Associate Attorney General Vanita Gupta Delivers Remarks at Elder Justice Coordinating Council Meeting

Associate Attorney General Vanita Gupta Delivers Remarks at Elder Justice Coordinating Council Meeting

Washington, DC - Tuesday, November 15, 2022

 

Remarks as Prepared for Delivery

Thank you for that warm welcome, Acting Assistant Secretary Barkoff. It is a pleasure to join you once again and to represent the Department of Justice at the Elder Justice Coordinating Council, alongside Andy Mao, the Department’s National Elder Justice Coordinator.    

I would like to thank Deputy Secretary Palm for the leadership role that HHS has played on the Council and for partnering with Council participants to protect older Americans from abuse, neglect and financial exploitation. 

For the past decade, combating elder fraud and abuse has been a top priority for the Justice Department. We remain committed to doing all we can to restore dignity to older adults who have been abused, and to repair the sense of safety and security for those who have been financially exploited or defrauded. Prevention, early detection and early intervention — combined with partnership at every level of government — are all necessary to combat elder abuse.

Let me begin with some updates since I last spoke to this group.

As outlined in our recent annual report to Congress, the Department pursued nearly 300 criminal and civil cases in the past year on issues ranging from COVID-19 fraud to grossly substandard care in nursing homes. We also returned millions of dollars to elder-fraud victims through asset forfeitures and other actions. At the same time, we developed tools for elder justice professionals on the front lines and devoted substantial resources to victim assistance, including by responding to a record number of calls on the National Elder Fraud Hotline. And the Department participated in public outreach on numerous elder justice topics to over 150,000 individuals, including members of law enforcement, legal aid attorneys, elder justice professionals and members of the public.

Collaboration and coordination at all levels of government have been key to the success of these departmental initiatives.  

First and foremost, this is reflected in our close partnership with other federal agencies. As many of you know, the Justice Department has focused much of our elder justice enforcement on transnational schemes, which comprised nearly 40% of our cases in the past year. Our whole-of-government approach has been critical to detecting and disrupting these schemes, which include grandparent scams, romance fraud, identity theft and lottery fraud. Our work to investigate, build and prosecute these cases has involved collaboration with the U.S. Postal Inspection Services, the Department of Homeland Security, the Social Security Administration’s Office of Inspector General, as well as the Federal Trade Commission, the Consumer Financial Protection Bureau and Treasury’s Financial Crimes Enforcement Network.

Our federal partners have likewise been instrumental in helping raise awareness on issues impacting older adults. For example, with the help of the Administration for Community Living, the Consumer Financial Protection Bureau, the National Institute on Aging and others, we convened a three-day virtual symposium last April focused on the role that decision-making capacity plays in elder justice proceedings, where criminal and civil judges are frequently called upon to undertake the complex and nuanced task of trying to assess the abilities of older adults to make independent decisions about personal and financial matters. 

Equally critical for the department’s work has been our continued collaboration and coordination at the state and local level. Our federal initiatives have long benefitted from the assistance of our state and local law enforcement partners — and I am excited that the Council will be hearing today from some of our state partners who are so committed to this work. 

We also have several efforts in the works to strengthen these partnerships in the days ahead.  

One example of a successful collaboration is the National Nursing Home Initiative. Launched in 2020, this initiative is designed to coordinate and enhance civil and criminal enforcement related to nursing homes that provide grossly substandard care by drawing on a wide network of state and local professionals, including state Medicaid Fraud Control Units, adult protective services, Long-Term Care Ombudsmen, state and local law enforcement and many others. 

Next month, the initiative will launch a significant new training effort with state Medicaid Fraud Control Unit Directors across the nation. In a series of six virtual convenings, the Justice Department’s Elder Justice and Health Care Fraud Coordinators will meet with Medicaid Fraud Control Unit Directors to discuss the most effective ways to collaborate on priority substandard care cases and share best practices related to this enforcement work.

