Academic journal article Generations

The States' Elder Abuse Victim Services: A System Still in Search of Support

Academic journal article Generations

The States' Elder Abuse Victim Services: A System Still in Search of Support

Article excerpt

Gains have been made since the Elder Justice Act's enactment, but real progress lags.

The abuse, neglect, and financial exploitation of older persons are far more common than previously known (Acierno et al., 2010). These situations are reported much less frequently than was earlier estimated, have very high morbidity and mortality rates (Lachs et al., 1998), and are extremely expensive (Gunther, 2011)-not only for victims but also for financial institutions and taxpayers.

There is now increased congressional awareness of, and attention paid to, elder abuse. Assistant Secretary for Aging Kathy Greenlee is providing strong leadership in the federal response to elder abuse. Nonetheless, our nation has failed to address this growing crisis in a meaningful way. The need for resources, research, and capacity-building support is especially acute in Adult Protective Services (APS), the nation's state-based, direct victim-services system for elder abuse.

A Long Journey for the Elder Justice Act

The Elder Justice Act (EJA) was first introduced in the 107th Congress and re-introduced every session thereafter, always with bipartisan support, until its passage in 2010. Upon introduction in 2002, the EJA bill declared that Congress found "The Federal Government has been slow to respond to the needs of victims of elder abuse, neglect, and exploitation or to undertake prevention efforts...and there are very limited resources available to those in the field directly dealing with these issues" (U.S. Congress, 2002). A full decade later, those findings still stand.

The new law authorizes approximately $190 million a year, of which $128 million is dedicated to APS, $100 million of that to be allocated to states' APS programs using a population-based formula. Another $25 million is authorized for APS demonstration projects in order to determine (for instance) the most effective interventions. Approximately $3 million annually would support a new federal office for APS at the U.S. Department of Health and Human Services (HHS).

After eight years of effort, the EJA was enacted into law in March 2010 as part of the Affordable Care Act. Two years later, however, Congress has yet to appropriate a single dollar to implement it. To his credit, President Obama requested a modest EJA funding level of $21.5 million in his fiscal year (FY) 2012 budget proposal, and his FY 2013 budget seeks $8 million for the EJA. Despite the reduced FY 2013 request, it is significant that President Obama included funding for this new initiative during such a budget-difficult era. The U.S. Senate Committee on Appropriations' 2013 Subcommittee on Labor, Health and Human Services, Education, and Related Agencies funding recommendation includes the $8 million for Adult Protective Services demonstration programs.

When funded, the EJA will address elder abuse in numerous ways, including expansion of the Long-Term Care Ombudsman Program, training for nursing home surveyors, and support for several elder abuse forensic centers, among other efforts. But the heart of the EJA is its recognition of state and local APS, the only nationwide, state-based system with the responsibility to investigate alleged elder abuse, neglect, and exploitation, and to provide protective and supportive services to victims. Using $60,000 as a conservative estimate of the annual cost of an APS investigator, the National Adult Protective Services Association (NAPSA) in 2009 projected that the EJA, if funded at the $100 million authorization level, would support approximately 1,700 APS frontline positions nationwide. As each year passes, however, the authorized level is worth less. According to the Department of Labor Inflation Calculator (http://146.142.4.24/ cgi-bin/cpicalc.pl), to achieve the $100 million authorization value that was proposed in 2003 would require $124 million in 2012.

What Is Adult Protective Services?

If a child is suspected of being abused or neglected, most people would know to contact Child Protective Services (CPS) to make a report, whereupon CPS would investigate the allegations and take any necessary steps to protect the child. …

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