SUBCHAPTER XX—BLOCK GRANTS AND PROGRAMS FOR SOCIAL SERVICES AND ELDER JUSTICE
Editorial Notes
Codification
2018—
Division A—Block Grants to States for Social Services
§1397. Purposes of division; authorization of appropriations
For the purposes of consolidating Federal assistance to States for social services into a single grant, increasing State flexibility in using social service grants, and encouraging each State, as far as practicable under the conditions in that State, to furnish services directed at the goals of—
(1) achieving or maintaining economic self-support to prevent, reduce, or eliminate dependency;
(2) achieving or maintaining self-sufficiency, including reduction or prevention of dependency;
(3) preventing or remedying neglect, abuse, or exploitation of children and adults unable to protect their own interests, or preserving, rehabilitating or reuniting families;
(4) preventing or reducing inappropriate institutional care by providing for community-based care, home-based care, or other forms of less intensive care; and
(5) securing referral or admission for institutional care when other forms of care are not appropriate, or providing services to individuals in institutions,
there are authorized to be appropriated for each fiscal year such sums as may be necessary to carry out the purposes of this division.
(Aug. 14, 1935, ch. 531, title XX, §2001, as added
Editorial Notes
Prior Provisions
A prior section 1397, act Aug. 14, 1935, ch. 531, title XX, §2001, as added Jan. 4, 1975,
Amendments
2010—
Statutory Notes and Related Subsidiaries
Effective Date
Study of State Social Service Programs; Report to Congress
§1397a. Payments to States
(a) Amount; covered services
(1) Each State shall be entitled to payment under this division for each fiscal year in an amount equal to its allotment for such fiscal year, to be used by such State for services directed at the goals set forth in
(2) For purposes of paragraph (1)—
(A) services which are directed at the goals set forth in
(B) expenditures for such services may include expenditures for—
(i) administration (including planning and evaluation);
(ii) personnel training and retraining directly related to the provision of those services (including both short- and long-term training at educational institutions through grants to such institutions or by direct financial assistance to students enrolled in such institutions); and
(iii) conferences or workshops, and training or retraining through grants to nonprofit organizations within the meaning of section 501(c)(3) of the Internal Revenue Code of 1986 or to individuals with social services expertise, or through financial assistance to individuals participating in such conferences, workshops, and training or retraining (and this clause shall apply with respect to all persons involved in the delivery of such services).
(b) Funding requirements
The Secretary shall make payments in accordance with
(c) Expenditure of funds
Payments to a State from its allotment for any fiscal year must be expended by the State in such fiscal year or in the succeeding fiscal year.
(d) Transfers of funds
A State may transfer up to 10 percent of its allotment under
(e) Use of portion of funds
A State may use a portion of the amounts described in subsection (a) for the purpose of purchasing technical assistance from public or private entities if the State determines that such assistance is required in developing, implementing, or administering programs funded under this division.
(f) Authority to use vouchers
A State may use funds provided under this division to provide vouchers, for services directed at the goals set forth in
(1) families who have become ineligible for assistance under a State program funded under part A of subchapter IV by reason of a durational limit on the provision of such assistance; and
(2) families denied cash assistance under the State program funded under part A of subchapter IV for a child who is born to a member of the family who is—
(A) a recipient of assistance under the program; or
(B) a person who received such assistance at any time during the 10-month period ending with the birth of the child.
(Aug. 14, 1935, ch. 531, title XX, §2002, as added
Editorial Notes
References in Text
Section 501 of the Internal Revenue Code of 1986, referred to in subsec. (a)(2)(B)(iii), is classified to
Prior Provisions
A prior section 1397a, acts Aug. 14, 1935, ch. 531, title XX, §2002, as added Jan. 4, 1975,
Amendments
2010—
1996—Subsec. (f).
1986—Subsec. (a)(2)(B)(iii).
1984—Subsec. (b).
Statutory Notes and Related Subsidiaries
Effective Date of 1984 Amendment
Amendment by
Temporary Suspension of Child Day Care Services Requirements
Reimbursement of Expenditures for Social Services Provided by States Prior to October 1, 1975; Authorization of Appropriations; Procedures Applicable to Payment of Unpaid Claims of States
Payments to States for Fiscal Period Beginning July 1, 1976, and Ending September 30, 1976, and Fiscal Years Ending September 30, 1977, 1978, and 1979, Computation Amounts, Limitations, Etc.
Requirements of Child Day Care Services
§1397b. Allotments
(a) Computation of amounts for jurisdictions of Puerto Rico, Guam, etc.
The allotment for any fiscal year to each of the jurisdictions of Puerto Rico, Guam, the Virgin Islands, and the Northern Mariana Islands shall be an amount which bears the same ratio to the amount specified in subsection (c) as the amount which was specified for allocation to the particular jurisdiction involved for the fiscal year 1981 under
(b) Computation of amounts for each State other than jurisdictions of Puerto Rico, Guam, etc.
The allotment for any fiscal year for each State other than the jurisdictions of Puerto Rico, Guam, the Virgin Islands, American Samoa, and the Northern Mariana Islands shall be an amount which bears the same ratio to—
(1) the amount specified in subsection (c), reduced by
(2) the total amount allotted to those jurisdictions for that fiscal year under subsection (a),
as the population of that State bears to the population of all the States (other than Puerto Rico, Guam, the Virgin Islands, American Samoa, and the Northern Mariana Islands) as determined by the Secretary (on the basis of the most recent data available from the Department of Commerce) and promulgated prior to the first day of the third month of the preceding fiscal year.
(c) Appropriations
The amount specified for purposes of subsections (a) and (b) shall be—
(1) $2,400,000,000 for the fiscal year 1982;
(2) $2,450,000,000 for the fiscal year 1983;
(3) $2,700,000,000 for the fiscal years 1984, 1985, 1986, 1987, and 1989;
(4) $2,750,000,000 for the fiscal year 1988;
(5) $2,800,000,000 for each of the fiscal years 1990 through 1995;
(6) $2,381,000,000 for the fiscal year 1996;
(7) $2,380,000,000 for the fiscal year 1997;
(8) $2,299,000,000 for the fiscal year 1998;
(9) $2,380,000,000 for the fiscal year 1999;
(10) $2,380,000,000 for the fiscal year 2000; and
(11) $1,700,000,000 for the fiscal year 2001 and each fiscal year thereafter.
(Aug. 14, 1935, ch. 531, title XX, §2003, as added
Editorial Notes
Prior Provisions
A prior section 1397b, act Aug. 14, 1935, ch. 531, title XX, §2003, as added Jan. 4, 1975,
Amendments
1998—Subsec. (c)(7).
Subsec. (c)(8).
Subsec. (c)(9) to (11).
1996—Subsec. (c)(5) to (8).
1989—Subsec. (c)(3).
Subsec. (c)(5).
1987—Subsec. (a).
Subsec. (b).
Subsec. (c)(2).
Subsec. (c)(3).
Subsec. (c)(4).
1986—Subsec. (b).
Subsec. (d).
1983—Subsec. (c)(3).
Subsec. (c)(4), (5).
1982—Subsec. (b).
Statutory Notes and Related Subsidiaries
Effective Date of 1998 Amendments
Amendment by
Effective Date of 1987 Amendment
Amendment by section 9135(a)(2) of
Effective Date of 1982 Amendment
Amendment by
Requirement That Additional Funds Supplement and Not Supplant Funds Available From Other Sources
"(A) be used only for the purpose of providing additional services under title XX of the Social Security Act [
"(B) be expended only to supplement the level of any funds that would, in the absence of the additional funds appropriated pursuant to such amendments, be available from other sources (including any amounts available under title XX of the Social Security Act without regard to such amendments) for services in accordance with such title, and shall in no case supplant such funds from other sources or reduce the level thereof."
Appropriations
"(a)(1) Notwithstanding any provision of title XX of the Social Security Act [
"(2) In addition to any other amounts appropriated under this resolution [
"(3) Amounts appropriated under this section shall remain available until September 30, 1985, without regard to section 102 of this resolution.
"(4) Except as otherwise provided in this section, each State's allotment of the additional amounts authorized and appropriated under this section shall be the same proportion of $25,000,000 as such State's proportional allotment of other title XX funds for fiscal year 1985, as determined under section 2003 of the Social Security Act [
"(b) The additional $25,000,000 made available to the States for fiscal year 1985 pursuant to subsection (a) shall—
"(1) be used only for the purpose of providing training and retraining (including training in the prevention of child abuse in child care settings) to providers of licensed or registered child care services, operators and staffs (including those receiving in-service training) of facilities where licensed or registered child care services are provided, State licensing and enforcement officials, and parents;
"(2) be expended only to supplement the level of any funds that would, in the absence of the additional funds appropriated under this section, be available from other sources (including any amounts available under title XX of the Social Security Act [
"(3) be separately accounted for in the reports and audits provided for in section 2006 of the Social Security Act [
"(c)(1) In order to provide guidance and assistance to the States in utilizing funds allocated pursuant to title XX of the Social Security Act [
"(A) minimum licensing or registration standards for day care centers, group homes, and family day care homes regarding matters including—
"(i) the training, development, supervision, and evaluation of staff;
"(ii) staff qualification requirements, by job classification;
"(iii) staff-child ratios;
"(iv) probation periods for new staff;
"(v) employment history checks for staff; and
"(vi) parent visitation; and
"(2)(A) Any State receiving an allotment under such title from the funds made available as a result of subsection (a) shall have in effect, not later than September 30, 1985—
"(i) procedures, established by State law or regulation, to provide for employment history and background checks; and
"(ii) provisions of State law, enacted in accordance with the provisions of
for all operators, staff or employees, or prospective operators, staff or employees of child care facilities (including any facility or program having primary custody of children for 20 hours or more per week), juvenile detention, correction or treatment facilities, with the objective of protecting the children involved and promoting such children's safety and welfare while receiving service through such facilities or programs.
"(B) In the case of any State not meeting the requirements of subparagraph (A) by September 30, 1985, such State's allotment for fiscal year 1986 or 1987 shall be reduced in the aggregate by an amount equal to one-half of the amount by which such State's allotment under such title was increased for fiscal year 1985 as a result of subsection (a).
"(d) The determination and promulgation required by section 2003(b) of the Social Security Act [
§1397c. State reporting requirements
Prior to expenditure by a State of payments made to it under
(Aug. 14, 1935, ch. 531, title XX, §2004, as added
Editorial Notes
Prior Provisions
A prior section 1397c, act Aug. 14, 1935, ch. 531, title XX, §2004, as added Jan. 4, 1975,
Amendments
2010—
§1397d. Limitation on use of grants; waiver
(a) Except as provided in subsection (b), grants made under this division may not be used by the State, or by any other person with which the State makes arrangements to carry out the purposes of this division—
(1) for the purchase or improvement of land, or the purchase, construction, or permanent improvement (other than minor remodeling) of any building or other facility;
(2) for the provision of cash payments for costs of subsistence or for the provision of room and board (other than costs of subsistence during rehabilitation, room and board provided for a short term as an integral but subordinate part of a social service, or temporary emergency shelter provided as a protective service);
(3) for payment of the wages of any individual as a social service (other than payment of the wages of welfare recipients employed in the provision of child day care services);
(4) for the provision of medical care (other than family planning services, rehabilitation services, or initial detoxification of an alcoholic or drug dependent individual) unless it is an integral but subordinate part of a social service for which grants may be used under this division;
(5) for social services (except services to an alcoholic or drug dependent individual or rehabilitation services) provided in and by employees of any hospital, skilled nursing facility, intermediate care facility, or prison, to any individual living in such institution;
(6) for the provision of any educational service which the State makes generally available to its residents without cost and without regard to their income;
(7) for any child day care services unless such services meet applicable standards of State and local law;
(8) for the provision of cash payments as a service (except as otherwise provided in this section);
(9) for payment for any item or service (other than an emergency item or service) furnished—
(A) by an individual or entity during the period when such individual or entity is excluded under this division or subchapter V, XVIII, or XIX pursuant to
(B) at the medical direction or on the prescription of a physician during the period when the physician is excluded under this division or subchapter V, XVIII, or XIX pursuant to
(10) in a manner inconsistent with the Assisted Suicide Funding Restriction Act of 1997 [
(b) The Secretary may waive the limitation contained in subsection (a)(1) and (4) upon the State's request for such a waiver if he finds that the request describes extraordinary circumstances to justify the waiver and that permitting the waiver will contribute to the State's ability to carry out the purposes of this division.
