Neal, Wyden, Casey, Bonamici Propose Legislation to Protect Seniors from Abuse and Neglect

Aug 26, 2020

Press Release 

 

Reauthorization and Funding for Elder Justice Act Would Support Exploited Seniors

 

WASHINGTON, DC – House Ways & Means Committee Chairman Richard E. Neal (D-MA), Senate Finance Committee Ranking Member Ron Wyden (D-OR), Senator Bob Casey (D-PA), and Congresswoman Suzanne Bonamici (D-OR), today offered a bill to protect seniors across the country by reauthorizing and funding the Elder Justice Act.

“The rampant spread of COVID-19 and the devastation this deadly virus has caused among seniors has highlighted the desperate need to better protect our nation’s elderly,” Chairman Neal said. “The abuse and neglect they experience is unacceptable, and this legislation will improve the federal government’s elder justice work by enhancing existing programs and funding research for response methods.”

“Now more than ever, seniors need to know they won’t be forgotten,” Ranking Member Wyden said. “The COVID-19 pandemic has revealed just how vulnerable seniors are, whether they live at an assisted living facility, with a relative or by themselves. The Elder Justice Act is aimed at protecting American seniors from abuse and neglect – it’s time to act.”

“Elder abuse is a pervasive scourge in our society. As our population ages, seniors deserve to live out their golden years free from financial, physical and emotional abuse,” said Senator Casey. “In cases where seniors are mistreated, we must ensure there are resources available to help them seek justice. The Elder Justice Reauthorization Act would provide funding to help address suspected cases of senior abuse and neglect, including the increasing number being reported during the current pandemic. It is critical that Congress quickly pass this legislation to help protect our nation’s older adults.”

“We must do all we can to make sure the older Americans who cared for our communities throughout their lives are not taken advantage of in their later years,” said Congresswoman Bonamici. “Far too many seniors have experienced abuse and neglect, and the coronavirus pandemic has increased isolation and put even more people at risk. As Co-Chair of the House Elder Justice Caucus, I will continue fighting for this important update to the Elder Justice Act.”

“The bipartisan Elder Justice Coalition commends Chairman Neal, Ranking Member Wyden, Senator Casey and Congresswoman Bonamici for the expected introduction of legislation to reauthorize the landmark Elder Justice Act,” said Bob Blancato, National Coordinator of the Elder Justice Coalition. “This bill recognizes two realities. The first is that elder abuse wherever it is committed remains a grave problem impacting millions of older adults annually. The second reality it recognizes is that we need a comprehensive and coordinated federal response to this problem, which must include dedicated funding for adult protective services, a stronger, better-trained long term care ombudsman program, forensic centers to better detect and report elder abuse, and adequate and well-trained staff working in nursing homes.”

The bill, called the Elder Justice Reauthorization Act, reauthorizes the Elder Justice Act and funds the bill’s provisions with over $2.2 billion. Key provisions of the bill would fund elder justice coordination and research activities, enhancements to the long-term care workforce and patient safety, grants to Adult Protective Services (APS) programs and protections for residents of long-term care facilities, among other activities.

The bill would also provide $200 million for the Social Services Block Grant to provide targeted support for APS programs and ensure their capacity to address abuse, neglect and exploitation of older adults and people with disabilities. This new funding is essential to meet the health and safety needs of APS program workers and the vulnerable individuals they serve by providing support to purchase personal protective equipment for APS staff and increase their capacity to investigate the skyrocketing reports and cases of abuse, neglect and exploitation associated with the COVID-19 pandemic.

Together, these activities are an important step toward a comprehensive federal response to ensure the safety and dignity of older adults and people with disabilities. The Elder Justice Act was first passed as a part of the Affordable Care Act, but authorizations for its programs and activities expired in 2014.

A one page summary of the bill can be found here. A section-by-section summary of the bill can be found here. The legislative text of the bill can be found here.

