b7 ,with respect to residents of participating providers and long-term care facilities who died on or after ,january #a1 #bjbj1 the age1 gender1 race1 ethnicity1 disability1 and preferred language of-- 7i7 all of such residents2 and 7ii7 all of such residents whose deaths are related to ,,covid-#ai4 7#c7 ,confidentiality ,any information reported under this subsection that is made available to the public shall be made so available in a manner that protects the identity of residents of participating providers and long-term care facilities4 #e4 ,establishing strike teams 7a7 ,in general ,a portion of any payments received or funds made available on or after ,july #a1 #bjbj1 for responding to the public health or fiscal impacts related to the ,coronavirus ,disease 7,,covid-#ai7 under ,federal legislation enacted on or after that date which primarily makes appropriations for the coronavirus response and related activities1 shall be used to establish and support the operation of statewide or regional strike teams that meet the requirements of subsection 7b7 to respond to ,,covid-#ai-related crises in participating providers1 notwithstanding the original purpose for which the amounts were appropriated to make such payments or funds available1 or any other provision of law restricting the use of such payments or funds4 7b7 ,strike team requirements ,the requirements of this section with respect to a strike team of a ,state are the following3 7#a7 ,strike teams may include assessment1 testing1 and clinical teams1 and the ,state shall establish a mission for each such team by written directive1 which may include performing medical examinations1 conducting ,,covid-#ai testing1 and assisting participating providers with the implementation of quarantine1 isolation1 or disinfection procedures4 7#b7 ,each strike team shall be comprised of individuals who have relevant skills1 qualifications1 and experience to serve as members of #a or more of the assessment1 testing1 and clinical teams described in paragraph 7#a71 such as employees of the ,state or any of its political subdivisions1 members of the militia on ,state activity duty1 members of ,,covid-#ai response teams sent to the ,state by the ,secretary1 or other individuals designated by the ,state agency with primary responsibility for promoting resident and employee safety in participating providers4 7#c7 ,strike teams and members of such teams shall be subject to the ,state's oversight and direction and team members shall receive a ,state-issued letter of authorization describing-- 7,a7 the individual's designation to serve on #a or more teams under an emergency proclamation2 7,b7 the mission of the team2 7,c7 the authority of the individual to perform the team mission on the ,state's behalf2 7,d7 the individual's authority to access places1 persons1 and materials necessary for the team member's performance of the team's mission2 and 7,e7 the requirement that team members maintain the confidentiality of patient information shared with such individuals by the facility4 7#d7 ,the ,state may1 at any time1 disband any strike team and rescind the letter of authorization for any team member4 7#e7 ,a team and team member may not use the letter of authorization described in paragraph 7#c7 for any purpose except in connection with the team's mission of acting in good faith to promote resident and employee safety in participating providers in which ,,covid-#ai is confirmed to be present4 7#f7 ,the ,state shall establish protocols and procedures for requesting the assistance of a strike team established under this section and any other procedures deemed necessary for the team's operation4 7#g7 ,if a strike team finds consistent quality of care deficiencies with respect to a participating provider and such deficiencies immediately jeopardize the health or safety of residents of the participating provider1 the team shall1 within #ah hours of making such finding1 alert the ,state survey agency 7which may take immediate enforcement action to remove the jeopardy and correct the deficiencies through the remedies specified in section #ahai7;h77#b77;,b77iii7 or #aiai7;h77#b77;,a77iii7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#c7;h77#b77;,b77iii71 #acifr7h77#b77;,a77iii771 the long-term care ombudsman of the ,state1 and the ,medicaid fraud control unit of such ,state74 #f4 ,promoting identification and reporting of potential abuse or neglect in long-term care facilities 7a7 ,use of claims data ,to identify instances of potential abuse or neglect in facilities ,section #aabh;,i of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;j7 is amended by adding at the end the following new subsection3 7i7 ,use of claims data ,to identify instances of potential abuse or neglect 7#a7 ,compilation of codes ,not later than #a year after the date of