(Aug. 14, 1935, ch. 531, title XX, §2005, as added
Editorial Notes
References in Text
The Assisted Suicide Funding Restriction Act of 1997, referred to in subsec. (a)(10), is
Prior Provisions
A prior section 1397d, act Aug. 14, 1935, ch. 531, title XX, §2005, as added Jan. 4, 1975,
Amendments
2010—
1997—Subsec. (a)(10).
1988—Subsec. (a)(9)(A), (B).
1987—Subsec. (a)(9).
Subsec. (a)(9)(A), (B).
Statutory Notes and Related Subsidiaries
Effective Date of 1997 Amendment
Amendment by
Effective Date of 1988 Amendments
Amendment by
Except as specifically provided in section 411 of
Effective Date of 1987 Amendment
Amendment by
§1397e. Administrative and fiscal accountability
(a) Reporting requirements; form, contents, etc.
Each State shall prepare reports on its activities carried out with funds made available (or transferred for use) under this division. Reports shall be prepared annually, covering the most recently completed fiscal year, and shall be in such form and contain such information (including but not limited to the information specified in subsection (c)) as the State finds necessary to provide an accurate description of such activities, to secure a complete record of the purposes for which funds were spent, and to determine the extent to which funds were spent in a manner consistent with the reports required by
(b) Audits; implementation, etc.
Each State shall, not less often than every two years, audit its expenditures from amounts received (or transferred for use) under this division. Such State audits shall be conducted by an entity independent of any agency administering activities funded under this division, in accordance with generally accepted auditing principles. Within 30 days following the completion of each audit, the State shall submit a copy of that audit to the legislature of the State and to the Secretary. Each State shall repay to the United States amounts ultimately found not to have been expended in accordance with this division, or the Secretary may offset such amounts against any other amount to which the State is or may become entitled under this division.
(c) State reports on expenditure and use of social services funds
Each report prepared and transmitted by a State under subsection (a) shall set forth (with respect to the fiscal year covered by the report)—
(1) the number of individuals who received services paid for in whole or in part with funds made available under this division, showing separately the number of children and the number of adults who received such services, and broken down in each case to reflect the types of services and circumstances involved;
(2) the amount spent in providing each such type of service, showing separately for each type of service the amount spent per child recipient and the amount spent per adult recipient;
(3) the criteria applied in determining eligibility for services (such as income eligibility guidelines, sliding fee scales, the effect of public assistance benefits, and any requirements for enrollment in school or training programs); and
(4) the methods by which services were provided, showing separately the services provided by public agencies and those provided by private agencies, and broken down in each case to reflect the types of services and circumstances involved.
The Secretary shall establish uniform definitions of services for use by the States in preparing the information required by this subsection, and make such other provision as may be necessary or appropriate to assure that compliance with the requirements of this subsection will not be unduly burdensome on the States.
(d) Additional accounting requirements
For other provisions requiring States to account for Federal grants, see
(Aug. 14, 1935, ch. 531, title XX, §2006, as added
Editorial Notes
Prior Provisions
A prior section 1397e, act Aug. 14, 1935, ch. 531, title XX, §2006, as added Jan. 4, 1975,
A prior section 1397e–1, act Aug. 14, 1935, ch. 531, title XX, §2007, as added Jan. 2, 1980,
Amendments
2010—
1988—Subsec. (a).
Subsecs. (c), (d).
1984—Subsec. (c).
Statutory Notes and Related Subsidiaries
Effective Date of 1984 Amendment
Amendment by
§1397f. Additional grants
(a) Entitlement
(1) In general
In addition to any payment under
(A) 2 grants under this section for each qualified empowerment zone in the State; and
(B) 1 grant under this section for each qualified enterprise community in the State.
(2) Amount of grants
(A) Empowerment grants
The amount of each grant to a State under this section for a qualified empowerment zone shall be—
(i) if the zone is designated in an urban area, $50,000,000, multiplied by that proportion of the population of the zone that resides in the State; or
(ii) if the zone is designated in a rural area, $20,000,000, multiplied by such proportion.
(B) Enterprise grants
The amount of the grant to a State under this section for a qualified enterprise community shall be 1/95 of $280,000,000, multiplied by that proportion of the population of the community that resides in the State.
(C) Population determinations
The Secretary shall make population determinations for purposes of this paragraph based on the most recent decennial census data available.
(3) Timing of grants
(A) Qualified empowerment zones
With respect to each qualified empowerment zone, the Secretary shall make—
(i) 1 grant under this section to each State in which the zone lies, on the date of the designation of the zone under part I of subchapter U of
(ii) 1 grant under this section to each such State, on the 1st day of the 1st fiscal year that begins after the date of the designation.
(B) Qualified enterprise communities
With respect to each qualified enterprise community, the Secretary shall make 1 grant under this section to each State in which the community lies, on the date of the designation of the community under part I of subchapter U of
(4) Funding
$1,000,000,000 shall be made available to the Secretary for grants under this section.
(b) Program options
Notwithstanding
(1) In order to prevent and remedy the neglect and abuse of children, a State may use amounts paid under this section to make grants to, or enter into contracts with, entities to provide residential or nonresidential drug and alcohol prevention and treatment programs that offer comprehensive services for pregnant women and mothers, and their children.
(2) In order to assist disadvantaged adults and youths in achieving and maintaining self-sufficiency, a State may use amounts paid under this section to make grants to, or enter into contracts with—
(A) organizations operated for profit or not for profit, for the purpose of training and employing disadvantaged adults and youths in construction, rehabilitation, or improvement of affordable housing, public infrastructure, and community facilities; and
(B) nonprofit organizations and community or junior colleges, for the purpose of enabling such entities to provide short-term training courses in entrepreneurism and self-employment, and other training that will promote individual self-sufficiency and the interests of the community.
(3) A State may use amounts paid under this section to make grants to, or enter into contracts with, nonprofit community-based organizations to enable such organizations to provide activities designed to promote and protect the interests of children and families, outside of school hours, including keeping schools open during evenings and weekends for mentoring and study.
(4) In order to assist disadvantaged adults and youths in achieving and maintaining economic self-support, a State may use amounts paid under this section to—
(A) fund services designed to promote community and economic development in qualified empowerment zones and qualified enterprise communities, such as skills training, job counseling, transportation services, housing counseling, financial management, and business counseling;
(B) assist in emergency and transitional shelter for disadvantaged families and individuals; or
(C) support programs that promote home ownership, education, or other routes to economic independence for low-income families and individuals.
(c) Use of grants
(1) In general
Subject to subsection (d) of this section, each State that receives a grant under this section with respect to an area shall use the grant—
(A) for services directed only at the goals set forth in paragraphs (1), (2), and (3) of
(B) in accordance with the strategic plan for the area; and
(C) for activities that benefit residents of the area for which the grant is made.
(2) Technical assistance
A State may use a portion of any grant made under this section in the manner described in
(d) Remittance of certain amounts
(1) Portion of grant upon termination of designation
Each State to which an amount is paid under this subsection during a fiscal year with respect to an area the designation of which under part I of subchapter U of
(2) Amounts paid to the States and not obligated within 2 years
Each State shall remit to the Secretary any amount paid to the State under this section that is not obligated by the end of the 2-year period that begins with the date of the payment.
(e) Reallocation of remaining funds
(1) Remitted amounts
The amount specified in
(2) Amounts not paid to the States
The amount specified in
(f) Definitions
As used in this section:
(1) Qualified empowerment zone
The term "qualified empowerment zone" means, with respect to a State, an area—
(A) which has been designated (other than by the Secretary of the Interior) as an empowerment zone under part I of subchapter U of
(B) with respect to which the designation is in effect;
(C) the strategic plan for which is a qualified plan; and
(D) part or all of which is in the State.
(2) Qualified enterprise community
The term "qualified enterprise community" means, with respect to a State, an area—
(A) which has been designated (other than by the Secretary of the Interior) as an enterprise community under part I of subchapter U of
(B) with respect to which the designation is in effect;
(C) the strategic plan for which is a qualified plan; and
(D) part or all of which is in the State.
(3) Strategic plan
The term "strategic plan" means, with respect to an area, the plan contained in the application for designation of the area under part I of subchapter U of
(4) Qualified plan
The term "qualified plan" means, with respect to an area, a plan that—
(A) includes a detailed description of the activities proposed for the area that are to be funded with amounts provided under this section;
(B) contains a commitment that the amounts provided under this section to any State for the area will not be used to supplant Federal or non-Federal funds for services and activities which promote the purposes of this section;
(C) was developed in cooperation with the local government or governments with jurisdiction over the area; and
(D) to the extent that any State will not use the amounts provided under this section for the area in the manner described in subsection (b), explains the reasons why not.
(5) Rural area
The term "rural area" has the meaning given such term in section 1393(a)(2) of the Internal Revenue Code of 1986.
(6) Urban area
The term "urban area" has the meaning given such term in section 1393(a)(3) of the Internal Revenue Code of 1986.
(Aug. 14, 1935, ch. 531, title XX, §2007, as added
Editorial Notes
References in Text
The Internal Revenue Code of 1986, referred to in subsecs. (a)(3), (d)(1), and (f), is classified generally to Title 26, Internal Revenue Code.
Prior Provisions
A prior section 1397f, act Aug. 14, 1935, ch. 531, title XX, §2007, as added Aug. 13, 1981,
Another prior section 1397f, act Aug. 14, 1935, ch. 531, title XX, §2008, formerly §2007, as added Jan. 4, 1975,
Amendments
1994—Subsecs. (e), (f).
§1397g. Demonstration projects to address health professions workforce needs
(a) Demonstration projects to provide low-income individuals with opportunities for education, training, and career advancement to address health professions workforce needs
(1) Authority to award grants
The Secretary, in consultation with the Secretary of Labor, shall award grants to eligible entities to conduct demonstration projects that are designed to provide eligible individuals with the opportunity to obtain education and training for occupations in the health care field that pay well and are expected to either experience labor shortages or be in high demand.
(2) Requirements
(A) Aid and supportive services
(i) In general
A demonstration project conducted by an eligible entity awarded a grant under this section shall, if appropriate, provide eligible individuals participating in the project with financial aid, child care, case management, and other supportive services.
(ii) Treatment
Any aid, services, or incentives provided to an eligible beneficiary participating in a demonstration project under this section shall not be considered income, and shall not be taken into account for purposes of determining the individual's eligibility for, or amount of, benefits under any means-tested program.
(B) Consultation and coordination
An eligible entity applying for a grant to carry out a demonstration project under this section shall demonstrate in the application that the entity has consulted with the State agency responsible for administering the State TANF program, the local workforce investment board in the area in which the project is to be conducted (unless the applicant is such board), the State workforce development board established under
(C) Assurance of opportunities for Indian populations
The Secretary shall award at least 3 grants under this subsection to an eligible entity that is an Indian tribe, tribal organization, or Tribal College or University.
(3) Reports and evaluation
(A) Eligible entities
An eligible entity awarded a grant to conduct a demonstration project under this subsection shall submit interim reports to the Secretary on the activities carried out under the project and a final report on such activities upon the conclusion of the entities' participation in the project. Such reports shall include assessments of the effectiveness of such activities with respect to improving outcomes for the eligible individuals participating in the project and with respect to addressing health professions workforce needs in the areas in which the project is conducted.