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Neal, Wyden, Casey, Bonamici Propose Legislation to Protect Seniors from Abuse and Neglect

‘Replace denial with proposal’ on long-term care, House committee told

“All viable proposals deserve to be vetted, studied and moved forward,”
Robert Blancato, national coordinator of the Elder Justice Coalition,
told the House Ways and Means Committee. (YouTube)

Congress must “replace denial with a detailed, bipartisan legislative proposal on long-term care” to address the needs of a growing older population facing high costs for healthcare and housing, Robert Blancato, national coordinator of the Elder Justice Coalition, told the House Ways and Means Committee at a hearing Thursday.

Blancato, one of six hearing witnesses, and Rep. Richard Neal (D-MA), chairman of the committee, both noted that assisted living costs more than $40,000 per year, on average.

“Navigating a fragmented and insufficient long-term care system can be not only confusing and emotionally taxing, but also enormously expensive – even unaffordable. …These high price tags weigh heavily on aging Americans and their families as they try to plan for future long-term care needs,” Neal said in prepared remarks, noting costs associated with nursing homes and home healthcare as well.

Long-term care-related costs are the biggest unfunded liability facing baby boomers, Blancato said in his prepared remarks. “Many older adults rely on Medicaid to fund their long-term care needs. However, states are increasingly considering waivers that would block-grant Medicaid, which could lead to individual caps on care funding,” he said.

Approximately 16.5% of assisted living residents rely on Medicaid to cover their assisted living services, according to the National Center for Assisted Living.

The National Investment Center on Seniors Housing & Care-funded study that found that 54% of the 14.4 million middle-income older adults in 2029 in the United States will lack the financial resources to pay for senior living and care, Blancato said, indicates that “future ability to privately pay [for long-term care needs] may be in jeopardy.”

The witness said “all viable proposals deserve to be vetted, studied and moved forward,” including those involving Medicare and Medicaid reform, to address long-term care costs. “I believe we can all agree that something needs to be done,” he said.

A “real national solution,” Blancato said, should include:

• A strong Medicaid program that continues to support home- and community-based services over institutional care.
• Possibly a long-term care benefit in Medicare.
• Use of the tax code to provide a “meaningful” tax credit for family caregivers and a tax deduction for the purchase of private long-term care insurance.

 

‘Disturbing pattern of abdication’

In addition to cost issues, Blancato noted in his prepared remarks, “We see a disturbing pattern of abdication by certain federal agencies vested by law with the responsibility to ensure quality care in nursing homes, assisted living and long-term care facilities.” He in part called for additional funding and training for long-term care ombudsmen “so they can expand their important work into assisted living.”

Hearing witness Richard Mollot, executive director of the Long Term Care Community Coalition, told committee members that alternatives to nursing home must be affordable, accessible and safe.

“Seniors and families want and deserve options to nursing homes that provide safety in a more home-like setting,” he said. “While most states are rightfully opening up assisted living to Medicaid beneficiaries, the utter lack of federal standards in this sector has, unsurprisingly, led to increasing reports of rampant abuse and neglect. Our seniors and their families deserve better.”

Mollot also cited “inadequate access to humane dementia care” as an issue involving assisted living and nursing home operators.

“Far too many facilities fail to anticipate the needs of individuals with dementia or equip their staff with the knowledge and skills necessary to provide comfort and care to residents who are experiencing common behavioral and psychological symptoms of the disease,” he said. “In what other industry would it be acceptable to be unable to meet the needs of the majority of one’s customers?”

Care planning benefit eludes most

Hearing witness Robert Egge, chief public policy officer of the Alzheimer’s Association, shared the findings of a recent study that found that in 2017, less than 1% of Medicare beneficiaries living with dementia received comprehensive dementia-specific care planning that could improve care, quality of life and medication management as well as reduce hospitalizations and emergency department visits. This is despite the fact that since 2017, physicians and other healthcare professionals have been able to obtain reimbursement for providing such care planning.

“For the benefits of care planning to reach more Americans affected by Alzheimer’s, more clinicians must use the care planning benefit,” he said. The bipartisan Improving Hope for Alzheimer’s Act (H.R. 1873 / S. 880), Egge added, would help achieve this goal by requiring the Department of Health and Human Services to educate clinicians and report to Congress on ways to increase the benefit’s use and on related barriers.

“This bill has already garnered significant bipartisan support in both chambers, and we urge the Committee on Ways and Means to hold a markup,” he said. “We look forward to working with the bill’s sponsors and committee leadership to ensure its movement in the full House and Senate.”