the enactment of this subsection1 the ,secretary1 in collaboration with the ,inspector ,general of the ,department of ,health and ,human ,services1 shall-- 7,a7 compile a comprehensive list of diagnosis codes that may indicate potential physical or sexual abuse or neglect of the elderly2 and 7,b7 develop a plan for reliance on data from claims under titles ,,xviii and ,,xix that contain #a or more of those codes1 for the purpose of identifying instances of potential physical or sexual abuse or neglect in facilities receiving reimbursement under such titles4 7#b7 ,availability to states ,not later than #b years after the date of the enactment of this subsection1 the ,secretary shall make such claims data available to ,state survey agencies to help verify compliance with ,federal and ,state mandatory reporting laws4 4 7b7 ,required training on signs and symptoms of potential abuse or neglect ,section #aabh;,i of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;j71 as amended by subsection 7a71 is amended by adding at the end the following new subsection3 7j7 ,required training on signs and symptom of potential abuse or neglect ,beginning not later than #a year after the date of the enactment of this subsection1 a facility shall ensure that any staff of the facility who provide direct care 7as defined in section #bjaa7 to residents of the facility receive training on the signs and symptoms of potential abuse or neglect of the elderly4 4 7c7 ,evaluation and report on protocols ,to encourage prompt reporting of suspected incidents of potential abuse or neglect 7#a7 ,evaluation and implementation of protocols ,the ,secretary1 in collaboration with the ,attorney ,general1 shall evaluate the effectiveness of current protocols and1 if warranted1 recommend and implement improvements in those protocols1 to encourage prompt reporting of suspected incidents of potential abuse or neglect to the appropriate law enforcement officials or adult protective services office1 by ,state and ,federal surveyors of ,medicare and ,medicaid covered entities4 7#b7 ,report ,not later than #ahj days after the completion of the evaluation under paragraph 7#a71 the ,secretary shall submit to ,congress a report containing the results of such evaluation1 together with recommendations for improvements1 including such legislation and administrative action as the ,secretary determines appropriate4 7d7 ,issuance of guidance ,to deter social media abuse in facilities 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,secretary shall-- 7,a7 update guidance1 and1 as necessary1 issue new guidance to clarify for ,state survey and certification agencies the requirements applicable to facilities 7as defined in section #dhc4e of title #db1 ,code of ,federal ,regulations 7or any successor regulations77 under part #dhc of title #db1 ,code of ,federal ,regulations 7or any successor regulations71 to protect resident privacy and prohibit mental abuse or exploitation1 specifically as it relates to exploitative photographs1 audio and video recordings1 and posting or sharing of such photographs or recordings on social media networks or through multimedia messages2 and 7,b7 establish procedures to ensure that violations of the safety and privacy requirements applicable to facilities 7as so defined7 under part #dhc of title #db1 ,code of ,federal ,regulations 7or any successor regulations71 which prohibit misuse of photographs1 audio and video recordings1 and the inappropriate posting or sharing of such photographs or recordings on social media networks or through multimedia messages1 are reported by ,state survey agencies to law enforcement agencies1 adult protective service agencies1 and other relevant agencies and that such violations are recorded and tracked in the ,automated ,survey ,processing ,environment 7,,aspen7 and the ,,aspen ,complaints_/,incident ,tracking ,system 7,,acts74 7#b7 ,clarification ,the guidance issued under paragraph 7#a7 shall clarify that enforcement penalties do not apply to the posting or sharing of such photographs or recordings that occurred solely for the purpose of documenting and promptly reporting1 to the appropriate authorities1 a case of abuse in a facility4 #g4 ,promoting quality of life of long-term care facility residents through televisitation 7a7 ,promoting televisitation for residents 7#a7 ,in general ,sections #ahai7;c77#c7 and #aiai7;c77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#c7;c77#c71 #acifr7c77#c77 are each amended-- 7,a7 in subparagraph 7,d71 by striking and at the end2 7,b7 in subparagraph 7,e71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following new subparagraph3 7,f7 provide for access to telecommunications devices and use of the internet1 including assistance from facility staff in the use of such technology1 if necessary or requested by the