(B) Evaluation
The Secretary shall, by grant, contract, or interagency agreement, evaluate the demonstration projects conducted under this subsection. Such evaluation shall include identification of successful activities for creating opportunities for developing and sustaining, particularly with respect to low-income individuals and other entry-level workers, a health professions workforce that has accessible entry points, that meets high standards for education, training, certification, and professional development, and that provides increased wages and affordable benefits, including health care coverage, that are responsive to the workforce's needs.
(C) Report to Congress
The Secretary shall submit interim reports and, based on the evaluation conducted under subparagraph (B), a final report to Congress on the demonstration projects conducted under this subsection.
(4) Definitions
In this subsection:
(A) Eligible entity
The term "eligible entity" means a State, an Indian tribe or tribal organization, an institution of higher education, a local workforce development board established under
(B) Eligible individual
(i) In general
The term "eligible individual" means a 1 individual receiving assistance under the State TANF program.
(ii) Other low-income individuals
Such term may include other low-income individuals described by the eligible entity in its application for a grant under this section.
(C) Indian tribe; tribal organization
The terms "Indian tribe" and "tribal organization" have the meaning given such terms in
(D) Institution of higher education
The term "institution of higher education" has the meaning given that term in
(E) State
The term "State" means each of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the United States Virgin Islands, Guam, and American Samoa.
(F) State TANF program
The term "State TANF program" means the temporary assistance for needy families program funded under part A of subchapter IV.
(G) Tribal College or University
The term "Tribal College or University" has the meaning given that term in
(b) Demonstration project to develop training and certification programs for personal or home care aides
(1) Authority to award grants
Not later than 18 months after March 23, 2010, the Secretary shall award grants to eligible entities that are States to conduct demonstration projects for purposes of developing core training competencies and certification programs for personal or home care aides. The Secretary shall—
(A) evaluate the efficacy of the core training competencies described in paragraph (3)(A) for newly hired personal or home care aides and the methods used by States to implement such core training competencies in accordance with the issues specified in paragraph (3)(B); and
(B) ensure that the number of hours of training provided by States under the demonstration project with respect to such core training competencies are not less than the number of hours of training required under any applicable State or Federal law or regulation.
(2) Duration
A demonstration project shall be conducted under this subsection for not less than 3 years.
(3) Core training competencies for personal or home care aides
(A) In general
The core training competencies for personal or home care aides described in this subparagraph include competencies with respect to the following areas:
(i) The role of the personal or home care aide (including differences between a personal or home care aide employed by an agency and a personal or home care aide employed directly by the health care consumer or an independent provider).
(ii) Consumer rights, ethics, and confidentiality (including the role of proxy decision-makers in the case where a health care consumer has impaired decision-making capacity).
(iii) Communication, cultural and linguistic competence and sensitivity, problem solving, behavior management, and relationship skills.
(iv) Personal care skills.
(v) Health care support.
(vi) Nutritional support.
(vii) Infection control.
(viii) Safety and emergency training.
(ix) Training specific to an individual consumer's needs (including older individuals, younger individuals with disabilities, individuals with developmental disabilities, individuals with dementia, and individuals with mental and behavioral health needs).
(x) Self-Care.
(B) Implementation
The implementation issues specified in this subparagraph include the following:
(i) The length of the training.
(ii) The appropriate trainer to student ratio.
(iii) The amount of instruction time spent in the classroom as compared to on-site in the home or a facility.
(iv) Trainer qualifications.
(v) Content for a "hands-on" and written certification exam.
(vi) Continuing education requirements.
(4) Application and selection criteria
(A) In general
(i) Number of States
The Secretary shall enter into agreements with not more than 6 States to conduct demonstration projects under this subsection.
(ii) Requirements for States
An agreement entered into under clause (i) shall require that a participating State—
(I) implement the core training competencies described in paragraph (3)(A); and
(II) develop written materials and protocols for such core training competencies, including the development of a certification test for personal or home care aides who have completed such training competencies.
(iii) Consultation and collaboration with community and vocational colleges
The Secretary shall encourage participating States to consult with community and vocational colleges regarding the development of curricula to implement the project with respect to activities, as applicable, which may include consideration of such colleges as partners in such implementation.
(B) Application and eligibility
A State seeking to participate in the project shall—
(i) submit an application to the Secretary containing such information and at such time as the Secretary may specify;
(ii) meet the selection criteria established under subparagraph (C); and
(iii) meet such additional criteria as the Secretary may specify.
(C) Selection criteria
In selecting States to participate in the program, the Secretary shall establish criteria to ensure (if applicable with respect to the activities involved)—
(i) geographic and demographic diversity;
(ii) that participating States offer medical assistance for personal care services under the State Medicaid plan;
(iii) that the existing training standards for personal or home care aides in each participating State—
(I) are different from such standards in the other participating States; and
(II) are different from the core training competencies described in paragraph (3)(A);
(iv) that participating States do not reduce the number of hours of training required under applicable State law or regulation after being selected to participate in the project; and
(v) that participating States recruit a minimum number of eligible health and long-term care providers to participate in the project.
(D) Technical assistance
The Secretary shall provide technical assistance to States in developing written materials and protocols for such core training competencies.
(5) Evaluation and report
(A) Evaluation
The Secretary shall develop an experimental or control group testing protocol in consultation with an independent evaluation contractor selected by the Secretary. Such contractor shall evaluate—
(i) the impact of core training competencies described in paragraph (3)(A), including curricula developed to implement such core training competencies, for personal or home care aides within each participating State on job satisfaction, mastery of job skills, beneficiary and family caregiver satisfaction with services, and additional measures determined by the Secretary in consultation with the expert panel;
(ii) the impact of providing such core training competencies on the existing training infrastructure and resources of States; and
(iii) whether a minimum number of hours of initial training should be required for personal or home care aides and, if so, what minimum number of hours should be required.
(B) Reports
(i) Report on initial implementation
Not later than 2 years after March 23, 2010, the Secretary shall submit to Congress a report on the initial implementation of activities conducted under the demonstration project, including any available results of the evaluation conducted under subparagraph (A) with respect to such activities, together with such recommendations for legislation or administrative action as the Secretary determines appropriate.
(ii) Final report
Not later than 1 year after the completion of the demonstration project, the Secretary shall submit to Congress a report containing the results of the evaluation conducted under subparagraph (A), together with such recommendations for legislation or administrative action as the Secretary determines appropriate.
(6) Definitions
In this subsection:
(A) Eligible health and long-term care provider
The term "eligible health and long-term care provider" means a personal or home care agency (including personal or home care public authorities), a nursing home, a home health agency (as defined in
(i) is licensed or authorized to provide services in a participating State; and
(ii) receives payment for services under subchapter XIX.
(B) Personal care services
The term "personal care services" has the meaning given such term for purposes of subchapter XIX.
(C) Personal or home care aide
The term "personal or home care aide" means an individual who helps individuals who are elderly, disabled, ill, or mentally disabled (including an individual with Alzheimer's disease or other dementia) to live in their own home or a residential care facility (such as a nursing home, assisted living facility, or any other facility the Secretary determines appropriate) by providing routine personal care services and other appropriate services to the individual.
(D) State
The term "State" has the meaning given that term for purposes of subchapter XIX.
(c) Funding
(1) In general
Subject to paragraph (2), out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary to carry out subsections (a) and (b), $85,000,000 for each of fiscal years 2010 through 2019.
(2) Training and certification programs for personal and home care aides
With respect to the demonstration projects under subsection (b), the Secretary shall use $5,000,000 of the amount appropriated under paragraph (1) for each of fiscal years 2010 through 2012 to carry out such projects. No funds appropriated under paragraph (1) shall be used to carry out demonstration projects under subsection (b) after fiscal year 2012.
(d) Nonapplication
(1) In general
Except as provided in paragraph (2), the preceding sections of this division shall not apply to grant 2 awarded under this section.
(2) Limitations on use of grants
(Aug. 14, 1935, ch. 531, title XX, §2008, as added and amended
Editorial Notes
References in Text
The Act of August 16, 1937, referred to in subsec. (a)(2)(B), (4)(A), is act Aug. 16, 1937, ch. 663,
Part A of subchapter IV, referred to in subsec. (a)(4)(F), is classified to §601 et seq. of this title.
Amendments
2018—Subsec. (c)(1).
2015—Subsec. (c)(1).
2014—Subsec. (a)(2)(B).
Subsec. (a)(4)(A).
Subsec. (c)(1).
2010—Subsec. (d).
Statutory Notes and Related Subsidiaries
Effective Date of 2014 Amendment
Amendment by
Extension of Demonstration Projects To Address Health Professions Workforce Needs
1 So in original. Probably should be "an".
§1397h. Program for early detection of certain medical conditions related to environmental health hazards
(a) Program establishment
The Secretary shall establish a program in accordance with this section to make competitive grants to eligible entities specified in subsection (b) for the purpose of—
(1) screening at-risk individuals (as defined in subsection (c)(1)) for environmental health conditions (as defined in subsection (c)(3)); and
(2) developing and disseminating public information and education concerning—
(A) the availability of screening under the program under this section;
(B) the detection, prevention, and treatment of environmental health conditions; and
(C) the availability of Medicare benefits for certain individuals diagnosed with environmental health conditions under
(b) Eligible entities
(1) In general
For purposes of this section, an eligible entity is an entity described in paragraph (2) which submits an application to the Secretary in such form and manner, and containing such information and assurances, as the Secretary determines appropriate.
(2) Types of eligible entities
The entities described in this paragraph are the following:
(A) A hospital or community health center.
(B) A Federally qualified health center.
(C) A facility of the Indian Health Service.
(D) A National Cancer Institute-designated cancer center.
(E) An agency of any State or local government.
(F) A nonprofit organization.
(G) Any other entity the Secretary determines appropriate.
(c) Definitions
In this section:
(1) At-risk individual
The term "at-risk individual" means an individual who—
(A)(i) as demonstrated in such manner as the Secretary determines appropriate, has been present for an aggregate total of 6 months in the geographic area subject to an emergency declaration specified under paragraph (2), during a period ending—
(I) not less than 10 years prior to the date of such individual's application under subparagraph (B); and
(II) prior to the implementation of all the remedial and removal actions specified in the Record of Decision for Operating Unit 4 and the Record of Decision for Operating Unit 7; or
(ii) meets such other criteria as the Secretary determines appropriate considering the type of environmental health condition at issue; and
(B) has submitted an application (or has an application submitted on the individual's behalf), to an eligible entity receiving a grant under this section, for screening under the program under this section.
(2) Emergency declaration
The term "emergency declaration" means a declaration of a public health emergency under
(3) Environmental health condition
The term "environmental health condition" means—
(A) asbestosis, pleural thickening, or pleural plaques, as established by—
(i) interpretation by a "B Reader" qualified physician of a plain chest x-ray or interpretation of a computed tomographic radiograph of the chest by a qualified physician, as determined by the Secretary; or
(ii) such other diagnostic standards as the Secretary specifies;
(B) mesothelioma, or malignancies of the lung, colon, rectum, larynx, stomach, esophagus, pharynx, or ovary, as established by—
(i) pathologic examination of biopsy tissue;
(ii) cytology from bronchioalveolar lavage; or
(iii) such other diagnostic standards as the Secretary specifies; and
(C) any other medical condition which the Secretary determines is caused by exposure to a hazardous substance or pollutant or contaminant at a Superfund site to which an emergency declaration applies, based on such criteria and as established by such diagnostic standards as the Secretary specifies.
(4) Hazardous substance; pollutant; contaminant
The terms "hazardous substance", "pollutant", and "contaminant" have the meanings given those terms in
(5) Superfund site
The term "Superfund site" means a site included on the National Priorities List developed by the President in accordance with
(d) Health coverage unaffected
Nothing in this section shall be construed to affect any coverage obligation of a governmental or private health plan or program relating to an at-risk individual.