Watch the hearing here. Read witness testimony here. Read Neal’s opening statement here.

Full Article & Source:
‘Replace denial with proposal’ on long-term care, House committee told

Boomers Facing Large-Scale Homelessness, Congress Warned

by Ted Knutson

Baby Boomers are facing large-scale homelessness, Congress was warned today.

“Without serious attention and planning, we will have elderly paupers on our streets and in our parks in large numbers,” Dr. Joanne Lynn, policy analyst for the Program to Improve Elder Care at the Medicare and Medicaid consulting firm Altarum asserted.

Her warning came in a House Ways and Means Committee hearing on the coming financial tsunami facing Boomers as they surge into their late 60s and beyond.

On Medicaid, which is often used by seniors to pay for long-term care when they run out of money, Lynn and Elder Justice Coalition National Coordinator Robert Blancato warned high demand by Baby Boomers could lead to restrictions on entrants and services in the program by the 2030s.

Ways and Means chair Massachusetts Democrat Richard Neal attacked long-term care in America as insufficient, confusing, emotionally taxing and unaffordable.

He asserted round-the-clock, in-home care costs $180,000 per year with over $80,000 a year to live in a nursing home and assisted living $43,000 yearly.

Long-term care could become out of reach for Boomers who had led financially secure lives when they were working as their savings are drained to pay for immediate health care needs, Blancato cautioned.

“(Boomers) will be unable to afford essential supports and will have to confront homelessness, food insecurity, inability to manage personal hygiene,” Lynn, a gerontologist asserted.

To make more housing available for aging Boomers when the crisis hits in the coming ten years, Dr. Lynn said housing codes could start requiring basic disability adaptation in all units, low-income housing vouchers could be more readily available, and elderly persons living in tents and cars could have some priority in obtaining housing before exposure makes them so sick as to require nursing home care.

“Now is the time to enact legislation to build greater capacity in housing that works for people across their life span through state grants. Housing stock that would be safe, affordable and accessible would prevent people from having to live in a nursing home when disability sets in (often paid by Medicaid) for lack of available housing.” Lynn told the House committee.

Other solutions she has advocated for the long-term-care financial crisis include: incentivizing personal saving for retirement, long-term care services and support insurance, and long-term care; investing in the work-readiness of young people so that the economy is strong and can yield more tax revenue; and standardizing and improving the quality of geriatric medical care.

She also advocated enabling communities to drive down the per capita cost of disability in old age and improve reliability and appropriateness of services through local innovation and collaboration.

Aging Boomers face the gloom of a shortage in hospice care, National Hospice and Palliative Care Organization President & CEO Edo Banach said during the session.

“The number of hospice and palliative care physicians and members of the interdisciplinary team will drop dramatically over the next two decades,” Banach warned.

Alzheimer’s Impact Movement executive director Robert Egge noted a study of Medicaid beneficiaries with Alzheimer’s found black/African Americans had significantly higher costs of care than whites or Hispanics primarily due to more inpatient care and medical problems in tandem with dementia.

Older black/African Americans are twice as likely to have Alzheimer’s and other dementia as whites, one and a half times that of Hispanics, he said.

Right now, the lives of many nursing home and assisted living facility residents are bleak, the Long Term Care Community Coalition executive director Richard Mollot told the House panel.

“Avoidable pain, degrading conditions and substandard care are a part of hundreds of thousands of nursing home residents’ lives every day,” Mollot said.

Mollot attacked nursing home oversight as harmfully weak, charging violation fines are “relatively a minor expense.”

He noted inspectors uncovered repeated violations of the same requirement three or more times over three years in more than 40% of nursing homes.

“But less than half of all nursing homes have received any federal fine whatsoever in the last three years and, of those, the average amount is approximately $1,600,” Mallot said.

He added while more than 50% of residents in assisted living and nursing homes have some form of dementia or cognitive impairment and 67% of dementia-related deaths occur in nursing homes, many facilities fail to equip their staff with the knowledge and skills necessary to provide comfort and care.