resident or a family member1 to support telecommunication1 including but not limited to audio1 visual1 text communication1 videoconference1 and two-way audio_/video options1 by residents of such facility with family members and other individuals4 4 7#b7 ,access during ,,covid-#ai public health emergency period 7,a7 ,in general ,not later than #cj days after the date of enactment of this ,act1 the ,secretary shall take steps necessary to ensure that the residents of each participating provider and licensed assisted living or residential care facility have access to telecommunications devices and use of the internet 7to the extent practicable71 including assistance from facility staff in the use of such technology1 if necessary or requested by the resident or a family member1 to support telecommunication1 including but not limited to audio1 visual1 text communication1 videoconference and two-way audio_/video options1 by residents of such provider or facility with family members and other individuals4 7,b7 ,requirements ,in taking such steps1 the ,secretary shall address-- 7i7 notification to residents1 family members1 and other individuals of access to televisitation described in subparagraph 7,a72 7ii7 how such a provider or facility will ensure or enable installation and access to a device purchased by1 or for the use or benefit of1 individual residents2 and 7iii7 operational issues and steps to avoid unnecessary barriers to the timely deployment of such televisitation4 7b7 ,funding ,a participating provider may use a portion of any emergency funding that the provider receives 7prior to and after the date of enactment of this ,act7 from the ,secretary related to the ,,covid-#ai public health emergency period to purchase any technology1 including telecommunications devices and internet service1 or any other items or services as necessary to implement the televisitation described in the provisions of1 and amendments made by1 subsection 7a71 notwithstanding any other provision of law restricting the use of such funding4 #h4 ,upgrading nursing home compare and the ,five-,star rating system 7a7 ,comprehensive review of ,five-,star quality rating system ,sections #ahai and #aiai of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#c1 #acifr7 are each amended-- 7#a7 by redesignating subsection 7j7 as subsection 7k72 and 7#b7 by inserting after subsection 7i7 the following new subsection3 7j7 ,comprehensive review and modification of ,five-,star quality rating system 7#a7 ,in general ,the ,secretary shall conduct a comprehensive review of the system maintained by the ,secretary to measure and publicly report the quality of skilled nursing facilities and nursing facilities 7commonly referred to as the ,five-,star ,quality ,rating ,system74 7#b7 ,timing ,the ,secretary shall conduct such review not later than #a year after the end of the ,,covid-#ai public health emergency period and shall implement modifications to the ,five-,star ,quality ,rating ,system 7or its successor system7 not later than #ahj days after the release of the report that is required under paragraph 7#d74 7#c7 ,requirements ,the review of the system under this subsection shall include an evaluation of the relative weight accorded to each of the following3 7,a7 ,the adequacy of the facility's procedures for preventing and reporting infection4 7,b7 ,the adequacy of the facility's procedures for preventing and reporting incidents of abuse1 neglect1 mistreatment1 or exploitation of residents of the facility4 7,c7 ,deficiencies identified in the facility's most recent standard survey and the extent to which the facility corrected such deficiencies since the date of the most recent survey4 7,d7 ,the number1 type1 severity1 and outcome of substantiated complaints4 7,e7 ,the number of adjudicated instances of criminal violations by a facility or the employees of a facility4 7,f7 ,the number of civil monetary penalties levied against the facility1 employees1 contractors1 and other agents of the facility4 7,g7 ,selected quality measures 7such as the percentages of long-stay residents who experience pressure ulcers1 are physically restrained1 experience falls with major injury1 or received antipsychotic medication74 7,h7 ,whether a facility is connected to an assisted living facility and whether such facilities should be rated separately from facilities that are standalone skilled nursing facilities or nursing facilities4 7,i7 ,other items determined appropriate by the ,secretary4 7#d7 ,report ,not later than #ahj days after the completion of the review under paragraph 7#a71 the ,secretary shall submit to the ,committee on ,finance of the ,senate and the ,committee on ,ways and ,means of the ,house of ,representatives a final report that includes such findings and recommendations as the ,secretary considers appropriate