national adult protective services association/national ... 2012... · aps saves the lives and...
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Kathleen Quinn NAPSA/NAPSRC National Adult Protective Services Association/National APS Resource Center
The national voice of vulnerable adults, advocating for the services they need.
Membership organization with representation in every state
Funded by the Administration on Aging to establish the first National APS Resource Center to provide training, technical assistance and access to research to Adult Protective Services (APS) practitioners
Hosts the only national, annual conference on elder abuse, vulnerable adult abuse and APS
23rd Annual NAPSA Conference
Ending Adult Abuse: On the Horizon?
October 16-18, 2012
3rd Annual
Elder Financial Exploitation Summit October 19, 2012
Pointe Hilton Squaw Peak Resort | Phoenix, AZ
Early Bird Registration Ends September 14, 2012!
REGISTER HERE Conference Registration - http://www.regonline.com/NAPSA2012
Pointe Hilton Squaw Peak Resort
A block of rooms have been reserved for October 14, 2012 - October 20,
2012. The special room rate of $105 per night will be available until
September 21, 2012 or until rooms are sold-out, whichever comes first.
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Booking a reservation from our site is simple. To begin the process,
visit the conference hotel reservation site and click on "Book a Room" to receive the NAPSA conference rate.
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Visit www.apsnetwork.org for conference & summit brochures and additional information.
National Adult Protective Services Association
US Department of Justice Law Enforcement Assistance Administration
Illinois Coalition Against Domestic Violence
Illinois Department on Aging/Adult Protective Services Administrator
Illinois Attorney General’s Office Policy Advisor
NAPSA Executive Director
Research
Practice
Policy
Elder abuse, neglect and exploitation represent a huge problem only now beginning to be recognized
Financial exploitation is often tied to the other types of abuse
Financial abuse is often the motivation for physical and emotional abuse and neglect
▶Elder abuse is committed both by
Strangers
and
Family members & trusted others
▶97% of older persons live in their
own homes - not in facilities
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RESEARCH
▶ELDER ABUSE IS:
▶VERY COMMON
▶VERY LETHAL and
▶VERY EXPENSIVE (to taxpayers and financial institutions as well as victims)
▶ New research findings from New York State Elder Abuse Prevalence Study (Dr. Lachs et al)
▶ Statewide random telephone surveys of community-dwelling older persons - results compared to elder abuse cases reported anywhere (APS, police, aging services, DV)
▶ One in 13 persons 60+ reported abuse within the previous 12 months (7.6%)
▶ The US rate of coronary artery disease is exactly 7.6% (American Heart Assn.)
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The National Elder Mistreatment Study (Acierno et al) found an even higher rate of elder abuse
It estimates that one in ten persons 60 and older are mistreated
Also found that 5.2% are financially abused by family members
NYS Prevalence Study (abuse by others):
▶ For every elder abuse case reported to any agency, 23.5 cases go unreported.
▶ For every case of financial exploitation reported, 44 go unreported.
▶ Seniors reported financial abuse occurs more frequently than any other type of elder abuse.
▶ Most reported elder abuse is committed by family members in the seniors’ own homes.
Abused seniors are:
▶Three times more likely to die compared to non-abused age cohorts (Lachs)
▶Four times more likely to go into a nursing home (Lachs)
▶Victims lose their hard earned assets and often their well-being, their homes and their trust in themselves and others
▶Financial institutions lose deposits
▶Victims of any type of abuse are likely to utilize medical services at higher rates
▶9% of financial abuse victims in Utah went on Medicaid as a direct result of their abuse (Utah study).
30% of people 75 and older may have mild cognitive impairment (MCI)
Persons with MCI lose their arithmetic abilities very rapidly – within about a year (Dr. Daniel Marson, University of Alabama at Birmingham)
Cannot count bills or change; maintain a checkbook or make sense of bills
Handling complex financial matters would seem to be completely out of the question
Almost 50% of persons 85+ have full-blown dementia
Older persons with healthy brains may still make poor financial decisions
They tend to focus on short term benefits rather than long-term risks (Natalie Denburg,
University of Iowa)
“After age 60, our financial literacy and savvy declines, no matter how well educated we are” (David Laibson, Harvard University)
We have more older people
Who have more money
Whose brains are declining
Result: increasing amounts of elder financial exploitation
Practice
Adult Protective Services
Law Enforcement/Prosecution
Regulators
Purpose:
▶ To investigate reports of abuse, neglect, self- neglect and exploitation of adults with disabilities age 18+ (42 states at minimum).
▶ To intervene to protect the victim to extent possible.
Authorization: ▶ APS is the statutorily authorized entity under each
state’s laws to receive and investigation reports of elder abuse.
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▶ APS professionals are the first responders to elder abuse and abuse of younger adults with disabilities
▶ APS investigates, intervenes, protects
▶ APS workers may be the only people who see victims in their homes (except for predators).
▶ APS work is often difficult and dangerous.
▶ APS saves the lives and assets of vulnerable adults.