The consumer advocate pointed to Illinois state inspectors claiming housekeeping and maintenance services at Alden Town Manor in the Chicago suburbs of Cicero had minimal harm despite finding maggot infestation on a resident’s genital area at the Alden Town Manor.

In a June report, the Government Accountability Office said it is imperative that the government agency responsible for ensuring nursing homes protect residents from abuse beef up its oversight.

The report said the Centers for Medicare and Medicaid Services falls short of that responsibility because information on abuse and perpetrator types is not readily available and incidents of abuse reported by nursing homes lack key information.

GAO said state agencies that conduct nursing home inspections should immediately report reasonable suspicions of crimes against residents to law enforcement.

However, the authors of the study complained those reports often can take weeks or months currently because CMS requires state agencies to tell police or other authorities about abuses only after they are substantiated.

 “Two (state) Medicaid Fraud Control Units d we interviewed told us the delay in receiving referrals limits their ability to collect evidence and prosecute cases—for example, bedding associated with potential sexual abuse may have been washed, and a victim’s wounds may have healed,” the GAO report said.

Close to 1.4 million elderly or disabled individuals reside in more than 15,500 nursing homes nationwide.

Full Article & Source:
Boomers Facing Large-Scale Homelessness, Congress Warned

Ending abuse of the disabled

Nicky’s Law, originally filed by state Senator Mike Moore of Millbury and state Representative Linda Dean Campbell of Methuen, passed the Senate 36-0 last summer but got stalled in the House Ways and Means Committee when the Legislature ended its formal sessions.

A society is — or should be — judged by how well it protects its most vulnerable citizens. But when it comes to protections for those with intellectual and developmental disabilities, Massachusetts still has a long way to go.

And by every statistic available, the problem of physical and sexual abuse is growing worse with every passing year.

“It is an epidemic of abuse against people with disabilities,” Nancy Alterio, executive director of Massachusetts’ Disabled Persons Protection Commission (DPPC), told a legislative oversight committee recently.

One way to make a dent in the problem is rather straightforward: a registry of caretakers against whom claims of abuse have been substantiated. The idea has gone by many names — often named for those victimized. The current version is called “Nicky’s Law,” after Nicky Chan, whose parents, Nick and Cheryl Chan, were made aware of a caretaker’s physical abuse of their son. The case against their son’s abuser actually went to court — few make it that far — but the caretaker was found not guilty and can, therefore, continue to work in group homes.

“I can tell you that the systems that are in place are not working,” testified Anna Eves, vice president of the Massachusetts Coalition of Families and Advocates. Her son, too, was the victim of abuse and neglect last year. Abuse claims were substantiated against seven people who worked with her son. Two of those workers were still on the job, she said.

The problem is that in many instances the victim is nonverbal, and absent visual evidence — and, sad to say in some cases, even with visual evidence — cases may be “substantiated” by the DPPC but not result in a successful criminal prosecution. (The standard for the latter is much higher.)

The victim remains the victim. But the abusing caregiver is free to move on to the next group home.
The numbers alone are horrifying. Last year the DPPC received 11,895 reports of abuse on the 24/7 hotline it operates — half of them involving people with intellectual and development disabilities. Of those reports, 878 dealt with allegations of sexual abuse — 387 involving people with intellectual disabilities, 409 involving those with mental health disabilities.

DPPC has seen a 30 percent increase in abuse allegations in the past five years, Alterio testified.

Thursday, members of a number of advocacy groups, including the Arc of Massachusetts, plan a vigil at the State House to make one last push for the registry legislation this year. Nicky’s Law, originally filed by state Senator Mike Moore of Millbury and state Representative Linda Dean Campbell of Methuen , passed the Senate 36-0 last summer but got stalled in the House Ways and Means Committee when the Legislature ended its formal sessions.

The bill was actually much improved as it made its way through the Senate, which added due process safeguards for accused caregivers, including an appeals process, and put the registry under the umbrella of the DPPC.

Massachusetts has made significant improvements in how its agencies handle reports of abuse and the level of services it now provides to victims. But all of that is after the fact. The registry can help prevent abuse by ridding the system of those who have no business being left to care for our most vulnerable citizens. They ought not have to wait another year for the Legislature to act.

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Ending abuse of the disabled