And just last month, the Justice Department’s Office for Victims of Crime announced the first of its kind effort to support a National Elder Justice Coalition Center to support the development of new state and tribal coalitions that will collaborate with federal agencies to coordinate elder justice work. The National Elder Justice Coalition Center will release a competitive solicitation early next summer to fund and support additional elder justice coalitions across the country.   

Finally, a bit of a coming attraction: I am pleased to announce that in the fall of 2023, the Justice Department will host an Elder Justice Summit specifically for state and local law enforcement. This Summit will provide a national platform for sharing strategies and best practices, information, and resources. Stay tuned for more information on this.

On behalf of the Justice Department, I want to thank you again for all that you have done and will do to advance the cause of elder justice. My colleagues and I look forward to continuing to partner with you on this important issue.   

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Associate Attorney General Vanita Gupta Delivers Remarks at Elder Justice Coordinating Council Meeting

Associate Attorney General Vanita Gupta Delivers Remarks at the Elder Justice Decision-Making Capacity Symposium

Associate Attorney General Vanita Gupta Delivers Remarks at the Elder Justice Decision-Making Capacity Symposium

Washington, DC

~

Tuesday, April 19, 2022

Remarks as Prepared for Delivery

Thank you, Andy, for that warm welcome and for all of your work as the Department of Justice’s National Elder Justice Coordinator. I also want to thank the Elder Justice Initiative, the Justice Department’s Office of Legal Education, the Civil Division’s Office of Training and our many federal partners, especially the Department of Health and Human Services, who helped to plan this remarkable symposium.

I want to thank our participants and panelists, and I am delighted to welcome all of you to the department’s first-ever Elder Justice Decision-Making Capacity Symposium.

The Department of Justice is committed to using all of its tools to ensure that older Americans receive the support and protections they deserve. Every year, millions of older Americans are abused, neglected and financially exploited, often by those who are entrusted to care for them. The department has aggressively pursued justice for elders in a wide variety of fields – from nursing homes that provide grossly substandard care, to guardians and others who abuse their positions of trust and to multinational fraud schemes that target older adults. The department has also formed strong collaborative relationships with state and local law enforcement and provides trainings and webinars on elder abuse and financial exploitation to hundreds of civil attorneys, prosecutors, judges, investigators and other elder justice professionals in multiple disciplines, to ensure that they can appropriately respond to the specific needs of older adults.

This symposium addresses a foundational part of our work to protect our nation’s older adults: ensuring that they have access to justice and that they are treated with dignity and fairness. Advocates, prosecutors, law enforcement officers, judges, clinicians and others have repeatedly reported that too often, older adults are being denied a full measure of justice, in part because of mistaken assumptions or inadequate assessments of their capacity to make decisions for themselves.

These assessments can have deep and lasting impacts on the lives of older adults. In the criminal context, these assessments may be critical in ensuring that justice is obtained for older adult victims and, through restitution in certain cases, that they are made financially whole again. For example, an older adult may be a critical witness to a crime that will not be prosecuted if she is deemed incompetent to testify. Perpetrators who target older adult victims may seek to manipulate them, and a victim’s decision-making capacity may affect their interactions with their abusers. Assessing the victim’s decision-making capacity can help law enforcement tailor investigations to identify those cases that may, initially, appear to be cases involving a consenting adult, when in fact the victim did not – or could not – consent.

In civil cases, assessments about the need for a guardianship or conservatorship may govern an older adult’s ability to make core life decisions – where she can live, what medical decisions she can make, how she can spend her hard-earned money and with whom she can develop friendships and find companionship and love.   

Those of us who work in the legal system need to have a deeper understanding of how to address the specific needs of older adults and how to appropriately assess an individual’s decision-making capacity in a given case. As we work to combat elder fraud and abuse, we must equip ourselves with the knowledge and tools to ensure that we protect their rights and pursue justice when they have been victimized.   