(e) Funding
(1) In general
Out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary, to carry out the program under this section—
(A) $23,000,000 for the period of fiscal years 2010 through 2014; and
(B) $20,000,000 for each 5-fiscal year period thereafter.
(2) Availability
Funds appropriated under paragraph (1) shall remain available until expended.
(f) Nonapplication
(1) In general
Except as provided in paragraph (2), the preceding sections of this subchapter shall not apply to grants awarded under this section.
(2) Limitations on use of grants
(Aug. 14, 1935, ch. 531, title XX, §2009, as added
Editorial Notes
Codification
§1397i. Additional funding for aging and disability services programs
(a) Appropriation
In addition to amounts otherwise available, there is appropriated for fiscal year 2021, out of any money in the Treasury not otherwise appropriated, $276,000,000, to remain available until expended, to carry out the programs described in division B of this subchapter.
(b) Use of funds
Of the amounts made available by subsection (a)—
(1) $88,000,000 shall be made available to carry out the programs described in division B of this subchapter in fiscal year 2021, of which not less than an amount equal to $100,0000,000 minus the amount previously provided in fiscal year 2021 to carry out
(2) $188,000,000 shall be made available to carry out the programs described in division B of this subchapter in fiscal year 2022, of which not less than $100,000,000 shall be for activities described in
(Aug. 14, 1935, ch. 531, title XX, §2010, as added
Division B—Elder Justice
§1397j. Definitions
In this division:
(1) Abuse
The term "abuse" means the knowing infliction of physical or psychological harm or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm.
(2) Adult protective services
The term "adult protective services" means such services provided to adults as the Secretary may specify and includes services such as—
(A) receiving reports of adult abuse, neglect, or exploitation;
(B) investigating the reports described in subparagraph (A);
(C) case planning, monitoring, evaluation, and other case work and services; and
(D) providing, arranging for, or facilitating the provision of medical, social service, economic, legal, housing, law enforcement, or other protective, emergency, or support services.
(3) Caregiver
The term "caregiver" means an individual who has the responsibility for the care of an elder, either voluntarily, by contract, by receipt of payment for care, or as a result of the operation of law, and means a family member or other individual who provides (on behalf of such individual or of a public or private agency, organization, or institution) compensated or uncompensated care to an elder who needs supportive services in any setting.
(4) Direct care
The term "direct care" means care by an employee or contractor who provides assistance or long-term care services to a recipient.
(5) Elder
The term "elder" means an individual age 60 or older.
(6) Elder justice
The term "elder justice" means—
(A) from a societal perspective, efforts to—
(i) prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation; and
(ii) protect elders with diminished capacity while maximizing their autonomy; and
(B) from an individual perspective, the recognition of an elder's rights, including the right to be free of abuse, neglect, and exploitation.
(7) Eligible entity
The term "eligible entity" means a State or local government agency, Indian tribe or tribal organization, or any other public or private entity that is engaged in and has expertise in issues relating to elder justice or in a field necessary to promote elder justice efforts.
(8) Exploitation
The term "exploitation" means the fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual, including a caregiver or fiduciary, that uses the resources of an elder for monetary or personal benefit, profit, or gain, or that results in depriving an elder of rightful access to, or use of, benefits, resources, belongings, or assets.
(9) Fiduciary
The term "fiduciary"—
(A) means a person or entity with the legal responsibility—
(i) to make decisions on behalf of and for the benefit of another person; and
(ii) to act in good faith and with fairness; and
(B) includes a trustee, a guardian, a conservator, an executor, an agent under a financial power of attorney or health care power of attorney, or a representative payee.
(10) Grant
The term "grant" includes a contract, cooperative agreement, or other mechanism for providing financial assistance.
(11) Guardianship
The term "guardianship" means—
(A) the process by which a State court determines that an adult individual lacks capacity to make decisions about self-care or property, and appoints another individual or entity known as a guardian, as a conservator, or by a similar term, as a surrogate decisionmaker;
(B) the manner in which the court-appointed surrogate decisionmaker carries out duties to the individual and the court; or
(C) the manner in which the court exercises oversight of the surrogate decisionmaker.
(12) Indian tribe
(A) In general
The term "Indian tribe" has the meaning given such term in
(B) Inclusion of Pueblo and Rancheria
The term "Indian tribe" includes any Pueblo or Rancheria.
(13) Law enforcement
The term "law enforcement" means the full range of potential responders to elder abuse, neglect, and exploitation including—
(A) police, sheriffs, detectives, public safety officers, and corrections personnel;
(B) prosecutors;
(C) medical examiners;
(D) investigators; and
(E) coroners.
(14) Long-term care
(A) In general
The term "long-term care" means supportive and health services specified by the Secretary for individuals who need assistance because the individuals have a loss of capacity for self-care due to illness, disability, or vulnerability.
(B) Loss of capacity for self-care
For purposes of subparagraph (A), the term "loss of capacity for self-care" means an inability to engage in 1 or more activities of daily living, including eating, dressing, bathing, management of one's financial affairs, and other activities the Secretary determines appropriate.
(15) Long-term care facility
The term "long-term care facility" means a residential care provider that arranges for, or directly provides, long-term care.
(16) Neglect
The term "neglect" means—
(A) the failure of a caregiver or fiduciary to provide the goods or services that are necessary to maintain the health or safety of an elder; or
(B) self-neglect.
(17) Nursing facility
(A) In general
The term "nursing facility" has the meaning given such term under
(B) Inclusion of skilled nursing facility
The term "nursing facility" includes a skilled nursing facility (as defined in
(18) Self-neglect
The term "self-neglect" means an adult's inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks including—
(A) obtaining essential food, clothing, shelter, and medical care;
(B) obtaining goods and services necessary to maintain physical health, mental health, or general safety; or
(C) managing one's own financial affairs.
(19) Serious bodily injury
(A) In general
The term "serious bodily injury" means an injury—
(i) involving extreme physical pain;
(ii) involving substantial risk of death;
(iii) involving protracted loss or impairment of the function of a bodily member, organ, or mental faculty; or
(iv) requiring medical intervention such as surgery, hospitalization, or physical rehabilitation.
(B) Criminal sexual abuse
Serious bodily injury shall be considered to have occurred if the conduct causing the injury is conduct described in section 2241 (relating to aggravated sexual abuse) or 2242 (relating to sexual abuse) of title 18 or any similar offense under State law.
(20) Social
The term "social", when used with respect to a service, includes adult protective services.
(21) State legal assistance developer
The term "State legal assistance developer" means an individual described in
(22) State Long-Term Care Ombudsman
The term "State Long-Term Care Ombudsman" means the State Long-Term Care Ombudsman described in
(Aug. 14, 1935, ch. 531, title XX, §2011, as added
§1397j–1. General provisions
(a) Protection of privacy
In pursuing activities under this division, the Secretary shall ensure the protection of individual health privacy consistent with the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 and applicable State and local privacy regulations.
(b) Rule of construction
Nothing in this division shall be construed to interfere with or abridge an elder's right to practice his or her religion through reliance on prayer alone for healing when this choice—
(1) is contemporaneously expressed, either orally or in writing, with respect to a specific illness or injury which the elder has at the time of the decision by an elder who is competent at the time of the decision;
(2) is previously set forth in a living will, health care proxy, or other advance directive document that is validly executed and applied under State law; or
(3) may be unambiguously deduced from the elder's life history.
(Aug. 14, 1935, ch. 531, title XX, §2012, as added
Editorial Notes
References in Text
Section 264(c) of the Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (a), is section 264(c) of
Part I—National Coordination of Elder Justice Activities and Research
subpart a—elder justice coordinating council and advisory board on elder abuse, neglect, and exploitation
§1397k. Elder Justice Coordinating Council
(a) Establishment
There is established within the Office of the Secretary an Elder Justice Coordinating Council (in this section referred to as the "Council").
(b) Membership
(1) In general
The Council shall be composed of the following members:
(A) The Secretary (or the Secretary's designee).
(B) The Attorney General (or the Attorney General's designee).
(C) The head of each Federal department or agency or other governmental entity identified by the Chair referred to in subsection (d) as having responsibilities, or administering programs, relating to elder abuse, neglect, and exploitation.
(2) Requirement
Each member of the Council shall be an officer or employee of the Federal Government.
(c) Vacancies
Any vacancy in the Council shall not affect its powers, but shall be filled in the same manner as the original appointment was made.
(d) Chair
The member described in subsection (b)(1)(A) shall be Chair of the Council.
(e) Meetings
The Council shall meet at least 2 times per year, as determined by the Chair.
(f) Duties
(1) In general
The Council shall make recommendations to the Secretary for the coordination of activities of the Department of Health and Human Services, the Department of Justice, and other relevant Federal, State, local, and private agencies and entities, relating to elder abuse, neglect, and exploitation and other crimes against elders.
(2) Report
Not later than the date that is 2 years after March 23, 2010, and every 2 years thereafter, the Council shall submit to the Committee on Finance of the Senate and the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives a report that—
(A) describes the activities and accomplishments of, and challenges faced by—
(i) the Council; and
(ii) the entities represented on the Council; and
(B) makes such recommendations for legislation, model laws, or other action as the Council determines to be appropriate.
(g) Powers of the Council
(1) Information from Federal agencies
Subject to the requirements of
(2) Postal services
The Council may use the United States mails in the same manner and under the same conditions as other departments and agencies of the Federal Government.
(h) Travel expenses
The members of the Council shall not receive compensation for the performance of services for the Council. The members shall be allowed travel expenses, including per diem in lieu of subsistence, at rates authorized for employees of agencies under subchapter I of
(i) Detail of Government employees
Any Federal Government employee may be detailed to the Council without reimbursement, and such detail shall be without interruption or loss of civil service status or privilege.
(j) Status as permanent Council
(k) Authorization of appropriations
There are authorized to be appropriated such sums as are necessary to carry out this section.
(Aug. 14, 1935, ch. 531, title XX, §2021, as added
Editorial Notes
Amendments
2022—Subsec. (j).
§1397k–1. Advisory Board on Elder Abuse, Neglect, and Exploitation
(a) Establishment
There is established a board to be known as the "Advisory Board on Elder Abuse, Neglect, and Exploitation" (in this section referred to as the "Advisory Board") to create short- and long-term multidisciplinary strategic plans for the development of the field of elder justice and to make recommendations to the Elder Justice Coordinating Council established under
(b) Composition
The Advisory Board shall be composed of 27 members appointed by the Secretary from among members of the general public who are individuals with experience and expertise in elder abuse, neglect, and exploitation prevention, detection, treatment, intervention, or prosecution.
(c) Solicitation of nominations
The Secretary shall publish a notice in the Federal Register soliciting nominations for the appointment of members of the Advisory Board under subsection (b).
(d) Terms
(1) In general
Each member of the Advisory Board shall be appointed for a term of 3 years, except that, of the members first appointed—
(A) 9 shall be appointed for a term of 3 years;
(B) 9 shall be appointed for a term of 2 years; and
(C) 9 shall be appointed for a term of 1 year.
(2) Vacancies
(A) In general
Any vacancy on the Advisory Board shall not affect its powers, but shall be filled in the same manner as the original appointment was made.
(B) Filling unexpired term
An individual chosen to fill a vacancy shall be appointed for the unexpired term of the member replaced.
(3) Expiration of terms
The term of any member shall not expire before the date on which the member's successor takes office.
(e) Election of officers
The Advisory Board shall elect a Chair and Vice Chair from among its members. The Advisory Board shall elect its initial Chair and Vice Chair at its initial meeting.
(f) Duties
(1) Enhance communication on promoting quality of, and preventing abuse, neglect, and exploitation in, long-term care
The Advisory Board shall develop collaborative and innovative approaches to improve the quality of, including preventing abuse, neglect, and exploitation in, long-term care.