based on the review1 including recommended actions to be taken to implement the specific recommendations in such report4 7#e7 ,consultation ,in conducting such review and implementing modifications of the system1 the ,secretary shall consult with each of the following3 7,a7 ,state long-term care ombudsman programs4 7,b7 ,adult protective services agencies4 7,c7 ,consumer advocacy and other nonprofit organizations whose mission is to promote the health1 safety1 and well being of older ,americans4 7,d7 ,provider stakeholder groups4 7,e7 ,statewide provider agencies and advocacy groups with relevant expertise4 7,f7 ,any other representatives of programs or groups the ,secretary determines appropriate4 7#f7 ,,covid-#ai public health emergency period ,in this subsection1 the term ,,covid-#ai public health emergency period means the period beginning on the first day of the emergency period defined in paragraph 7#a77;,b7 of section #aace7;g7 and ending on the last day of the calendar quarter in which the last day of such emergency period occurs4 4 7b7 ,transparency ,the ,secretary shall publicly report data1 at least quarterly1 regarding each ,state's enforcement actions with respect to deficiencies or statutory violations that have been reported to the ,centers for ,medicare ,medicaid ,services1 corrective actions1 if any1 that were recommended to resolve such deficiencies or statutory violations1 and the status of implementation of each such recommended corrective action by the participating provider involved4 7c7 ,funding ,the ,secretary shall transfer to the ,centers for ,medicare ,medicaid ,services ,program ,management ,account1 from the ,federal ,hospital ,insurance ,trust ,fund established under section #ahag of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i7 a one-time allocation of #bj1jjj1jjj1 to be used to carry out sections #ahai7;j7 and #aiai7;j7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#c1 #acifr7 7as added by subsection 7a7 and subsection 7b774 ,the amount shall be available on the date of the enactment of this ,act and shall remain available until expended4 #i4 ,enhancing ,federal oversight of nursing homes participating in ,medicare or ,medicaid 7a7 ,identification of facilities included in1 or candidates for1 the special focus facility program ,not later than #fj days after the date of enactment of this ,act1 the ,secretary shall publish the following lists on the official internet website of the ,federal ,government for ,medicare beneficiaries 7commonly referred to as the ,nursing ,home ,compare ,medicare website7 7or a successor website73 7#a7 ,a list of all participating providers that are included in the special focus facility program conducted under sections #ahai7;f77#h7 and #aiai7;f77#aj7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#c7;f77#h71 #acifr7f77#aj774 7#b7 ,a list of all participating providers that have been identified as candidates for such program1 based on the most recent survey of the facility4 7b7 ,regularly published updates ,the ,secretary shall publish periodic updates of the lists published under subsection 7a7 no less often than once every #cj days4 7c7 ,data collection ,to the extent that the ,secretary maintains a system to collect certification deficiencies and licensure violations relating to participating providers 7such as the ,automated ,survey ,processing ,environment ,,aspen or a successor system71 the ,secretary shall develop methods to separately track reports of confirmed incidents of abuse or neglect in such providers on survey forms through such system4 7d7 ,guidance on the meaning of terms ,not later than #ah months after the date of enactment of this ,act1 the ,secretary1 after consultation with staff of participating providers and other long-term care facilities that receive provider payments under the ,medicare or ,medicaid programs1 shall issue guidance for such participating providers and other long-term care facilities to clarify the meaning of certain terms1 such as suspicious1 injuries of unknown source1 and mistreatment1 when used in the statutory and regulatory requirements for such providers relating to reporting and tracking incidents of abuse1 sexual abuse1 neglect1 mistreatment1 or exploitation of residents of such providers by facility staff1 including on social media4 #aj4 ,continuing funding for programs to prevent and prosecute elder abuse and neglect 7a7 ,long-,term care ombudsman program grants and training ,section #bjdc of the ,social ,security ,act 7#db ,u4,s4,c4 #acigm-#b7 is amended-- 7#a7 in subsection 7a77#b7-- 7,a7 in subparagraph 7,b71 by striking and after the semicolon2 7,b7 in subparagraph 7,c71 by striking the period at the end and inserting 2 and2 and 7,c7 by adding at the end the following3 7,d7 for each of fiscal years #bjbj through #bjbc1 #ab1jjj1jjj4 2 