That is why I am truly excited that you all have joined us for this symposium. Over the next three days, we will be engaging in a robust conversation about how we can best serve and protect older adults in this country. Participants span the spectrum of experts – including professors, clinicians, researchers, judges, prosecutors, law enforcement officers, aging services and social services professionals, administrative officials and many others. Although you come from many different fields, we are all here because we share a deep commitment to supporting and protecting older adults.

Your diversity of experiences is critical: it is through the cross-sectional expertise that you all bring that we will be able to have a fuller understanding of how to safeguard the rights of older adults. We need clinicians to help legal professionals, judges and adult protective services officials understand what capacity assessments can and cannot tell us about an older person’s abilities, and we must ensure that the tools used to assess decision-making capacity are valid and reliable.

Clinicians and elder justice professionals also need to share common understandings about their respective roles in the legal system, and I hope we can learn how to enhance communication between and among clinicians and elder justice professionals.

Finally, this symposium will explore how misconceptions about aging and decision-making capacity impact our civil and criminal legal systems. We need to confront and dispel negative stereotypes about the cognitive and decision-making capabilities of older adults. Even when a person has been diagnosed with a cognitive disability, we must understand how to reliably assess their actual decision-making capacity and how that capacity impacts the outcomes of a specific case or prosecution.

This symposium is just the beginning of the work we must do to ensure that all of us – judges, prosecutors, advocates, academics, researchers, guardians, adult protective services, aging services, social services professionals, elder justice professionals, doctors and clinicians, law enforcement officers and government officials – have a greater understanding of how aging and decision-making capacity impacts older adults so that the civil and criminal legal systems honor the rights of older adults, provide them with the greatest autonomy possible and protect those who have been abused, neglected or subjected to financial exploitation.

Thank you for sharing your vision, expertise and leadership as we forge forward together in pursuit of justice for our country’s older adults.

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Associate Attorney General Vanita Gupta Delivers Remarks at the Elder Justice Decision-Making Capacity Symposium

When a Nurse and a Social Worker Collaborate for Elder Justice, Good Things Happen

When a Nurse and a Social Worker Collaborate for Elder Justice, Good Things Happen

How Ferrell Moore and Laura Brown developed a powerful hospital training curriculum

https://www.bmhgiving.org

The most effective teams, whether in sports, business, or elder justice, comprise people with a complementary set of skills. From that perspective, Ferrell Moore and Laura Brown are a dream team, combining their distinct personalities and talents to create a methodology for training healthcare personnel to detect, treat, and hopefully prevent elder abuse. Both will be honored for their work by receiving the Georgia Anetzberger Award during the Second University of Southern California Judith D. Tamkin International Symposium on Elder Abuse in the spring of 2018.

The pair works at the Baptist Memorial Hospital in Memphis, Tenn., Moore as a Clinical Resource Nurse and Brown as a Licensed Master Social Worker. Early 2014, Moore was asked if she would work on an elder abuse project, figuring at most she would be responsible for making a poster presentation. Moore says, after reviewing the hospital’s grant proposal for the Plough Foundation:

“I quickly realized I’d said yes to a very needed and very huge undertaking. From the first meeting of our Coordinated Response to Elder Abuse (CREA) group, I knew I’d been placed on a path of purpose greater than myself.”

Although familiar with abuse cases, Moore hadn’t imagined that elder abuse was so “rampant” in her community and that people were, as she puts it, “getting away with it.” She quickly focused on creating a program that would respond to the growing epidemic, and realized that while the first response to abuse was typically medical in nature, social workers performed the bulk of the ensuing work. And, she recounts, when that became clear, the one person she wanted on her team was Brown, a social worker in the hospital’s Emergency Department (ED). Although Brown had been assigned to the ED for just a short time, she had quickly earned a reputation as a passionate advocate who got things done. While the ED didn’t want to give Brown up, Moore refused to work on the grant without her.

Like Moore, Brown also initially imagined the project would require only a small commitment, before realizing, she says, “how intensive the work would be and how significant an impact” they could make. And though neither woman was fully aware just how well-matched their partnership would be, their interlocking skills soon became evident.