(2) Collaborative efforts to develop consensus around the management of certain quality-related factors
(A) In general
The Advisory Board shall establish multidisciplinary panels to address, and develop consensus on, subjects relating to improving the quality of long-term care. At least 1 such panel shall address, and develop consensus on, methods for managing resident-to-resident abuse in long-term care.
(B) Activities conducted
The multidisciplinary panels established under subparagraph (A) shall examine relevant research and data, identify best practices with respect to the subject of the panel, determine the best way to carry out those best practices in a practical and feasible manner, and determine an effective manner of distributing information on such subject.
(3) Report
Not later than the date that is 18 months after March 23, 2010, and annually thereafter, the Advisory Board shall prepare and submit to the Elder Justice Coordinating Council, the Committee on Finance of the Senate, and the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives a report containing—
(A) information on the status of Federal, State, and local public and private elder justice activities;
(B) recommendations (including recommended priorities) regarding—
(i) elder justice programs, research, training, services, practice, enforcement, and coordination;
(ii) coordination between entities pursuing elder justice efforts and those involved in related areas that may inform or overlap with elder justice efforts, such as activities to combat violence against women and child abuse and neglect; and
(iii) activities relating to adult fiduciary systems, including guardianship and other fiduciary arrangements;
(C) recommendations for specific modifications needed in Federal and State laws (including regulations) or for programs, research, and training to enhance prevention, detection, and treatment (including diagnosis) of, intervention in (including investigation of), and prosecution of elder abuse, neglect, and exploitation;
(D) recommendations on methods for the most effective coordinated national data collection with respect to elder justice, and elder abuse, neglect, and exploitation; and
(E) recommendations for a multidisciplinary strategic plan to guide the effective and efficient development of the field of elder justice.
(g) Powers of the Advisory Board
(1) Information from Federal agencies
Subject to the requirements of
(2) Sharing of data and reports
The Advisory Board may request from any entity pursuing elder justice activities under the Elder Justice Act of 2009 or an amendment made by that Act, any data, reports, or recommendations generated in connection with such activities.
(3) Postal services
The Advisory Board may use the United States mails in the same manner and under the same conditions as other departments and agencies of the Federal Government.
(h) Travel expenses
The members of the Advisory Board shall not receive compensation for the performance of services for the Advisory Board. The members shall be allowed travel expenses for up to 4 meetings per year, including per diem in lieu of subsistence, at rates authorized for employees of agencies under subchapter I of
(i) Detail of Government employees
Any Federal Government employee may be detailed to the Advisory Board without reimbursement, and such detail shall be without interruption or loss of civil service status or privilege.
(j) Status as permanent advisory committee
(k) Authorization of appropriations
There are authorized to be appropriated such sums as are necessary to carry out this section.
(Aug. 14, 1935, ch. 531, title XX, §2022, as added
Editorial Notes
References in Text
The Elder Justice Act of 2009, referred to in subsec. (g)(2), is subtitle H (§§6701–6703) of title VI of
Amendments
2022—Subsec. (j).
1 So in original. Probably should be "Advisory Board".
§1397k–2. Research protections
(a) Guidelines
The Secretary shall promulgate guidelines to assist researchers working in the area of elder abuse, neglect, and exploitation, with issues relating to human subject protections.
(b) Definition of legally authorized representative for application of regulations
For purposes of the application of subpart A of part 46 of title 45, Code of Federal Regulations, to research conducted under this subpart, the term "legally authorized representative" means, unless otherwise provided by law, the individual or judicial or other body authorized under the applicable law to consent to medical treatment on behalf of another person.
(Aug. 14, 1935, ch. 531, title XX, §2023, as added
§1397k–3. Authorization of appropriations
There are authorized to be appropriated to carry out this subpart—
(1) for fiscal year 2011, $6,500,000; and
(2) for each of fiscal years 2012 through 2014, $7,000,000.
(Aug. 14, 1935, ch. 531, title XX, §2024, as added
subpart b—elder abuse, neglect, and exploitation forensic centers
§1397l. Establishment and support of elder abuse, neglect, and exploitation forensic centers
(a) In general
The Secretary, in consultation with the Attorney General, shall make grants to eligible entities to establish and operate stationary and mobile forensic centers, to develop forensic expertise regarding, and provide services relating to, elder abuse, neglect, and exploitation.
(b) Stationary forensic centers
The Secretary shall make 4 of the grants described in subsection (a) to institutions of higher education with demonstrated expertise in forensics or commitment to preventing or treating elder abuse, neglect, or exploitation, to establish and operate stationary forensic centers.
(c) Mobile centers
The Secretary shall make 6 of the grants described in subsection (a) to appropriate entities to establish and operate mobile forensic centers.
(d) Authorized activities
(1) Development of forensic markers and methodologies
An eligible entity that receives a grant under this section shall use funds made available through the grant to assist in determining whether abuse, neglect, or exploitation occurred and whether a crime was committed and to conduct research to describe and disseminate information on—
(A) forensic markers that indicate a case in which elder abuse, neglect, or exploitation may have occurred; and
(B) methodologies for determining, in such a case, when and how health care, emergency service, social and protective services, and legal service providers should intervene and when the providers should report the case to law enforcement authorities.
(2) Development of forensic expertise
An eligible entity that receives a grant under this section shall use funds made available through the grant to develop forensic expertise regarding elder abuse, neglect, and exploitation in order to provide medical and forensic evaluation, therapeutic intervention, victim support and advocacy, case review, and case tracking.
(3) Collection of evidence
The Secretary, in coordination with the Attorney General, shall use data made available by grant recipients under this section to develop the capacity of geriatric health care professionals and law enforcement to collect forensic evidence, including collecting forensic evidence relating to a potential determination of elder abuse, neglect, or exploitation.
(e) Application
To be eligible to receive a grant under this section, an entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.
(f) Authorization of appropriations
There are authorized to be appropriated to carry out this section—
(1) for fiscal year 2011, $4,000,000;
(2) for fiscal year 2012, $6,000,000; and
(3) for each of fiscal years 2013 and 2014, $8,000,000.
(Aug. 14, 1935, ch. 531, title XX, §2031, as added
Part II—Programs To Promote Elder Justice
§1397m. Enhancement of long-term care
(a) Grants and incentives for long-term care staffing
(1) In general
The Secretary shall carry out activities, including activities described in paragraphs (2) and (3), to provide incentives for individuals to train for, seek, and maintain employment providing direct care in long-term care.
(2) Specific programs to enhance training, recruitment, and retention of staff
(A) Coordination with Secretary of Labor to recruit and train long-term care staff
The Secretary shall coordinate activities under this subsection with the Secretary of Labor in order to provide incentives for individuals to train for and seek employment providing direct care in long-term care.
(B) Career ladders and wage or benefit increases to increase staffing in long-term care
(i) In general
The Secretary shall make grants to eligible entities to carry out programs through which the entities—
(I) offer, to employees who provide direct care to residents of an eligible entity or individuals receiving community-based long-term care from an eligible entity, continuing training and varying levels of certification, based on observed clinical care practices and the amount of time the employees spend providing direct care; and
(II) provide, or make arrangements to provide, bonuses or other increased compensation or benefits to employees who achieve certification under such a program.
(ii) Application
To be eligible to receive a grant under this subparagraph, an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require (which may include evidence of consultation with the State in which the eligible entity is located with respect to carrying out activities funded under the grant).
(iii) Authority to limit number of applicants
Nothing in this subparagraph shall be construed as prohibiting the Secretary from limiting the number of applicants for a grant under this subparagraph.
(3) Specific programs to improve management practices
(A) In general
The Secretary shall make grants to eligible entities to enable the entities to provide training and technical assistance.
(B) Authorized activities
An eligible entity that receives a grant under subparagraph (A) shall use funds made available through the grant to provide training and technical assistance regarding management practices using methods that are demonstrated to promote retention of individuals who provide direct care, such as—
(i) the establishment of standard human resource policies that reward high performance, including policies that provide for improved wages and benefits on the basis of job reviews;
(ii) the establishment of motivational and thoughtful work organization practices;
(iii) the creation of a workplace culture that respects and values caregivers and their needs;
(iv) the promotion of a workplace culture that respects the rights of residents of an eligible entity or individuals receiving community-based long-term care from an eligible entity and results in improved care for the residents or the individuals; and
(v) the establishment of other programs that promote the provision of high quality care, such as a continuing education program that provides additional hours of training, including on-the-job training, for employees who are certified nurse aides.
(C) Application
To be eligible to receive a grant under this paragraph, an eligible entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require (which may include evidence of consultation with the State in which the eligible entity is located with respect to carrying out activities funded under the grant).
(D) Authority to limit number of applicants
Nothing in this paragraph shall be construed as prohibiting the Secretary from limiting the number of applicants for a grant under this paragraph.
(4) Accountability measures
The Secretary shall develop accountability measures to ensure that the activities conducted using funds made available under this subsection benefit individuals who provide direct care and increase the stability of the long-term care workforce.
(5) Definitions
In this subsection:
(A) Community-based long-term care
The term "community-based long-term care" has the meaning given such term by the Secretary.
(B) Eligible entity
The term "eligible entity" means the following:
(i) A long-term care facility.
(ii) A community-based long-term care entity (as defined by the Secretary).
(b) Certified EHR technology grant program
(1) Grants authorized
The Secretary is authorized to make grants to long-term care facilities for the purpose of assisting such entities in offsetting the costs related to purchasing, leasing, developing, and implementing certified EHR technology (as defined in
(2) Use of grant funds
Funds provided under grants under this subsection may be used for any of the following:
(A) Purchasing, leasing, and installing computer software and hardware, including handheld computer technologies.
(B) Making improvements to existing computer software and hardware.
(C) Making upgrades and other improvements to existing computer software and hardware to enable e-prescribing.
(D) Providing education and training to eligible long-term care facility staff on the use of such technology to implement the electronic transmission of prescription and patient information.
(3) Application
(A) In general
To be eligible to receive a grant under this subsection, a long-term care facility shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require (which may include evidence of consultation with the State in which the long-term care facility is located with respect to carrying out activities funded under the grant).
(B) Authority to limit number of applicants
Nothing in this subsection shall be construed as prohibiting the Secretary from limiting the number of applicants for a grant under this subsection.
(4) Participation in State health exchanges
A long-term care facility that receives a grant under this subsection shall, where available, participate in activities conducted by a State or a qualified State-designated entity (as defined in
(5) Accountability measures
The Secretary shall develop accountability measures to ensure that the activities conducted using funds made available under this subsection help improve patient safety and reduce adverse events and health care complications resulting from medication errors.
(c) Adoption of standards for transactions involving clinical data by long-term care facilities
(1) Standards and compatibility
The Secretary shall adopt electronic standards for the exchange of clinical data by long-term care facilities, including, where available, standards for messaging and nomenclature. Standards adopted by the Secretary under the preceding sentence shall be compatible with standards established under part C of subchapter XI, standards established under subsections (b)(2)(B)(i) and (e)(4) of
(2) Electronic submission of data to the Secretary
(A) In general
Not later than 10 years after March 23, 2010, the Secretary shall have procedures in place to accept the optional electronic submission of clinical data by long-term care facilities pursuant to the standards adopted under paragraph (1).
(B) Rule of construction
Nothing in this subsection shall be construed to require a long-term care facility to submit clinical data electronically to the Secretary.
(3) Regulations
The Secretary shall promulgate regulations to carry out this subsection. Such regulations shall require a State, as a condition of the receipt of funds under this part, to conduct such data collection and reporting as the Secretary determines are necessary to satisfy the requirements of this subsection.
(d) Authorization of appropriations
There are authorized to be appropriated to carry out this section—
(1) for fiscal year 2011, $20,000,000;
(2) for fiscal year 2012, $17,500,000; and
(3) for each of fiscal years 2013 and 2014, $15,000,000.