and 7#b7 in subsection 7b77#b71 by inserting before the period the following3 1 and for each of fiscal years #bjbj through #bjbc1 #ab1jjj1jjj4 7b7 ,elder abuse1 neglect1 and exploitation forensic centers ,section #bjca7;f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acigl7f77 is amended-- 7#a7 in paragraph 7#b71 by striking and after the semicolon2 7#b7 in paragraph 7#c71 by striking the period at the end and inserting 2 and2 and 7#c7 by adding at the end the following3 7#d7 for each of fiscal years #bjbj through #bjbc1 #aj1jjj1jjj4 4 7c7 ,elder justice coordinating council 7#a7 ,membership ,section #bjba7;b77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acigk7b77#a77 is amended-- 7,a7 by redesignating subparagraph 7,c7 as subparagraph 7,d72 and 7,b7 by inserting after subparagraph 7,b71 the following3 7,c7 ,the ,administrator of the ,federal ,emergency ,management ,agency4 4 7#b7 ,duties ,section #bjba7;f77#a7 of such ,act 7#db ,u4,s4,c4 #acigk7f77#a77 is amended by inserting the ,federal ,emergency ,management ,agency1 after ,justice14 7d7 ,adult protective services functions and grant programs ,section #bjdb of the ,social ,security ,act 7#db ,u4,s4,c4 #acigm-#a7 is amended-- 7#a7 in subsection 7a77#b71 by striking #c1jjj1jjj and all that follows through the period and inserting #e1jjj1jjj for each of fiscal years #bjbj through #bjbc42 7#b7 in subsection 7b77#e71 by striking #ajj1jjj1jjj and all that follows through the period and inserting #abj1jjj1jjj for each of fiscal years #bjbj through #bjbc42 and 7#c7 in subsection 7c77#f71 by striking #be1jjj1jjj and all that follows through the period and inserting #cj1jjj1jjj for each of fiscal years #bjbj through #bjbc44 7e7 ,technical amendment ,section #bjaa7ab77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;j7#ab77;,a77 is amended by striking #dej;b and inserting #ecjd4 #aa4 ,increasing resources to investigate abuse or neglect and extend services to victims 7a7 ,funding for adult protective services during the ,,covid-#ai public health emergency 7#a7 ,in general ,a total of #fj1jjj1jjj of the amounts appropriated to make payments or funds available on or after ,july #a1 #bjbj1 for responding to the public health or fiscal impacts related to the ,coronavirus ,disease 7,,covid-#ai7 under ,federal legislation enacted on or after that date which primarily makes appropriations for the coronavirus response and related activities1 shall be transferred and made available to the ,secretary to make direct payments under this subsection to the agency of each ,state with primary responsibility for adult protective services and to tribally operated adult protective services agencies1 notwithstanding the original purpose for which the amounts were appropriated to make such payments or funds available1 or any other provision of law restricting the use of such payments or funds4 7#b7 ,payments 7,a7 ,in general ,from the funds transferred and made available under paragraph 7#a71 the ,secretary shall-- 7i7 reserve #c percent of such funds for making payments to tribally operated adult protective services agencies in such manner1 and based on such information1 as the ,secretary shall specify2 and 7ii7 make allotments to ,states from the remainder of such funds 7after the application of clause 7i771 in the same manner as amounts are allotted to ,states for fiscal year #bjbj under section #bjjc7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;b7b774 7,b7 ,direct payments ,the ,secretary shall make direct payment from the amounts reserved under subparagraph 7,a7 to tribally operated adult protective services agencies and from the amounts allotted under that subparagraph to the agency of each ,state with primary responsibility for adult protective services4 7#c7 ,other requirements 7,a7 ,no match ,no cash or in-kind matching requirement shall apply to the payments made under this subsection4 7,b7 ,deadline ,the ,secretary shall make the payments required under this subsection not later than #fj days after the date on which funds are transferred and made available under paragraph 7#a74 7,c7 ,use of funds ,each agency that receives funds from a payment made under this subsection shall use the funds to provide adult protective services during the ,,covid-#ai public health emergency period4 7,d7 ,prohibition ,no funds from a payment made under this subsection shall be used to satisfy any requirement of a federally funded program relating to ,state or local matching funds or in-kind contributions4 7#d7 ,definitions ,in this subsection3 7,a7 ,adult protective services ,the term adult protective services has the meaning given that term in section #bjaa7b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;j7#b774 7,b7 ,indian country ,the term ,indian country has the meaning given that term in section #aaea of title #ah1 ,united ,states ,code4 7,c7 ,state ,the term ,state has the meaning given that term in section #aaja7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acja7;a77#a77 for purposes of title ,,xx of such ,act4 7,d7 ,tribally operated adult protective services agency ,the term tribally operated adult protective services agency means an agency of the recognized governing body of any ,indian or ,alaska ,native ,tribe1 band1 ,nation1 pueblo1 village1 community1 component band1 or component reservation1 individually identified 7including parenthetically7 in the list published most recently as of the date of enactment of this ,act pursuant to section #ajd of the ,federally ,recognized ,indian ,tribe ,list ,act of #aiid 7#be ,u4,s4,c4 #eaca7 whose primary purpose is to protect any vulnerable adult who is the victim of an alleged or substantiated incident of abuse1 neglect1 or exploitation in ,indian ,country4 7b7 ,authority for transfers from the crime victims fund ,section #adjb7;d77#c7 of the ,victims of ,crime ,act of #aihd 7#cd ,u4,s4,c4 #bjaja7;d77#c77 is amended by adding at the end the following3 7,c7 7i7 ,notwithstanding subparagraph 7,b71 the ,director may use not more than #c percent of the amount to be distributed from the ,fund under this paragraph in a particular fiscal year to provide and improve services for victims of elder abuse1 neglect1 or exploitation by a department or agency of the ,federal ,government other than the ,department of ,justice4 4 #ab4 ,protecting ,americans with dementia 7a7 ,alzheimer's disease best practices and reporting 7#a7 ,addressing ,alzheimer's disease in best practices 7,a7 ,in general ,section #aja7;b7 of the ,elder ,abuse ,prevention and ,prosecution ,act 7#cd ,u4,s4,c4 #bagaa7;b77 is amended-- 7i7 by redesignating subparagraphs 7,a71 7,b71 and 7,c7 of paragraph 7#b7 as clauses 7i71 7ii71 and 7iii71 respectively1 and adjusting the margin accordingly2 7ii7 by redesignating paragraphs 7#a71 7#b71 and 7#c7 as subparagraphs 7,a71 7,b71 and 7,c71 respectively1 and adjusting the margin accordingly2 7iii7 by striking ,not later than and inserting the following3 7#a7 ,in general ,not later than 2 7iv7 in paragraph 7#a77;,b71 as so redesignated-- 7,i7 in clause 7ii71 by inserting 1 including witnesses who have ,alzheimer's disease and related dementias after other legal issues2 and 7,,ii7 in clause 7iii71 by striking elder abuse cases1 and inserting elder abuse cases 7including victims and witnesses who have ,alzheimer's disease and related dementias712 and 7v7 by adding at the end the following3 7#b7 ,training materials 7,a7 ,in general ,in creating or compiling replication guides and training materials under paragraph 7#a77;,b71 the ,elder ,justice ,coordinator shall consult with the ,secretary of ,health and ,human ,services1 ,state1 local1 and ,tribal adult protective services1 aging1 social1 and human services agencies1 ,federal1 ,state1 local1 and ,tribal law enforcement agencies1 and nationally recognized nonprofit associations with relevant expertise1 as appropriate4 7,b7 ,updating ,the ,elder ,justice ,coordinator shall-- 7i7 review the best practices identified and replication guides and training materials created or compiled under paragraph 7#a77;,b7 to determine if the replication guides or training materials require updating2 and 7ii7 perform any necessary updating of the replication guides or training materials4 4 7,b7 ,applicability ,the amendments made by subparagraph 7,a7 shall-- 7i7 take effect on the date of enactment of this ,act2 and 7ii7 apply on and after the date that is #a year after the date of enactment of this ,act4 7#b7 ,report on outreach 7,a7 ,in general ,section #aja7;c77#b7 of the ,elder ,abuse ,prevention and ,prosecution ,act 7#cd ,u4,s4,c4 #bagaa7;c77#b77 is amended-- 7i7 by redesignating subparagraphs 7,a7 through 7,d7 as clauses 7i7 through 7iv71 respectively1 and adjusting the margin accordingly2 7ii7 by striking a report detailing and inserting the following3 8a report-- 7,a7 detailing 2 and 7iii7 by adding at the end the following3 7,b7 with respect to the report by the ,attorney ,general1 including a link to the publicly available best practices identified under subsection 7b77#a77;,b7 and the replication guides and training materials created or compiled under such subsection4 4 7,b7 ,applicability ,the amendments made by subparagraph 7,a7 shall apply with respect to the report under section #aja7;c77#b7 of the ,elder ,abuse ,prevention and ,prosecution ,act 7#cd ,u4,s4,c4 #bagaa7;c77#b77 submitted during the second year beginning after the date of enactment of this ,act1 and each year thereafter4 7b7 ,promoting accountability of court-,appointed guardians ,section #bjdb7;c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acigm-#a7;c77 is amended-- 7#a7 in paragraph 7#a71 by striking paragraph 