APS can differ from state to state and even county to county:
▶ Administration: State (DHS or Aging)/County (7 states)/Other
▶ Definitions of abuse
▶ Client eligibility:
Age and Disability
18+ with disability (most states)
18+ with disability and 60 (65)+ without disability
Residence: Community – all states Facilities – half of states
▶ Mandated reporting – Service and health care providers are usually mandated reporters; 11 states require financial institutions to report abuse to APS
▶ Resources and Training
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2
3
28
Location (n=50)
State Unit on Aging
Independent State
Agency
Independent entity
within another state
agency
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7
11
Administration (n=51)
State Administered
County
Administered
Other
State-authorized finders of fact
Stress victim self-determination, but may take protective measures, with court approval, if victim lacks cognitive capacity
No designated federal funding, no national data collection, no national standards
Over 30 states rely on SSBG funds to help support APS
Did average caseload per caseworkers / investigators increase or decrease over the past 5 years?
Increase 85.7%
Is your staffing level an increase or decrease over the past five years.
Decrease 47.7%
In crease 85.7 %
Almost half of APS Programs investigate abuse, neglect & exploitation in nursing homes.
TRUE 45% (24) investigate in nursing homes
59% (31) investigate in assisted livings
69% (36) investigate in board & care homes
41% (21) investigate in DD facilities
39% (30) investigate in MH facilities
15 states require all persons to report suspected elder/vulnerable adult abuse
32 states require a range of professionals to report suspected abuse
3 states (CO, NY and SD) do not mandate reporting
Reports may be made anonymously and reporter confidentiality is protected
Reporters are provided with immunity for good faith reports
All P
ers
ons
Socia
l Serv
ices
Law
Enfo
rcem
ent
Legal
Agin
g S
erv
ices
Dis
abilit
y S
erv
ices
Govt.
Em
plo
yees
Healt
h C
are
Fin
ance
Cle
rgy
Vete
rinari
ans
Funera
l D
irecto
rs
Oth
er
15
30 31
15
26 26
16
32
10 12
6 5
19
Police
Sheriffs
State Police
District Attorneys
Attorneys General
Specialized law enforcement agencies
Federal agencies
FBI, FTC, Postal Inspectors, Secret Service . . .
State securities regulators
State bank regulators
State insurance departments
Federal securities regulators / FINRA
Federal bank regulators
Medicaid Fraud Control Units
Guardianship/conservatorship
Powers of Attorney
Both can be a source of exploitation as well as of protection
▶Multi-disciplinary teams
▶ Specific to financial abuse (FASTs)
▶ To review all types of elder abuse cases
▶ Fatality review teams
▶ Elder abuse coalitions for public awareness, etc.
▶Co-location: law enforcement with APS
▶Forensic Centers
▶Philadelphia Bank Project
POLICY
More laws to address elder abuse
Increased public awareness, i.e. World Elder Abuse Awareness Day activities
More emphasis on multi-disciplinary efforts
More law enforcement getting involved and more specialists in elder crimes
More prosecutors are creating elder abuse units
Attorneys General creating elder abuse task forces
Elder Justice Act (EJA) ◦ First comprehensive legislation to address
elder abuse (first elder abuse hearing was in 1976; EJA was introduced in 2002 and passed in 2010)
◦ Zero funds appropriated to date
◦ $125 million authorized for APS:
$100M for population-based grants to states
$25M for demonstration projects
2013 administration budget requested $8M
Senate Appropriations Committee approved $8M
Everything is on hold until after the election
NAPSA estimated in 2009 that $100M could translate into 1,700 APS investigators based on conservative $60,000 per capita cost
Demonstration projects could facilitate national data collection and test effective interventions
Administration on Aging
◦ Funds National Center on Elder Abuse (NCEA)
◦ Funds National APS Resource Center (NAPSRC)
Assistant Secretary for Aging Kathy Greenlee has made elder abuse her legacy issue
White House World Elder Abuse Awareness Day Event on June 14, 2012
◦ Focus on financial exploitation and partnerships with financial services industry
◦ Creation of Elder Justice Coordinating Council
◦ Announcement of $5M for elder abuse prevention grant
More interest in Congress – Senate Hearing in 2011
Three bills this session:
◦ Sen. Blumenthal – Elder Exploitation Enterprises
Would create the APS Resource Center in law
Would permit APS programs to enter into interstate compacts
◦ Sen. Blumenthal – Elder Protection and Abuse Prevention Act
Would provide various supports to APS
◦ Sen. Manchin - Seniors’ Financial Bill of Rights
Would require states to create Seniors’ Financial Bill of Rights
Would require all funded aging programs to screen for and report elder abuse
ELDER JUSTICE: Stronger Federal Leadership Could Enhance National Response to Elder Abuse GAO Report 11-208, March, 2011
Pending Report on elder financial exploitation: expected release November, 2012
Pending Report on SSA representative payees
Other reports under discussion
More hearings possible
Related legislation and initiatives
◦ Monitoring and training of guardians (bill)
◦ Increased emphasis on preventing and stopping Medicare fraud
◦ Consumer Financial Protection Board (CFPB) collecting data on financial exploitation
◦ Much more interest on part of financial services industry
