A nearly decade-long fight for increased federal focus on elder abuse won a huge victory Tuesday when the Elder Justice Act was signed into law as part of health care reform legislation.
For the first time ever, efforts to prevent elder abuse will be coordinated at the federal level. Additional research, worker training for adult protective services (APS) and elder abuse forensic studies, plus an ombudsman to oversee the program, will provide crucial help for a problem that is only expected to grow as boomers reach retirement age, experts say.
“Congress has now passed the most comprehensive federal legislation to combat elder abuse, neglect and exploitation in its history,” says Robert Blancato, national coordinator of the Elder Justice Coalition, which led the effort to get the bill signed. “Hopefully for a lot of seniors, this is about raising awareness across the country so that older Americans never have to confront elder abuse.”
Abuse, often unreported, “can impact older adults across the spectrum regardless of who they are,” says Rhonda Richards, senior legislative representative for AARP. “This bill will hopefully mean better coordination of existing efforts across prevention, detection and law enforcement.”
Help for uncovering abuse
Inadequate research hampers efforts to mitigate elder abuse in its many forms—physical, emotional or sexual abuse; financial exploitation; neglect (either self-neglect or by a caretaker); and abandonment. For example, a National Center on Elder Abuse study states that more than 500,000 Americans over age 60 were victims of abuse in 1996. Other more recent estimates suggest there may be as many as 5 million victims a year. With a discrepancy that wide, it’s impossible to know how to properly address the problem.
“I think the starting need is really around data,” says Charles Sabatino, director of the American Bar Association Commission on Law and Aging. “We’ve got all kinds of programs out there; we really have very little evaluative research as to what works.”
Now that federal funding will be available for research grants, more academics interested in studying elder abuse should be able to pursue their research. “You’ve had wonderful people doing research on this and they did it unfunded because they had such a passion for it,” says Pamela Teaster, director of the Graduate Center for Gerontology at the University of Kentucky. “But not being funded can easily affect the quality of and ability to do the work. So this is a huge shot in the arm for this field.”
More troops in the trenches
The passage couldn’t come at a better time, says Kathleen Quinn, executive director of the National Adult Protective Services Association (NAPSA). A recent survey of 38 states by NAPSA showed that caseloads at APS agencies, which investigate reported cases of elder abuse, increased by 24 percent in 2009. Yet state agency funding was cut by an average 14 percent. The bill’s provision for adult protective services would allow an additional 1,700 caseworkers to be hired nationwide, a huge boon to a sector that badly needs more manpower, Quinn says.
“If you’re somebody who wants to report abuse, the phone might ring 20 minutes before it’s answered,” she says. “In some states, workers are triaging reports and can only respond to those people in imminent danger.”
Quinn also says that workers have been unable to be proactive in preventing abuse. But now, the game has changed. “If we can get out there early we might be able to prevent all a person’s assets from being stolen,” she says.
Another bill included in the health care legislation that’s also aimed at protecting elders from abuse will increase workers on the front lines. The Patient Safety and Abuse Prevention Act will expand a successful pilot program that created a national criminal background check system for employees in nursing homes and long-term care facilities. Most current background checks are only done at the state level, allowing job applicants to easily cross state lines without fear of their criminal history being revealed.
The patient safety bill “has been down a long road, having been introduced for the first time over a decade ago,” says Sen. Herb Kohl, D-Wis., chairman of the Senate Special Committee on Aging. “With passage of this provision, thousands of predators with records of substantiated abuse or violence will be kept from working with frail elders and disabled individuals.”
A long road
Since it was first introduced in 2003, the Elder Justice Act had passed the Senate Finance Committee four times and the House of Representatives once. But the bill had stalled until Sen. Blanche Lincoln, D-Ark., headed efforts to get it added to the health care reform bill. She called the Elder Justice Act a monumental piece of legislation that is long overdue.
“It’s high time that our nation give elder abuse the same attention and resources as those devoted to child abuse and violence against women,” Lincoln says. “I am proud to have championed this legislation for nearly a decade, and thrilled that our nation is finally taking necessary action to protect America’s seniors from unwarranted abuse.”
Passage of the Elder Justice Act is a home run for its advocates, but the ball game isn’t over yet. While the $700 million bill approves the amount of money to be spent, it does not actually award those funds. That process now sits at the feet of the House and Senate appropriation committees, where advocates like Blancato will now have to “scrub around and look for unspent money.”
“We’re confident that the case can be made for funding this,” Blancato says. “I’ve always said that I thought getting the money would be easier than getting the bill passed. I still believe it.”
Experts say that the Elder Justice Act is a huge leap forward in protecting seniors, but much more needs to be done legislatively. Last year, Department of Justice provisions that would have funded increased elder abuse training for law enforcement and prosecutors were stripped from the bill. Those items were repackaged as the Elder Abuse Victims Act, which was passed by the House but has yet to make it out of the Senate Judiciary Committee. Blancato says he will continue to advocate for its passing.
Cynthia Ramnarace writes about health and families from Rockaway Beach, N.Y.