7#b77;,e7 and inserting subparagraphs 7,e71 7,f71 7,g71 and 7,h7 of paragraph 7#b72 7#b7 in paragraph 7#b7-- 7,a7 in the matter preceding subparagraph 7,a7-- 7i7 by striking ,funds and inserting ,subject to paragraph 7#g71 funds2 and 7ii7 by striking subparagraph 7,e7 and inserting subparagraphs 7,e71 7,f71 7,g71 and 7,h72 7,b7 in subparagraph 7,e71 by striking or at the end2 7,c7 by redesignating subparagraph 7,f7 as subparagraph 7,i72 and 7,d7 by inserting after subparagraph 7,e7 the following new paragraphs3 7,f7 methods to assess ,state guardianship statistics such as the creation of ,state databases to collect information about the number and characteristics of guardianship arrangements1 guardians1 and individuals subject to guardianship2 7,g7 the use of trained court visitors to improve court administration of guardianship arrangements1 including the appointment and oversight of guardians2 7,h7 methods for collecting1 storing1 and making available to the appropriate individuals1 organizations1 and entities information on prospective1 current1 and previously appointed guardians1 which may include-- 7i7 contact and identifying information2 7ii7 information relating to background check investigations2 7iii7 court decisions regarding petitions for appointment as a guardian1 including the rationale for such decisions2 and 7iv7 information relating to the cause for removal of the guardian or termination of the guardianship arrangement2 or 2 7#c7 in paragraph 7#d71 by striking paragraph 7#b77;,e7 and inserting subparagraphs 7,e71 7,f71 7,g71 and 7,h7 of paragraph 7#b72 7#d7 in paragraph 7#e71 by striking paragraph 7#b77;,e7 each place it appears and inserting subparagraphs 7,e71 7,f71 7,g71 and 7,h7 of paragraph 7#b72 and 7#e7 by adding at the end the following new paragraph3 7#g7 ,ensuring demonstration program funding for the highest courts of states ,the ,secretary shall ensure that up to #e percent of the total of any funds made available to carry out this subsection in a fiscal year 7beginning with fiscal year #bjbj7 is awarded under grants to the highest courts of ,states for purposes of conducting demonstration programs described in subparagraphs 7,e71 7,f71 7,g71 and 7,h7 of paragraph 7#b74 4 #ac4 ,reducing racial and ethnic disparities in long-term care facilities 7a7 ,task force ,the ,secretary shall establish a task force1 to be known as the ,ethnic and ,racial ,disparities in ,long-,term ,care ,facilities ,task ,force 7referred to in this section as the task force71 to gather data on racial and ethnic disparities in long-term care facilities and provide recommendations to ,federal1 ,state1 local1 and ,tribal policymakers on ways to reduce such disparities4 7b7 ,membership ,the task force shall be composed of the ,secretary1 the ,surgeon ,general1 other ,federal1 ,state1 and local government officials1 and individuals appointed by the ,secretary with firsthand knowledge of1 or expertise relating to1 disparities in access to quality care for residents of long-term care facilities who are members of racial or ethnic minority groups4 ,in appointing such individuals1 the ,secretary shall ensure the individuals appointed provide ample representation with respect to the demographics of residents and caregivers of such facilities1 particularly with respect to residents and caregivers of such facilities who are members of racial or ethnic minority groups4 7c7 ,administration 7#a7 ,chairperson ,the ,secretary shall serve as the chairperson of the task force4 ,the ,surgeon ,general shall serve as the vice chairperson4 7#b7 ,staff ,the task force shall have #b full-time staff members4 7#c7 ,meetings ,the task force shall convene at least monthly1 with the first meeting to occur within #fj days after the enactment of this ,act4 7d7 ,reporting and recommendations 7#a7 ,monthly reports ,not later than #de days after the #ast meeting of the task force1 and monthly thereafter1 the task force shall submit to ,congress and the ,federal ,emergency ,management ,agency a report that includes-- 7,a7 recommended methodologies for improving ,federal data collection on resident outcomes in long-term care facilities with disproportionately high rates of admission of individuals who are members of racial or ethnic minority groups2 7,b7 the identification of long-term care facilities evidencing racial or ethnic disparities in psychotropic drug usage1 infection prevention and control deficiencies1 hospitalization rates1 infectious disease rates1 injury rates1 abuse rates1 neglect rates1 fatality rates1 and any additional areas1 as determined by the task force based on available public health data 7or1 if no such data are available1 on the basis of such other publicly available data or information as the task force may determine72 7,c7 the identification of factors1 including ,federal and ,state