Subcategory: Federal - Pending

“I. Creating Federal Leadership and Resources to Assist Families, Communities and States in the Fight Against Elder Abuse, Neglect and Exploitation

Dual Offices of Elder Justice are established at the Departments of Health and Human Services (in the Administration on Aging) and Justice (in the Office of Justice Programs). These offices will serve programmatic, grant-making, policy and technical assistance functions relating to efforts to address all types of elder abuse, neglect and exploitation. Positions in the leadership offices of both agencies will be funded to assure high level attention and agency-wide coordination. A federal home and more consistent funding for Adult Protective Services (APS) is also established.

Given the myriad entities and issues implicated by elder abuse, coordination at all levels is critical. A public-private Elder Justice Coordinating Council will coordinate activities of the Departments of Justice (DOJ) and Health and Human Services (HHS), other relevant federal agencies, states, communities and private and not-for-profit entities. Funding also would go to states to create their own coordinating bodies if they do not already exist and to send delegations to an annual Summit of the Elder Justice Coordinating Council.

II. Implementing Successful Strategies for Preventing and Combating Elder Abuse, Neglect, and Exploitation

Better information for consumers and others – An Elder Justice Resource Center will provide information for consumers, providers, advocates, researchers, policy makers, regulators and law enforcement to learn about preventing and addressing elder abuse, neglect or exploitation. The first-ever “National Elder Justice Library” of training, technical assistance and promising practices will prevent “re-inventing” the wheel. The center will also provide a centralized data repository, critical to getting a handle on the nature and dimensions of elder abuse.

Building a knowledge base and funding promising projects – Elder abuse has been virtually absent from the research agenda in this country. Basing policies to combat elder abuse on proven successes is smart government. Five “Centers of Excellence” will develop expertise, research, clinical practices, training and dissemination of information relating to elder abuse. Research priorities include: a national incidence and prevalence study; jump-starting intervention research; identifying community strategies to make elders safer; and examining and funding multi-disciplinary efforts.

Developing Forensic Capacity – It is imperative that we be able to identify the signs of abuse and neglect, but no body of data exists to assist in detection. Mobile and stationary forensic centers will develop expertise and enhance the capacity to detect elder abuse. Funding will be provided to train health professionals in both forensic pathology and geriatrics.

Victim Advocacy, “Safe Havens” and Support for At-Risk Elders – Grants to five diverse communities will pilot test what elder “safe havens” are needed when seniors are not safe where they live. In addition, efforts to better identify and meet the special needs of older victims, including funding victim advocates, will be supported. Legal advocates, volunteers, faith-based organizations and not-for-profit entities will support at-risk seniors in the fight against elder abuse. A study will clarify the roles, responsibilities and needs of APS, long-term care ombudsmen and other entities in protecting the elderly as well as identify barriers to success.

Enhancing the Law Enforcement Response – Among the most significant impediments to pursuing elder abuse cases -- especially those involving neglect -- is lack of expertise in recognizing and investigating these crimes. A Center for the Prosecution of Elder Abuse, Neglect and Exploitation will assist local prosecutors. In addition, funding will provide technical, investigative and victim assistance support for federal cases involving elder justice. Efforts to enhance the role of community policing in protecting at-risk elders will be supported.

Training - Training to combat elder abuse, neglect and exploitation is supported within disciplines and in multi-disciplinary settings.

Meeting the Needs of Underserved Popu-lations: Rural, Minority and Indian Seniors - Special programs are included to identify and address the needs of underserved seniors.

Model State Laws and Practices - A study will review state practices and laws regarding: (1) definitions of elder abuse, neglect and exploitation; (2) mandatory reporting laws; (3) evidentiary rules (including televised testimony); (4) laws requiring immediate reporting of all nursing home deaths to the county; (5) guardianship; and (6) banking practices. Recommendations will be made to assist Congress in determining any need for future legislation based on successful state practices.

III. Increasing Security, Collaboration, and Consumer Information in Long-Term Care

Security measures — (1) immediate reporting to law enforcement of crimes victimizing residents; (2) FBI national criminal background checks for all employees and contractors of federally-funded long-term providers; (3) 60-days advance notice of nursing facility closures and assurance of the proper relocation of all residents; and (4) a new federal cause of action permitting DOJ to pursue criminal and civil cases where abuse or neglect results in serious harm.

Enhancing staffing — Recognizing that staffing is critical in preventing abuse and neglect, enhancement measures include (1) grants and tax incentives to bolster recruitment; (2) loan forgiveness, tax incentives and bonuses for long-term care workers who remain in the field for more than five years; (3) subsidized continuing training and development of career ladders with accompanying wage increases or benefit packages; and (4) training and technical assistance to create and institute management practices that reduce turnover rates.

Helping consumers — A Long-Term Care Consumer Clearinghouse will assist the millions of American families trying to navigate options in long-term care. An Institute of Medicine study of long-term care options will provide much-needed information on how different types of facilities are defined, the level of services they offer, criteria for admission and discharge, elements included in the price and standards of care, and oversight and enforcement provisions.

Promoting collaboration — Funding will assist representatives of the various sectors of the long-term care community (nursing home administrators, consumer advocates, local law enforcement, etc.) to work together on improvement efforts.

IV. Evaluation - Determining What Works

Given the dearth of data, it is vital to build the knowledge base and begin a coherent assessment of which efforts are worth replicating. In keeping with this philosophy, funded projects must include a validated evaluation component designed to measure efficacy. In addition, grants will evaluate other ongoing or new elder abuse, neglect and exploitation efforts.”