The Perfect Team

Says Brown: “Ferrell is calm and collected, and I am often not either of those things.”

Adds Moore: “Laura is the more outspoken, go-getter type, and I’m more about doing research, on the computer, planning. Laura can work the crowd, but can get a little rambunctious – her passion and drive are inspirational — whereas I’ve learned how to deal with the corporate politics and finesse a situation to get the desired results.”

“As different as we are,” agrees Brown, “we have a lot in common. We are both single moms, both passionate about advocating for people that cannot advocate for themselves. Neither of us commit to work unless we plan to do it well and with conviction. Ferrell has taught me how to focus my energy in a professional way. She has taught me that there is often more power in silence or a calm response than there is in a loud and fast reaction.”

Thus, this duo of neatly complementary differences and similarities attacked the task at hand. With consulting help from Laura Mosqueda, MD, Director of the National Center on Elder Abuse, they collaborated on creating a training curriculum based on best practices in the areas of forensics, law, medicine, risk management, and law enforcement.

Their initial curriculum, which after feedback was winnowed down from six hours to three hours, was pilot-tested on the hundred members of the hospital’s emergency department – doctors, nurses, paramedics, social workers, and ancillary staff. The plan is for it to be available for implementation in hospital systems. Exactly how and when it will be distributed is still being determined by the organizations that funded the CREA project. Individuals can contact Moore and Brown if they are interested in receiving progress updates and/or learning more about potential implementation in their hospital system.

Overwhelming Positive Response

The response to the curriculum has been overwhelmingly positive. Both Moore and Brown were surprised by the magnitude of the need – and the desire – for such training. They have seen an increase in awareness and knowledge in identifying and intervening in elder abuse. The curriculum has been assessed using extensive evaluation instruments, and the preliminary results have been promising. An overwhelming majority of the medical professionals at Baptist Memorial reported that the curriculum was engaging and resulted in “a significant increase in knowledge” regarding elder abuse identification, response, and referral. Implementation has also led to changes in policy and procedures, making the process more conducive to the identification of elder abuse. A proposal has also been floated for a multidisciplinary team in the Emergency Department where the curriculum was piloted.

Moore and Brown were invited to present their curriculum at the June 2016 meeting convened by The John A. Hartford Foundation in Texas of the “Seen in Hospital, Safe at Home” project. This project is aimed at translating rigorous research results on elder mistreatment into a coherent, practical model of care that will transform real-world practice at scale. The conference led Moore to consider next steps. She says, “That meeting helped me understand how beneficial it would be to have a dedicated multidisciplinary team or lead within the hospital’s ED. As a Clinical Resource Nurse, I’m in a great position to make this happen, and I’m researching it now. After successfully implementing our curriculum throughout our hospital, I plan to draft a proposal to my management team, so that we can continue slowly branching out to the community.”

The immediate goal for both Moore and Brown is to continue to teach professionals how to intervene and advocate for elder abuse victims. Long term, they are considering teaming up to do consulting and certifying in Project Management.

Observes Brown: “If there is anything I have learned, it’s that elder abuse is preventable. If we recognize signs early on, we can provide resources and make appropriate intervention to keep older adults safe, protected from their abusers, and living with dignity.”

Moore adds: “The most rewarding aspect is seeing an older adult who has entered our system in a horrible, life-altering situation receive the love, attention, action, compassion, and resources needed to turn that situation around and begin a new life or better life.”

Laura Brown, LMSW is currently working with the Coordinated Response to Elder Abuse (CREA) to educate professionals on dynamics of elder abuse. Prior to joining the CREA project she worked in various settings as a victim advocate and conducted trainings for professionals and the community on dynamics of abuse. While working in the emergency department at Baptist Memorial Hospital Memphis, she and Ferrell Moore, RN developed and piloted a multi-disciplinary curriculum for elder abuse, which was sponsored by CREA and the Plough Foundation.Laura Brown can be contacted at laurabrownlmsw@gmail.com.