policies1 that have contributed to racial or ethnic health disparities in resident outcomes in long-term care facilities1 and actions ,congress 7and if appropriate1 other entities7 can take to address these factors2 and 7,d7 recommendations for best practices to promote improvements in long-term care facilities evidencing racial or ethnic disparities in psychotropic drug usage1 infection prevention and control deficiencies1 hospitalization rates1 infectious disease rates1 injury rates1 abuse and neglect rates1 fatality rates1 or any additional areas determined by the task force4 7#b7 ,consultation with indian tribes ,in submitting reports and recommendations under this subsection1 the task force shall consult with ,indian ,tribes and ,tribal organizations4 7#c7 ,sunset ,the task force shall terminate on ,december #ca1 #bjba4 #ad4 ,establishing reciprocity with ,drug ,enforcement ,administration to address improper prescribing of controlled substances 7a7 ,notification of the attorney general by the ,secretary of ,health and ,human ,services in cases of improper prescribing of controlled substances 7#a7 ,in general ,section #ahff7;j7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7j77 is amended by adding at the end the following new paragraph3 7#aj7 ,notification of attorney general 7,a7 ,in general ,if the ,secretary makes a determination described in subparagraph 7,b7 with respect to improper prescribing of a controlled substance 7as defined in section #ajb7f7 of the ,controlled ,substances ,act71 the ,secretary shall notify the ,attorney ,general in accordance with subparagraph 7,c74 7,b7 ,determination by secretary ,a determination described in this subparagraph is a determination by the ,secretary under which-- 7i7 the enrollment of a provider of services or supplier under this title is revoked1 based in whole or in part on a finding by the ,secretary under section #dbd4ece7;a77#ad7 of title #db1 ,code of ,federal ,regulations 7or any successor regulation71 as applied to improper prescribing of controlled substances2 or 7ii7 a provider of services or supplier is placed on the preclusion list as defined under sections #dbb4b and #dbc4ajj of such title #db 7or any successor regulation71 based in whole or in part on a finding by the ,secretary that such provider or supplier has engaged in conduct1 in connection with prescribing of controlled substances1 that would be considered improper prescribing under such section #dbd4ece7;a77#ad71 if the provider of services or supplier were enrolled under this title4 7,c7 ,notification ,if the ,secretary revokes an enrollment or makes a preclusion list placement as described in subparagraph 7,b71 the ,secretary shall notify the ,attorney ,general of such revocation or placement1 no later than #cj days after-- 7i7 the affirmation of such ,secretarial action1 in response to a request for reconsideration by the provider of services or supplier involved under section #dbd4ede7;a7 or part #dih of such title #db1 as applicable 7or any successor regulations72 or 7ii7 absent such a request for reconsideration1 expiration of the time period during which such a request may be filed4 7,d7 ,subsequent notification ,in the case that a revocation of enrollment or a preclusion list placement as described in subparagraph 7,b7 is reversed under proceedings subsequent to the appropriate notification under subparagraph 7,c71 the ,secretary shall inform the ,attorney ,general of such reversal 7and as applicable1 reinstatement of such enrollment or removal from the preclusion list74 4 7#b7 ,technical correction to citation for appeals provision ,section #ahff7;j77#e77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7j77#e77;,b77 is amended by striking paragraph 7#g7 and inserting paragraph 7#i74 7b7 ,revocation of registration under the ,controlled ,substances ,act ,section #cjd of the ,controlled ,substances ,act 7#ba ,u4,s4,c4 #hbd7 is amended by adding at the end the following3 7h7 7#a7 ,upon receipt of a notification from the ,secretary under section #ahff7;j77#aj77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7j77#aj77;,c77 of a determination of the ,secretary to revoke an enrollment or make a preclusion list placement1 the ,attorney ,general shall revoke the registration granted under section #cjc of this ,act of the registrant that is the subject of such revocation or placement4 7#b7 ,after revocation of a registration under paragraph 7#a71 if the ,attorney ,general receives information from the ,secretary under section #ahff7;j77#aj77;,d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7j77#aj77;,d77 that the determination of the ,secretary described in paragraph 7#a7 has been reversed1 the ,attorney ,general may reverse the revocation of the registration if the ,attorney ,general determines such reversal is appropriate4 4