(Aug. 14, 1935, ch. 531, title XX, §2041, as added
Editorial Notes
References in Text
Part C of subchapter XI, referred to in subsec. (c)(1), is classified to
§1397m–1. Adult protective services functions and grant programs
(a) Secretarial responsibilities
(1) In general
The Secretary shall ensure that the Department of Health and Human Services—
(A) provides funding authorized by this part to State and local adult protective services offices that investigate reports of the abuse, neglect, and exploitation of elders;
(B) collects and disseminates data annually relating to the abuse, exploitation, and neglect of elders in coordination with the Department of Justice;
(C) develops and disseminates information on best practices regarding, and provides training on, carrying out adult protective services;
(D) conducts research related to the provision of adult protective services; and
(E) provides technical assistance to States and other entities that provide or fund the provision of adult protective services, including through grants made under subsections (b) and (c).
(2) Authorization of appropriations
There are authorized to be appropriated to carry out this subsection, $3,000,000 for fiscal year 2011 and $4,000,000 for each of fiscal years 2012 through 2014.
(b) Grants to enhance the provision of adult protective services
(1) Establishment
There is established an adult protective services grant program under which the Secretary shall annually award grants to States in the amounts calculated under paragraph (2) for the purposes of enhancing adult protective services provided by States and local units of government.
(2) Amount of payment
(A) In general
Subject to the availability of appropriations and subparagraphs (B) and (C), the amount paid to a State for a fiscal year under the program under this subsection shall equal the amount appropriated for that year to carry out this subsection multiplied by the percentage of the total number of elders who reside in the United States who reside in that State.
(B) Guaranteed minimum payment amount
(i) 50 States
Subject to clause (ii), if the amount determined under subparagraph (A) for a State for a fiscal year is less than 0.75 percent of the amount appropriated for such year, the Secretary shall increase such determined amount so that the total amount paid under this subsection to the State for the year is equal to 0.75 percent of the amount so appropriated.
(ii) Territories
In the case of a State other than 1 of the 50 States, clause (i) shall be applied as if each reference to "0.75" were a reference to "0.1".
(C) Pro rata reductions
The Secretary shall make such pro rata reductions to the amounts described in subparagraph (A) as are necessary to comply with the requirements of subparagraph (B).
(3) Authorized activities
(A) Adult protective services
Funds made available pursuant to this subsection may only be used by States and local units of government to provide adult protective services and may not be used for any other purpose.
(B) Use by agency
Each State receiving funds pursuant to this subsection shall provide such funds to the agency or unit of State government having legal responsibility for providing adult protective services within the State.
(C) Supplement not supplant
Each State or local unit of government shall use funds made available pursuant to this subsection to supplement and not supplant other Federal, State, and local public funds expended to provide adult protective services in the State.
(4) State reports
Each State receiving funds under this subsection shall submit to the Secretary, at such time and in such manner as the Secretary may require, a report on the number of elders served by the grants awarded under this subsection.
(5) Authorization of appropriations
There are authorized to be appropriated to carry out this subsection, $100,000,000 for each of fiscal years 2011 through 2014.
(c) State demonstration programs
(1) Establishment
The Secretary shall award grants to States (and, in the case of demonstration programs described in paragraph (2)(E), to the highest courts of States) for the purposes of conducting demonstration programs in accordance with paragraph (2).
(2) Demonstration programs
Funds made available pursuant to this subsection may be used by States and local units of government (and the highest courts of States, in the case of demonstration programs described in subparagraph (E)) to conduct demonstration programs that test—
(A) training modules developed for the purpose of detecting or preventing elder abuse;
(B) methods to detect or prevent financial exploitation of elders;
(C) methods to detect elder abuse;
(D) whether training on elder abuse forensics enhances the detection of elder abuse by employees of the State or local unit of government;
(E) subject to paragraph (3), programs to assess the fairness, effectiveness, timeliness, safety, integrity, and accessibility of adult guardianship and conservatorship proceedings, including the appointment and the monitoring of the performance of court-appointed guardians and conservators, and to implement changes deemed necessary as a result of the assessments such as mandating background checks for all potential guardians and conservators, and implementing systems to enable the annual accountings and other required conservatorship and guardianship filings to be completed, filed, and reviewed electronically in order to simplify the filing process for conservators and guardians and better enable courts to identify discrepancies and detect fraud and the exploitation of protected persons; or
(F) other matters relating to the detection or prevention of elder abuse.
(3) Requirements for court-appointed guardianship oversight demonstration programs
(A) Award of grants
In awarding grants to the highest courts of States for demonstration programs described in paragraph (2)(E), the Secretary shall consider the recommendations of the Attorney General and the State Justice Institute, as established by
(B) Collaboration
The highest court of a State awarded a grant to conduct a demonstration program described in paragraph (2)(E) shall collaborate with the State Unit on Aging for the State and the Adult Protective Services agency for the State in conducting the demonstration program.
(4) Application
To be eligible to receive a grant under this subsection, a State (and, in the case of demonstration programs described in paragraph (2)(E), the highest court of a State) shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.
(5) State reports
Each State (or, in the case of demonstration programs described in paragraph (2)(E), the highest court of a State) that receives funds under this subsection shall submit to the Secretary a report at such time, in such manner, and containing such information as the Secretary may require on the results of the demonstration program conducted by the State (or, in the case of demonstration programs described in paragraph (2)(E), the highest court of a State) using funds made available under this subsection.
(6) Authorization of appropriations
There are authorized to be appropriated to carry out this subsection, $25,000,000 for each of fiscal years 2011 through 2014.
(Aug. 14, 1935, ch. 531, title XX, §2042, as added
Editorial Notes
Amendments
2017—Subsec. (c)(1).
Subsec. (c)(2).
Subsec. (c)(2)(E), (F).
Subsec. (c)(3).
Subsec. (c)(4).
Subsec. (c)(5).
Subsec. (c)(6).
§1397m–2. Long-term care ombudsman program grants and training
(a) Grants to support the long-term care ombudsman program
(1) In general
The Secretary shall make grants to eligible entities with relevant expertise and experience in abuse and neglect in long-term care facilities or long-term care ombudsman programs and responsibilities, for the purpose of—
(A) improving the capacity of State long-term care ombudsman programs to respond to and resolve complaints about abuse and neglect;
(B) conducting pilot programs with State long-term care ombudsman offices or local ombudsman entities; and
(C) providing support for such State long-term care ombudsman programs and such pilot programs (such as through the establishment of a national long-term care ombudsman resource center).
(2) Authorization of appropriations
There are authorized to be appropriated to carry out this subsection—
(A) for fiscal year 2011, $5,000,000;
(B) for fiscal year 2012, $7,500,000; and
(C) for each of fiscal years 2013 and 2014, $10,000,000.
(b) Ombudsman training programs
(1) In general
The Secretary shall establish programs to provide and improve ombudsman training with respect to elder abuse, neglect, and exploitation for national organizations and State long-term care ombudsman programs.
(2) Authorization of appropriations
There are authorized to be appropriated to carry out this subsection, for each of fiscal years 2011 through 2014, $10,000,000.
(Aug. 14, 1935, ch. 531, title XX, §2043, as added
§1397m–3. Provision of information regarding, and evaluations of, elder justice programs
(a) Provision of information
To be eligible to receive a grant under this part, an applicant shall agree—
(1) except as provided in paragraph (2), to provide the eligible entity conducting an evaluation under subsection (b) of the activities funded through the grant with such information as the eligible entity may require in order to conduct such evaluation; or
(2) in the case of an applicant for a grant under
(b) Use of eligible entities to conduct evaluations
(1) Evaluations required
Except as provided in paragraph (2), the Secretary shall—
(A) reserve a portion (not less than 2 percent) of the funds appropriated with respect to each program carried out under this part; and
(B) use the funds reserved under subparagraph (A) to provide assistance to eligible entities to conduct evaluations of the activities funded under each program carried out under this part.
(2) Certified EHR technology grant program not included
The provisions of this subsection shall not apply to the certified EHR technology grant program under
(3) Authorized activities
A recipient of assistance described in paragraph (1)(B) shall use the funds made available through the assistance to conduct a validated evaluation of the effectiveness of the activities funded under a program carried out under this part.
(4) Applications
To be eligible to receive assistance under paragraph (1)(B), an entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a proposal for the evaluation.
(5) Reports
Not later than a date specified by the Secretary, an eligible entity receiving assistance under paragraph (1)(B) shall submit to the Secretary, the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives, and the Committee on Finance of the Senate a report containing the results of the evaluation conducted using such assistance together with such recommendations as the entity determines to be appropriate.
(c) Evaluations and audits of certified EHR technology grant program by the Secretary
(1) Evaluations
The Secretary shall conduct an evaluation of the activities funded under the certified EHR technology grant program under
(2) Audits
The Secretary shall conduct appropriate audits of grants made under
(Aug. 14, 1935, ch. 531, title XX, §2044, as added
§1397m–4. Report
Not later than October 1, 2014, the Secretary shall submit to the Elder Justice Coordinating Council established under
(1) compiling, summarizing, and analyzing the information contained in the State reports submitted under subsections (b)(4) and (c)(4) 1 of
(2) containing such recommendations for legislative or administrative action as the Secretary determines to be appropriate.
(Aug. 14, 1935, ch. 531, title XX, §2045, as added
Editorial Notes
References in Text
Subsection (c)(4) of
1 See References in Text note below.
§1397m–5. Rule of construction
Nothing in this division shall be construed as—
(1) limiting any cause of action or other relief related to obligations under this division that is available under the law of any State, or political subdivision thereof; or
(2) creating a private cause of action for a violation of this division.
(Aug. 14, 1935, ch. 531, title XX, §2046, as added
Division C—Social Impact Demonstration Projects
§1397n. Purposes
The purposes of this division are the following:
(1) To improve the lives of families and individuals in need in the United States by funding social programs that achieve real results.
(2) To redirect funds away from programs that, based on objective data, are ineffective, and into programs that achieve demonstrable, measurable results.
(3) To ensure Federal funds are used effectively on social services to produce positive outcomes for both service recipients and taxpayers.
(4) To establish the use of social impact partnerships to address some of our Nation's most pressing problems.
(5) To facilitate the creation of public-private partnerships that bundle philanthropic or other private resources with existing public spending to scale up effective social interventions already being implemented by private organizations, nonprofits, charitable organizations, and State and local governments across the country.
(6) To bring pay-for-performance to the social sector, allowing the United States to improve the impact and effectiveness of vital social services programs while redirecting inefficient or duplicative spending.
(7) To incorporate outcomes measurement and randomized controlled trials or other rigorous methodologies for assessing program impact.
(Aug. 14, 1935, ch. 531, title XX, §2051, as added
§1397n–1. Social impact partnership application
(a) Notice
Not later than 1 year after February 9, 2018, the Secretary of the Treasury, in consultation with the Federal Interagency Council on Social Impact Partnerships, shall publish in the Federal Register a request for proposals from States or local governments for social impact partnership projects in accordance with this section.
(b) Required outcomes for social impact partnership project
To qualify as a social impact partnership project under this division, a project must produce one or more measurable, clearly defined outcomes that result in social benefit and Federal, State, or local savings through any of the following:
(1) Increasing work and earnings by individuals in the United States who are unemployed for more than 6 consecutive months.
(2) Increasing employment and earnings of individuals who have attained 16 years of age but not 25 years of age.
(3) Increasing employment among individuals receiving Federal disability benefits.
(4) Reducing the dependence of low-income families on Federal means-tested benefits.
(5) Improving rates of high school graduation.
(6) Reducing teen and unplanned pregnancies.
(7) Improving birth outcomes and early childhood health and development among low-income families and individuals.
(8) Reducing rates of asthma, diabetes, or other preventable diseases among low-income families and individuals to reduce the utilization of emergency and other high-cost care.
(9) Increasing the proportion of children living in two-parent families.
