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Senior Citizen Opinions & Analysis
Congress Targets Senior Abuse in Elder Justice Act
as Part of Health Care Reform
As part of health care overhaul legislation,
lawmakers are taking steps that would for the first time establish a
federal beachhead in fighting elder abuse
Produced in collaboration by the Los Angeles Times and Kaiser Health
News
 Nov. 23, 2009 - When it comes to political, social
or health causes, elder abuse has not had the star power of some other
movements focusing on the rights of vulnerable people. Last month, actress Nicole Kidman headlined a
congressional hearing on violence against women, and stars of "Law &
Order: Special Victims Unit" appeared at a Capitol Hill rally for
child-abuse victims. An event sponsored by a coalition of elder abuse
groups, meanwhile, featured ordinary senior citizens, recounting in
sometimes aching detail how they or their loved ones had been physically
and emotionally abused or financially exploited.
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Opinions & Analysis for Seniors |
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The lack of glitter has been reflected over the
years in federal support for protecting seniors -- which is to say,
support has been limited. That may be about to change. As part of health
care overhaul legislation, lawmakers are taking steps that would for the
first time establish a federal beachhead in fighting elder abuse.
The
House health care bill would launch a nationwide program of
background checks for people who care for the elderly, overhauling a
patchwork of state laws that critics say has allowed known offenders to
repeatedly end up in positions of trust.
The Senate is considering an even more expansive
Elder Justice Act. It would boost federal aid for identifying and
investigating elder abuse at the state and local levels, require
long-term care providers to report possible crimes to federal
authorities and create new oversight within the Department of Health and
Human Services for coordinating state and federal anti-abuse efforts.
These provisions, already approved by the Senate Finance Committee, are
included in the health legislation that is being prepared for floor
debate after Thanksgiving.
With broad support in and out of Congress, at least
some of the measures appear to have good prospects for being enacted
into law. More than 500 advocacy groups have lined up behind the
legislation. It still faces opposition on budget grounds, although
proponents say the cost of the Elder Justice Act -- about $757 million
over four years -- is pocket change in the context of a near $1-trillion
healthcare bill.
Abuse Victims Face More Risk Of Dying
About 11% of people ages 60 and older suffer from
some kind of abuse every year, according to a March study for the
National Institute of Justice, an arm of the Justice Department.
Other studies have shown that elderly victims of abuse, neglect and
exploitation have twice the risk of dying within a year.
Anecdotal evidence of such abuse abounds. A home aide working near
Fresno was convicted of involuntary manslaughter last year after giving
an 85-year-old woman a lethal overdose of morphine and methadone and
ransacking her house. The caregiver had a history of domestic assaults
and drug smuggling.
Last month, a postal worker in San Diego pleaded
guilty to one count of felony financial elder abuse after taking more
than $50,000 from elderly women on her delivery route. "She was using
the economy to pour excuses on herself and borrow money," said Paul
Greenwood, an assistant district attorney. "We found out she was
spending a lot of the money in the casinos."
Financial exploitation of the elderly costs as much
as $2.6 billion a year. The problem was highlighted with the October
conviction of the son of New York philanthropist Brooke Astor for
stealing tens of millions of dollars from his mother while she was
suffering from Alzheimer's disease. But advocates for the elderly say
such abuse occurs on a lesser scale much more frequently.
Enhancing the rights of the elderly might seem a
no-brainer for lawmakers on both sides of the aisle. After all, people
older than 55 constitute the fastest-growing population group in the
country. Congress is even aging: The average age of a House member is
now 56 years, and for a senator, 61.7 years.
But opponents say they are concerned about runaway
federal spending and stepping on the toes of state and local
governments. The Elder Justice legislation, first introduced in 2002,
was opposed by the Bush administration, which felt it would create a new
and unnecessary federal bureaucracy.
Others question the expense and efficacy of
background checks when even proponents acknowledge that most abuse is
perpetrated by people who are already well-known to the victims. Until
last year, the background-check bill, first introduced in the Senate in
1997 by Democrat Herb Kohl of Wisconsin, had never made it out of
committee.
Still, opposing such measures can be politically
tricky. "Why do you want to beat up old people?" Stephen Colbert
demanded in an interview with Republican Rep. Cynthia Lummis of Wyoming
on his Comedy Central show "The Colbert Report" in March. Lummis voted
against legislation earlier this year that would have made federal money
available to state and local elder-abuse prosecutors. She told Colbert,
"I am opposed to irresponsible spending."
"So you want us to beat up old people in a fiscally
responsible manner?" he shot back.
Now backers of the legislation have maneuvered to
link its fate to the debate over healthcare reform, in which it has
become an important consideration for some centrist Democrats, such as
Sen. Blanche Lincoln of Arkansas, who is considered a crucial swing vote
on healthcare legislation. Lincoln, a longtime member of the Senate
Special Committee on Aging, is a co-sponsor of the Elder Justice Act.
(The median age of her constituents back home is also one of the highest
in the nation.)
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Supporters say elder abuse should be addressed in
healthcare overhaul legislation because it pushes up healthcare costs
and because financial exploitation of the elderly leaves many destitute
and reliant on public assistance.
"This is prevention, which is a healthcare issue,"
says Robert Blancato, who heads the
Elder Justice Coalition, an umbrella group for more than 500 groups
that support the legislation. They include AARP, the American Bar Assn.,
and industry groups representing nursing homes and long-term providers,
among others.
State and local governments have long been on the
front lines of such problems. But many studies have shown a shortage of
resources among licensing agencies, long-term-care ombudsmen and adult
protective service workers.
"The universal lack of resources, the enormous
variation across jurisdictions and the low priority given to elder abuse
and neglect make it difficult to see how significant progress can be
made without federal standards and financial support," concluded
researchers at Texas A&M University in a report prepared for the Justice
Department last month.
Worker Screening
The current health care bills would require states
to conduct comprehensive screening of a wide range of people who are
working with the elderly, including those in the burgeoning and
unregulated area of home-based care.
More than a dozen states, including California and
Florida, currently do not regulate those workers. Most states only check
the backgrounds of medical workers, such as nurse aides, and only for
crimes they committed in their own states. In 2006, a woman who had been
convicted in Kansas of pushing an elderly woman out of a vehicle in a
carjacking was discovered to be working in nursing homes in Missouri.
The legislation also would require states to
establish clear criteria for prohibiting employment of applicants with a
history of violent crime. It also would mandate the development of
appeals processes for individuals who are denied employment, plus
systems in which workers who have been checked and cleared, but who
subsequently commit a disqualifying crime, would be terminated.
Even proponents of the new federal standards say
they can go only so far. Studies show that most elder abuse takes place
in private homes and that the assailants are family members or trusted
advisors, in up to 90% of cases.
The challenges increase as more elderly people
spend their time at home or in community and group living arrangements.
By comparison, teachers and other professionals outside the home act as
a safety net in cases of suspected child abuse because they are required
to report evidence of abuse to authorities.
"Adult abuse is a lot harder to get your arms
around," says Marsha Greenfield, a lawyer and senior legislative counsel
for the American Assn. of Homes & Services for the Aging, a trade group
for nonprofit long-term care providers.
"There are many more elderly people both in
community and group living arrangements," Greenfield says. "But they are
also a more invisible population because there are so many people in
their own homes."
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 This
information was reprinted from
kaiserhealthnews.org with permission from the Henry J.
Kaiser Family Foundation. You can view the entire Kaiser
Daily Health Policy Report, search the archives and sign up
for email delivery. © Henry J. Kaiser Family Foundation. All
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