Ferrell Moore works at Baptist Memorial Healthcare Memphis, where she has over 12 years of bedside nursing experience in the emergency department. She is a charge and resource nurse of her unit, serves as Chair of the Professional Practice Council of her unit and was honored as one of Baptists’ top 100 nurses of Celebrate Nursing.

Yet her most prized accomplishment is being a loving mother to her creative and gifted 17-year-old son Christopher. Her future plans include continuing her education to obtain a Master’s Degree of Nursing, with the goal of becoming a Certified Emergency Nurse Practitioner with a Holistic Concentration.Ferrell Moore can be contacted at Ferrell.Moore@Bmhcc.org.

By Marilyn Harris, an independent writer and editor specializing in business, technology, legal, and social issues.

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When a Nurse and a Social Worker Collaborate for Elder Justice, Good Things Happen

Brooke Astor’s grandson makes case for ‘Elder Abuse’ postage stamp

The grandson of swindled New York philanthropist Brooke Astor still hopes to help “stamp” out elder abuse — with a fundraising US postage stamp.

Twelve years after he outed his own father for neglecting and stealing from the multi-millionaire Astor, Philip Marshall has joined with other elder abuse activists and two New York legislators to urge an “Elder Abuse” postage stamp.

“Those two words should never be paired together,” Marshall said of elder abuse, a cause he now devotes himself to full time. “But they are. One in 10 seniors is victim of elder abuse, which has many forms,” including neglect and financial exploitation, he said.

In a case that got national attention, Marshall reluctantly took his father, Anthony Marshall, to court in 2006 for secluding the dementia-suffering Astor in her squalid Park Avenue apartment while looting tens of millions of dollars from her fortune.

The grandson mustered support from Astor’s A-list of powerful pals, including David Rockefeller, Henry Kissinger and Annette de la Renta, and successfully had his father removed as Astor’s legal guardian — and prosecuted for grand larceny.

“I think the sad circumstance surrounding my grandmother informed a timely cause in elder justice, and increased awareness nationwide about elder abuse,” he told The Post.

Fundraising stamps must be approved by Congress, and have previously been issued to raise federal funding and awareness for Alzheimer’s and breast cancer.

The “Stamp out Elder Abuse Act of 2018” was introduced in both the House and Senate this week; among its bipartisan House sponsors were Reps. Peter King (R-Long Island) and Carolyn Maloney (D-Brooklyn).

Also pushing for the stamp is the Elder Justice Coalition.

“The EJC is proud to have worked closely on this legislation with the sponsors and advocates, including Philip C. Marshall, founder of Beyond Brooke, a cause-based campaign named to honor Philip’s late grandmother,” said the group’s national coordinator, Bob Blancato.

Under the bill, proceeds from the stamp would fund elder abuse efforts at the federal Administration on Aging and the Department of Justice.

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Brooke Astor’s grandson makes case for ‘Elder Abuse’ postage stamp

The goal of elder justice dangles within reach

By Barbara Peters Smith 

"I know she steals my silverware, but at least she comes every day."

Terry Fulmer, president of the John A. Hartford Foundation, quoted these words of her former patient in a Grantmakers in Aging webinar this week, "Making Elder Justice a Reality." The poignant mix of vulnerability and pragmatism at work here is no doubt familiar to a lot of elders and their caregivers, and it illustrates the difficulty of finally doing something meaningful about the complex problem of elder abuse.

Kathy Greenlee

Joining her in the talk was Kathy Greenlee, U.S. assistant secretary for aging and a passionate advocate for raising the profile of elder abuse. The fact that abuse can be physical, emotional and financial complicates the work to combat it, Greenlee said.

"When we talk about an estimated 10 percent of older adults having abuse every year, the number is so large that it becomes a bit numbing," she said. "We are decades behind other fields, such as domestic violence and child abuse, and we really need research in every direction to help us form a response."

Since the passage of the 2010 Elder Justice Act, in concert with the Affordable Care Act, the ball started rolling slowly but is picking up speed. Greenlee is working with a coalition of some 12 federal departments and agencies to put together the first federal "home" for adult protective services.