(10) Reducing incidences and adverse consequences of child abuse and neglect.
(11) Reducing the number of youth in foster care by increasing adoptions, permanent guardianship arrangements, reunifications, or placements with a fit and willing relative, or by avoiding placing children in foster care by ensuring they can be cared for safely in their own homes.
(12) Reducing the number of children and youth in foster care residing in group homes, child care institutions, agency-operated foster homes, or other non-family foster homes, unless it is determined that it is in the interest of the child's long-term health, safety, or psychological well-being to not be placed in a family foster home.
(13) Reducing the number of children returning to foster care.
(14) Reducing recidivism among juvenile offenders, individuals released from prison, or other high-risk populations.
(15) Reducing the rate of homelessness among our most vulnerable populations.
(16) Improving the health and well-being of those with mental, emotional, and behavioral health needs.
(17) Improving the educational outcomes of special-needs or low-income children.
(18) Improving the employment and well-being of returning United States military members.
(19) Increasing the financial stability of low-income families.
(20) Increasing the independence and employability of individuals who are physically or mentally disabled.
(21) Other measurable outcomes defined by the State or local government that result in positive social outcomes and Federal savings.
(c) Application required
The notice described in subsection (a) shall require a State or local government to submit an application for the social impact partnership project that addresses the following:
(1) The outcome goals of the project.
(2) A description of each intervention in the project and anticipated outcomes of the intervention.
(3) Rigorous evidence demonstrating that the intervention can be expected to produce the desired outcomes.
(4) The target population that will be served by the project.
(5) The expected social benefits to participants who receive the intervention and others who may be impacted.
(6) Projected Federal, State, and local government costs and other costs to conduct the project.
(7) Projected Federal, State, and local government savings and other savings, including an estimate of the savings to the Federal Government, on a program-by-program basis and in the aggregate, if the project is implemented and the outcomes are achieved as a result of the intervention.
(8) If savings resulting from the successful completion of the project are estimated to accrue to the State or local government, the likelihood of the State or local government to realize those savings.
(9) A plan for delivering the intervention through a social impact partnership model.
(10) A description of the expertise of each service provider that will administer the intervention, including a summary of the experience of the service provider in delivering the proposed intervention or a similar intervention, or demonstrating that the service provider has the expertise necessary to deliver the proposed intervention.
(11) An explanation of the experience of the State or local government, the intermediary, or the service provider in raising private and philanthropic capital to fund social service investments.
(12) The detailed roles and responsibilities of each entity involved in the project, including any State or local government entity, intermediary, service provider, independent evaluator, investor, or other stakeholder.
(13) A summary of the experience of the service provider in delivering the proposed intervention or a similar intervention, or a summary demonstrating the service provider has the expertise necessary to deliver the proposed intervention.
(14) A summary of the unmet need in the area where the intervention will be delivered or among the target population who will receive the intervention.
(15) The proposed payment terms, the methodology used to calculate outcome payments, the payment schedule, and performance thresholds.
(16) The project budget.
(17) The project timeline.
(18) The criteria used to determine the eligibility of an individual for the project, including how selected populations will be identified, how they will be referred to the project, and how they will be enrolled in the project.
(19) The evaluation design.
(20) The metrics that will be used in the evaluation to determine whether the outcomes have been achieved as a result of the intervention and how the metrics will be measured.
(21) An explanation of how the metrics used in the evaluation to determine whether the outcomes achieved as a result of the intervention are independent, objective indicators of impact and are not subject to manipulation by the service provider, intermediary, or investor.
(22) A summary explaining the independence of the evaluator from the other entities involved in the project and the evaluator's experience in conducting rigorous evaluations of program effectiveness including, where available, well-implemented randomized controlled trials on the intervention or similar interventions.
(23) The capacity of the service provider to deliver the intervention to the number of participants the State or local government proposes to serve in the project.
(24) A description of whether and how the State or local government and service providers plan to sustain the intervention, if it is timely and appropriate to do so, to ensure that successful interventions continue to operate after the period of the social impact partnership.
(d) Project intermediary information required
The application described in subsection (c) shall also contain the following information about any intermediary for the social impact partnership project (whether an intermediary is a service provider or other entity):
(1) Experience and capacity for providing or facilitating the provision of the type of intervention proposed.
(2) The mission and goals.
(3) Information on whether the intermediary is already working with service providers that provide this intervention or an explanation of the capacity of the intermediary to begin working with service providers to provide the intervention.
(4) Experience working in a collaborative environment across government and nongovernmental entities.
(5) Previous experience collaborating with public or private entities to implement evidence-based programs.
(6) Ability to raise or provide funding to cover operating costs (if applicable to the project).
(7) Capacity and infrastructure to track outcomes and measure results, including—
(A) capacity to track and analyze program performance and assess program impact; and
(B) experience with performance-based awards or performance-based contracting and achieving project milestones and targets.
(8) Role in delivering the intervention.
(9) How the intermediary would monitor program success, including a description of the interim benchmarks and outcome measures.
(e) Feasibility studies funded through other sources
The notice described in subsection (a) shall permit a State or local government to submit an application for social impact partnership funding that contains information from a feasibility study developed for purposes other than applying for funding under this division.
(Aug. 14, 1935, ch. 531, title XX, §2052, as added
§1397n–2. Awarding social impact partnership agreements
(a) Timeline in awarding agreement
Not later than 6 months after receiving an application in accordance with
(b) Considerations in awarding agreement
In determining whether to enter into an agreement for a social impact partnership project (the application for which was submitted under
(1) The recommendations made by the Commission on Social Impact Partnerships.
(2) The value to the Federal Government of the outcomes expected to be achieved if the outcomes specified in the agreement are achieved as a result of the intervention.
(3) The likelihood, based on evidence provided in the application and other evidence, that the State or local government in collaboration with the intermediary and the service providers will achieve the outcomes.
(4) The savings to the Federal Government if the outcomes specified in the agreement are achieved as a result of the intervention.
(5) The savings to the State and local governments if the outcomes specified in the agreement are achieved as a result of the intervention.
(6) The expected quality of the evaluation that would be conducted with respect to the agreement.
(7) The capacity and commitment of the State or local government to sustain the intervention, if appropriate and timely and if the intervention is successful, beyond the period of the social impact partnership.
(c) Agreement authority
(1) Agreement requirements
In accordance with this section, the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships and the head of any Federal agency administering a similar intervention or serving a population similar to that served by the project, may enter into an agreement for a social impact partnership project with a State or local government if the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships, determines that each of the following requirements are met:
(A) The State or local government agrees to achieve one or more outcomes as a result of the intervention, as specified in the agreement and validated by independent evaluation, in order to receive payment.
(B) The Federal payment to the State or local government for each specified outcome achieved as a result of the intervention is less than or equal to the value of the outcome to the Federal Government over a period not to exceed 10 years, as determined by the Secretary, in consultation with the State or local government.
(C) The duration of the project does not exceed 10 years.
(D) The State or local government has demonstrated, through the application submitted under
(E) The State, local government, intermediary, or service provider has experience raising private or philanthropic capital to fund social service investments (if applicable to the project).
(F) The State or local government has shown that each service provider has experience delivering the intervention, a similar intervention, or has otherwise demonstrated the expertise necessary to deliver the intervention.
(2) Payment
The Secretary shall pay the State or local government only if the independent evaluator described in
(d) Notice of Agreement Award
Not later than 30 days after entering into an agreement under this section the Secretary shall publish a notice in the Federal Register that includes, with regard to the agreement, the following:
(1) The outcome goals of the social impact partnership project.
(2) A description of each intervention in the project.
(3) The target population that will be served by the project.
(4) The expected social benefits to participants who receive the intervention and others who may be impacted.
(5) The detailed roles, responsibilities, and purposes of each Federal, State, or local government entity, intermediary, service provider, independent evaluator, investor, or other stakeholder.
(6) The payment terms, the methodology used to calculate outcome payments, the payment schedule, and performance thresholds.
(7) The project budget.
(8) The project timeline.
(9) The project eligibility criteria.
(10) The evaluation design.
(11) The metrics that will be used in the evaluation to determine whether the outcomes have been achieved as a result of each intervention and how these metrics will be measured.
(12) The estimate of the savings to the Federal, State, and local government, on a program-by-program basis and in the aggregate, if the agreement is entered into and implemented and the outcomes are achieved as a result of each intervention.
(e) Authority to transfer administration of agreement
The Secretary may transfer to the head of another Federal agency the authority to administer (including making payments under) an agreement entered into under subsection (c), and any funds necessary to do so.
(f) Requirement on funding used to benefit children
Not less than 50 percent of all Federal payments made to carry out agreements under this section shall be used for initiatives that directly benefit children.
(Aug. 14, 1935, ch. 531, title XX, §2053, as added
§1397n–3. Feasibility study funding
(a) Requests for funding for feasibility studies
The Secretary shall reserve a portion of the amount made available to carry out this division to assist States or local governments in developing feasibility studies to apply for social impact partnership funding under
(1) A description of the outcome goals of the social impact partnership project.
(2) A description of the intervention, including anticipated program design, target population, an estimate regarding the number of individuals to be served, and setting for the intervention.
(3) Evidence to support the likelihood that the intervention will produce the desired outcomes.
(4) A description of the potential metrics to be used.
(5) The expected social benefits to participants who receive the intervention and others who may be impacted.
(6) Estimated costs to conduct the project.
(7) Estimates of Federal, State, and local government savings and other savings if the project is implemented and the outcomes are achieved as a result of each intervention.
(8) An estimated timeline for implementation and completion of the project, which shall not exceed 10 years.
(9) With respect to a project for which the State or local government selects an intermediary to operate the project, any partnerships needed to successfully execute the project and the ability of the intermediary to foster the partnerships.
(10) The expected resources needed to complete the feasibility study for the State or local government to apply for social impact partnership funding under
(b) Federal selection of applications for feasibility study
Not later than 6 months after receiving an application for feasibility study funding under subsection (a), the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships and the head of any Federal agency administering a similar intervention or serving a population similar to that served by the project, shall select State or local government feasibility study proposals for funding based on the following:
(1) The recommendations made by the Commission on Social Impact Partnerships.
(2) The likelihood that the proposal will achieve the desired outcomes.
(3) The value of the outcomes expected to be achieved as a result of each intervention.
(4) The potential savings to the Federal Government if the social impact partnership project is successful.
(5) The potential savings to the State and local governments if the project is successful.
(c) Public disclosure
Not later than 30 days after selecting a State or local government for feasibility study funding under this section, the Secretary shall cause to be published on the website of the Federal Interagency Council on Social Impact Partnerships information explaining why a State or local government was granted feasibility study funding.
(d) Funding restriction
(1) Feasibility study restriction
The Secretary may not provide feasibility study funding under this section for more than 50 percent of the estimated total cost of the feasibility study reported in the State or local government application submitted under subsection (a).
(2) Aggregate restriction
Of the total amount made available to carry out this division, the Secretary may not use more than $10,000,000 to provide feasibility study funding to States or local governments under this section.
(3) No guarantee of funding
The Secretary shall have the option to award no funding under this section.
(e) Submission of feasibility study required
Not later than 9 months after the receipt of feasibility study funding under this section, a State or local government receiving the funding shall complete the feasibility study and submit the study to the Federal Interagency Council on Social Impact Partnerships.
(f) Delegation of authority
The Secretary may transfer to the head of another Federal agency the authorities provided in this section and any funds necessary to exercise the authorities.
(Aug. 14, 1935, ch. 531, title XX, §2054, as added
§1397n–4. Evaluations
(a) Authority to enter into agreements
For each State or local government awarded a social impact partnership project approved by the Secretary under this division, the head of the relevant agency, as recommended by the Federal Interagency Council on Social Impact Partnerships and determined by the Secretary, shall enter into an agreement with the State or local government to pay for all or part of the independent evaluation to determine whether the State or local government project has achieved a specific outcome as a result of the intervention in order for the State or local government to receive outcome payments under this division.