"It's significant," she said. "At a federal level we've had an office for child protective services for decades." But for adults, "we have 50 different approaches. It creates a patchwork across the country and gives us no real sense of what the national picture looks like, in terms of data and quality."

Even with better research, it won't be easy. Greenlee cited a new report by the Frameworks Institute that was designed to answer her question of "why not everybody in the world is as enraged as I am about elder abuse." The provocative report highlights the thin line between protection and paternalism:

"When thinking about elder abuse, people assume that it is up to younger people to make decisions for older people. When this mode of thinking is active, the public understands older people as objects to be cared for and protected, rather than as actors with voices and minds of their own. These understandings not only fuel ageism but also make it hard for the public to understand how older people’s integration and participation in the community can help to prevent elder abuse."

Hospital price check

The march to greater transparency in health care costs continues: The Florida Hospital Association has unveiled a new section of its “Mission to Care” website, with information on hospital prices and quality. The website also provides context for the cost data and emphasizes that patients should contact their hospitals, physicians and health plans for accurate out-of-pocket estimates.

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The goal of elder justice dangles within reach

White House Conference On Aging 2015: Elder Justice

As you likely sadly know, elder financial abuse is a tragic problem in America. As Richard Cordray, director of the federal Consumer Financial Protection Bureau said at the Elder Justice in the Twenty-First Century panel of the White House Conference on Aging (WHCOA): “Older Americans all too often fall prey to financial exploitation.”

In a recent Wells Fargo survey of 1,005 investors, 32% of respondents said they know someone who has been the victim of investment scams or financial abuse targeted at the elderly.

What you might not know: “Only a small fraction of elder abuse is ever reported,” said Cordray.

White House Conference on Aging panelist Lynne Person, Long-Term Care Ombudsman at the Office of the D.C. Department of Health Care, said “often, victims are fearful of reporting abuse from a caregiver because the caregiver is the one they depend on for the activities of daily living.” Another panelist, James Baker, director of Law Enforcement Operations and Support at the International Association of Chiefs of Police, added that “often they are embarrassed or there’s no one there to help them ask for help.”

Panelist Elizabeth Loewy, a former prosecutor and now General Counsel and senior VP of Industry Relations at Eversafe.com, an elderfraud prevention service, said: “We have blindfolds on with respect to the tsunami of elder fraud.”

The moderator of this panel, U.S. Department of Health and Human Services Assistant Secretary for Aging Kathleen Greenlee, who’s the administration’s de facto point person on elder abuse (“it’s in my DNA”) said: “It’s an outrage against humanity.” President Obama seems outraged, too. He railed against elder abuse in his morning remarks at the July 13th conference. It may have been the first time a president has ever mentioned “elder abuse,” Greenlee said.

Older people are attractive targets, Cordray and Greenlee noted, because they have money, homes or both; they may have impaired mental capacity and they’re often socially isolated.  (Continue Reading)

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White House Conference On Aging 2015: Elder Justice

California Senate Launches Aging and Long Term Care Committee

The California Senate has launched a new five-member Select Committee on Aging and Long-Term Care, HealthyCal reports.

Background
California has the largest population of residents over age 65 in the U.S., according to HealthyCal. Further, about one in five Californians by 2030 is expected to be age 65 or older.

The state Assembly has a committee dedicated to aging and long-term care issues, but a similar Senate committee was disbanded in 2012.

Details of the Committee:
The new Senate committee will be chaired by Sen. Carol Liu (D-Glendale), who pushed to create the panel.

HealthyCal, the committee will focus on addressing:
Elder justice;
Housing;
Mental health; and
Transportation.

Liu said her goals for the committee include:
Streamlining California's long-term care systems;
Educating the public about issues related to the state's aging services; and
Creating programs to address California's diverse aging population.

A joint hearing of the new committee and the Assembly's Aging and Long-Term Care Committee will be held on Aug. 12.

Source:
California Senate Launches Aging and Long Term Care Committee