(b) Evaluator qualifications
The head of the relevant agency may not enter into an agreement with a State or local government unless the head determines that the evaluator is independent of the other parties to the agreement and has demonstrated substantial experience in conducting rigorous evaluations of program effectiveness including, where available and appropriate, well-implemented randomized controlled trials on the intervention or similar interventions.
(c) Methodologies to be used
The evaluation used to determine whether a State or local government will receive outcome payments under this division shall use experimental designs using random assignment or other reliable, evidence-based research methodologies, as certified by the Federal Interagency Council on Social Impact Partnerships, that allow for the strongest possible causal inferences when random assignment is not feasible.
(d) Progress report
(1) Submission of report
The independent evaluator shall—
(A) not later than 2 years after a project has been approved by the Secretary and biannually thereafter until the project is concluded, submit to the head of the relevant agency and the Federal Interagency Council on Social Impact Partnerships a written report summarizing the progress that has been made in achieving each outcome specified in the agreement; and
(B) before the scheduled time of the first outcome payment and before the scheduled time of each subsequent payment, submit to the head of the relevant agency and the Federal Interagency Council on Social Impact Partnerships a written report that includes the results of the evaluation conducted to determine whether an outcome payment should be made along with information on the unique factors that contributed to achieving or failing to achieve the outcome, the challenges faced in attempting to achieve the outcome, and information on the improved future delivery of this or similar interventions.
(2) Submission to the Secretary and Congress
Not later than 30 days after receipt of the written report pursuant to paragraph (1)(B), the Federal Interagency Council on Social Impact Partnerships shall submit the report to the Secretary and each committee of jurisdiction in the House of Representatives and the Senate.
(e) Final report
(1) Submission of report
Within 6 months after the social impact partnership project is completed, the independent evaluator shall—
(A) evaluate the effects of the activities undertaken pursuant to the agreement with regard to each outcome specified in the agreement; and
(B) submit to the head of the relevant agency and the Federal Interagency Council on Social Impact Partnerships a written report that includes the results of the evaluation and the conclusion of the evaluator as to whether the State or local government has fulfilled each obligation of the agreement, along with information on the unique factors that contributed to the success or failure of the project, the challenges faced in attempting to achieve the outcome, and information on the improved future delivery of this or similar interventions.
(2) Submission to the Secretary and Congress
Not later than 30 days after receipt of the written report pursuant to paragraph (1)(B), the Federal Interagency Council on Social Impact Partnerships shall submit the report to the Secretary and each committee of jurisdiction in the House of Representatives and the Senate.
(f) Limitation on cost of evaluations
Of the amount made available under this division for social impact partnership projects, the Secretary may not obligate more than 15 percent to evaluate the implementation and outcomes of the projects.
(g) Delegation of authority
The Secretary may transfer to the head of another Federal agency the authorities provided in this section and any funds necessary to exercise the authorities.
(Aug. 14, 1935, ch. 531, title XX, §2055, as added
§1397n–5. Federal Interagency Council on Social Impact Partnerships
(a) Establishment
There is established the Federal Interagency Council on Social Impact Partnerships (in this section referred to as the "Council") to—
(1) coordinate with the Secretary on the efforts of social impact partnership projects funded under this division;
(2) advise and assist the Secretary in the development and implementation of the projects;
(3) advise the Secretary on specific programmatic and policy matter related to the projects;
(4) provide subject-matter expertise to the Secretary with regard to the projects;
(5) certify to the Secretary that each State or local government that has entered into an agreement with the Secretary for a social impact partnership project under this division and each evaluator selected by the head of the relevant agency under
(6) address issues that will influence the future of social impact partnership projects in the United States;
(7) provide guidance to the executive branch on the future of social impact partnership projects in the United States;
(8) prior to approval by the Secretary, certify that each State and local government application for a social impact partnership contains rigorous, independent data and reliable, evidence-based research methodologies to support the conclusion that the project will yield savings to the State or local government or the Federal Government if the project outcomes are achieved;
(9) certify to the Secretary, in the case of each approved social impact partnership that is expected to yield savings to the Federal Government, that the project will yield a projected savings to the Federal Government if the project outcomes are achieved, and coordinate with the relevant Federal agency to produce an after-action accounting once the project is complete to determine the actual Federal savings realized, and the extent to which actual savings aligned with projected savings; and
(10) provide periodic reports to the Secretary and make available reports periodically to Congress and the public on the implementation of this division.
(b) Composition of Council
The Council shall have 11 members, as follows:
(1) Chair
The Chair of the Council shall be the Director of the Office of Management and Budget.
(2) Other members
The head of each of the following entities shall designate one officer or employee of the entity to be a Council member:
(A) The Department of Labor.
(B) The Department of Health and Human Services.
(C) The Social Security Administration.
(D) The Department of Agriculture.
(E) The Department of Justice.
(F) The Department of Housing and Urban Development.
(G) The Department of Education.
(H) The Department of Veterans Affairs.
(I) The Department of the Treasury.
(J) The Corporation for National and Community Service.
(Aug. 14, 1935, ch. 531, title XX, §2056, as added
§1397n–6. Commission on Social Impact Partnerships
(a) Establishment
There is established the Commission on Social Impact Partnerships (in this section referred to as the "Commission").
(b) Duties
The duties of the Commission shall be to—
(1) assist the Secretary and the Federal Interagency Council on Social Impact Partnerships in reviewing applications for funding under this division;
(2) make recommendations to the Secretary and the Federal Interagency Council on Social Impact Partnerships regarding the funding of social impact partnership agreements and feasibility studies; and
(3) provide other assistance and information as requested by the Secretary or the Federal Interagency Council on Social Impact Partnerships.
(c) Composition
The Commission shall be composed of nine members, of whom—
(1) one shall be appointed by the President, who will serve as the Chair of the Commission;
(2) one shall be appointed by the Majority Leader of the Senate;
(3) one shall be appointed by the Minority Leader of the Senate;
(4) one shall be appointed by the Speaker of the House of Representatives;
(5) one shall be appointed by the Minority Leader of the House of Representatives;
(6) one shall be appointed by the Chairman of the Committee on Finance of the Senate;
(7) one shall be appointed by the ranking member of the Committee on Finance of the Senate;
(8) one member shall be appointed by the Chairman of the Committee on Ways and Means of the House of Representatives; and
(9) one shall be appointed by the ranking member of the Committee on Ways and Means of the House of Representatives.
(d) Qualifications of Commission members
The members of the Commission shall—
(1) be experienced in finance, economics, pay for performance, or program evaluation;
(2) have relevant professional or personal experience in a field related to one or more of the outcomes listed in this division; or
(3) be qualified to review applications for social impact partnership projects to determine whether the proposed metrics and evaluation methodologies are appropriately rigorous and reliant upon independent data and evidence-based research.
(e) Timing of appointments
The appointments of the members of the Commission shall be made not later than 120 days after February 9, 2018, or, in the event of a vacancy, not later than 90 days after the date the vacancy arises. If a member of Congress fails to appoint a member by that date, the President may select a member of the President's choice on behalf of the member of Congress. Notwithstanding the preceding sentence, if not all appointments have been made to the Commission as of that date, the Commission may operate with no fewer than five members until all appointments have been made.
(f) Term of appointments
(1) In general
The members appointed under subsection (c) shall serve as follows:
(A) Three members shall serve for 2 years.
(B) Three members shall serve for 3 years.
(C) Three members (one of which shall be Chair of the Commission appointed by the President) shall serve for 4 years.
(2) Assignment of terms
The Commission shall designate the term length that each member appointed under subsection (c) shall serve by unanimous agreement. In the event that unanimous agreement cannot be reached, term lengths shall be assigned to the members by a random process.
(g) Vacancies
Subject to subsection (e), in the event of a vacancy in the Commission, whether due to the resignation of a member, the expiration of a member's term, or any other reason, the vacancy shall be filled in the manner in which the original appointment was made and shall not affect the powers of the Commission.
(h) Appointment power
Members of the Commission appointed under subsection (c) shall not be subject to confirmation by the Senate.
(Aug. 14, 1935, ch. 531, title XX, §2057, as added
§1397n–7. Limitation on use of funds
Of the amounts made available to carry out this division, the Secretary may not use more than $2,000,000 in any fiscal year to support the review, approval, and oversight of social impact partnership projects, including activities conducted by—
(1) the Federal Interagency Council on Social Impact Partnerships; and
(2) any other agency consulted by the Secretary before approving a social impact partnership project or a feasibility study under
(Aug. 14, 1935, ch. 531, title XX, §2058, as added
§1397n–8. No Federal funding for credit enhancements
No amount made available to carry out this division may be used to provide any insurance, guarantee, or other credit enhancement to a State or local government under which a Federal payment would be made to a State or local government as the result of a State or local government failing to achieve an outcome specified in an agreement.
(Aug. 14, 1935, ch. 531, title XX, §2059, as added
§1397n–9. Availability of funds
Amounts made available to carry out this division shall remain available until 10 years after February 9, 2018.
(Aug. 14, 1935, ch. 531, title XX, §2060, as added
§1397n–10. Website
The Federal Interagency Council on Social Impact Partnerships shall establish and maintain a public website that shall display the following:
(1) A copy of, or method of accessing, each notice published regarding a social impact partnership project pursuant to this division.
(2) A copy of each feasibility study funded under this division.
(3) For each State or local government that has entered into an agreement with the Secretary for a social impact partnership project, the website shall contain the following information:
(A) The outcome goals of the project.
(B) A description of each intervention in the project.
(C) The target population that will be served by the project.
(D) The expected social benefits to participants who receive the intervention and others who may be impacted.
(E) The detailed roles, responsibilities, and purposes of each Federal, State, or local government entity, intermediary, service provider, independent evaluator, investor, or other stakeholder.
(F) The payment terms, methodology used to calculate outcome payments, the payment schedule, and performance thresholds.
(G) The project budget.
(H) The project timeline.
(I) The project eligibility criteria.
(J) The evaluation design.
(K) The metrics used to determine whether the proposed outcomes have been achieved and how these metrics are measured.
(4) A copy of the progress reports and the final reports relating to each social impact partnership project.
(5) An estimate of the savings to the Federal, State, and local government, on a program-by-program basis and in the aggregate, resulting from the successful completion of the social impact partnership project.
(Aug. 14, 1935, ch. 531, title XX, §2061, as added
§1397n–11. Regulations
The Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships, may issue regulations as necessary to carry out this division.
(Aug. 14, 1935, ch. 531, title XX, §2062, as added
§1397n–12. Definitions
In this division:
(1) Agency
The term "agency" has the meaning given that term in
(2) Intervention
The term "intervention" means a specific service delivered to achieve an impact through a social impact partnership project.
(3) Secretary
The term "Secretary" means the Secretary of the Treasury.
(4) Social impact partnership project
The term "social impact partnership project" means a project that finances social services using a social impact partnership model.
(5) Social impact partnership model
The term "social impact partnership model" means a method of financing social services in which—
(A) Federal funds are awarded to a State or local government only if a State or local government achieves certain outcomes agreed on by the State or local government and the Secretary; and
(B) the State or local government coordinates with service providers, investors (if applicable to the project), and (if necessary) an intermediary to identify—
(i) an intervention expected to produce the outcome;
(ii) a service provider to deliver the intervention to the target population; and
(iii) investors to fund the delivery of the intervention.
(6) State
The term "State" means each State of the United States, the District of Columbia, each commonwealth, territory or possession of the United States, and each federally recognized Indian tribe.
(Aug. 14, 1935, ch. 531, title XX, §2063, as added
§1397n–13. Funding
Out of any money in the Treasury of the United States not otherwise appropriated, there is hereby appropriated $100,000,000 for fiscal year 2018 to carry out this division.
(Aug. 14, 1935, ch. 531, title XX, §2064, as added