Welcome to the California Elder Justice Workgroup Wiki Site!

The California Elder Justice Workgroup (CEJW) was launched in October 2009 to protect the rights, independence, security, and well being of vulnerable elders in California by improving the response of the legal, long-term care, and protective service systems.    Visit About Us to learn more about CEJW or Click here to download the full Project description in PDF format.

 

 

 

 

 

 

 

 

 

 

 

It’s out!

Improving California’s Response to Elder Abuse, Neglect, and Exploitation: A Blueprint. 

 

The document represents over two years of exploration and discussions by advocates, service providers, experts in elder abuse prevention and related fields, and others with an interest in ensuring justice, safety, and security for older adults in California. These include the findings from the first state summit on elder abuse, held in April of 2010, an environmental scan to gather the collective knowledge about abuse and related topics, and discussions with the leaders of state agencies, professional associations, and advocacy groups. We welcome you to use the Blueprint to:

• Guide your work with abused and vulnerable elders;
• Assist you design new programs and expand existing programs by identifying unmet needs and justifying funding proposals;
• Craft public policy; and
• Set research agendas.

 

Hard copies of the Blueprint are being sent to summit delegates, members of CEJW’s Technical Advisory Group, and state and federal policy makers. 

 

Click below to download now:

Improving California’s Response to Elder Abuse, Neglect, and Exploitation

 Improving California’s Response to Elder Abuse, Neglect, and Exploitation: Executive Summary

 

We’d like to know your thoughts, ideas, and plans for using the Blueprint. Please take a moment to fill out our survey.

We’ll also use it to keep you up-to-date about plans for implementing the Blueprint.

Click here to complete the survey https://www.surveymonkey.com/s/XYRTT8Y

Thank you!

 

Upcoming Conferences

 

 

 

November 2, 2011:  Call to Action (Southern California)

The Elder Financial Protection Network will be hosting its signature Call to Action event in Southern California on Wednesday, November 2.  The Honorable Kim Hubbard will serve as Master of Ceremonies. The event will feature many of the cutting edge workshops featured at the Northern California event last spring and bring together professionals representing financial institutions, law enforcement, social services, elder justice advocates, and the legal community to share best practices. The event is also expected to draw hundreds of seniors For more, visit EFPN’s website at: http://bewiseonline.org

 

November 3-4, 2011:  Research Center on the Prevention of Financial Fraud

The newly formed Center will be hosting an inaugural conference The State and Future of Financial Fraud on November 3-4 in Washington. The Center is a joint initiative of the Stanford Center on Longevity and the Financial Industry Regulatory Authority (FINRA) Investor Education Foundation, which was formed in 2009 to further the understanding, prevention, and detection of financial fraud and connect interdisciplinary research to practical fraud-fighting efforts.  Activities include conferences and events and facilitating further study through research and funding. The Center’s website includes interdisciplinary research, including foundational and recent innovative works from the disciplines of  neuropsychology, marketing, criminology, finance, policy development, and law. Among the featured speakers at the event are Mary Schapiro, Chairman of the U.S. Securities and Exchange Commission, and Dr. Robert Cialdini, leading persuasion researcher and author of the New York Times Bestseller, Influence.

For more on the Center, see: http://fraudresearchcenter.org/

For more on the event, see:  The State and Future of Financial Fraud

 

November 14-16, 2011:  California Association of Area Agencies on Aging (C4A)

CEJW will again be a co-sponsor of the annual C4A conference, which takes place on November 14-16 at the Marriott Los Angles Downtown. CEJW is collaborating with the California Welfare Directors Association on two workshops. Sessions in the works include:

•  The impact of federal and state policy developments on vulnerable and abused older adults.
  This session will focus on how the Elder Justice Act, the Social Security Act 1115 waiver demonstration projects, the realignment of Adult Protective Services, and other state and federal developments will affect local service delivery to vulnerable and abused elders. The session, which is jointly sponsored by the California Welfare Directors Association and the California Elder Justice Workgroup, will provide an opportunity for information-sharing and strategizing.
•  Promoting Excellence in Adult Protective Services
  With shrinking budgets and burgeoning caseloads, APS programs need new and effective strategies and resources. This session will highlight what Area Agencies on Aging (AAAs) are doing/can do to prevent elder abuse.  AAAs are playing a critical role in promoting elder justice and preventing abuse and neglect. State Ombudsman Joe Rodriquez will describe how AAAs are using their Title 7 (OAA) funds for elder abuse programs. Representatives from the California Elder Justice workgroup will introduce their newly released Improving California’s Response to Elder Abuse, Neglect, and Exploitation: A Blueprint, report on the progress that’s been made in implementing it and engage participants in discussing ways that they can use the Blueprint to develop elder abuse programs. The session will also focus on the important role that AAA Advisory Groups can play in promoting elder abuse prevention.
• Addressing the mental health service needs of abused and vulnerable elders
  This session will describe the mental health service needs of abused and vulnerable elders and innovative projects to address them.

 

For more on the C4A conference, click here. 

 

 

News & Updates

 

California’s Grade on Long Term Care: Needs Improvement

On September 27, CEJW Chair Lisa Nerenberg and Community Liaison Mary Counihan attended the SCAN Foundation’s Summit on Transforming California’s Long-Term Services and Supports (LTSS). The following day, they participated in a daylong conference for members of Regional Coalitions and the California Collaborative.

 

The summit focused on the findings of the Raising Expectations State Scorecard Report, a comparative analysis of states’ LTSS systems. LTSS, previously referred to as long-term care, includes home care, adult day care, residential services such as assisted living, nursing homes, respite care,  and other supports for family caregivers. The scorecard was produced jointly by AARP, the Commonwealth Fund, and The SCAN Foundation under the guidance of national experts, academics, researchers, aging and disability officials, and consumer advocates.

 

The Scorecard defines high-performing LTSS systems as having the following characteristics:

1. Affordability and access: Consumers should be able to easily find and afford the services they need;
2. Choice of setting and provider:  A person-centered approach to LTSS should place high value on allowing consumers to exercise choice and control over where they receive services and who provides them;
3. Quality of life and quality of care.  Services should maximize positive outcomes and consumers should be treated with respect.  Personal preferences should be honored when possible; and
4. Support  for family caregivers: The needs of family caregivers should be assessed and addressed so that they can continue in their caregiving role without being overburdened.

 

Each of the categories contains specific indicators for a total of 25 indicators. States were ranked by overall performance, their performance on each category, and on each indicator.

 

California’s Score: From Outstanding to Abysmal

Although California ranked a respectable if lackluster overall rating of 15, its performance on specific categories and indicators is perhaps more revealing:  

• ·      California excelled in Category 1, Affordability and Access, which can largely be attributed to the state’s Medi-Cal coverage policies. California ranked second among the 50 states and the District of Columbia in connecting needy low and moderate income people with Medi-Cal services.  In a typical month, 70% of low- and moderate-income California residents with disabilities used Medi-Cal LTSS, which is nearly twice the national median rate of 36%.  

 

• ·      The state ranked even higher--first in the nation--in the number of people enrolled in programs that are deemed “consumer-directed, which is credited to the In-Home Supportive Services (IHSS) program, the largest consumer-directed program in the country. Tempering this accomplishment, however, was California’s dismal ranking of 45th in “providing tools and programs to facilitate consumer choice and 42nd on the availability of home health and personal care aides for older Californians. As those in our network know, consumer choice with inadequate choices or help in choosing can be a dangerous combination.

 

• ·      Other causes for alarm, California ranked: 
• ·      A shocking 49th on the percent of long-stay nursing home residents who experienced physical restraint; 
• ·      40th for the percent of high-risk nursing home residents with pressure sores;
• ·      46^th in the number of family caregivers who feel they usually or always get needed support (rank: 46th); and
• ·     

 

Not surprisingly, much of the discussion during the summit and conference focused on the imminent dismantling of California’s LTSS system, most notably the planned closure of Adult Day Health Centers and transitioning of clients into managed care. Still, the inattention to issues of security, safety, and quality of life is disturbing, particularly in light of the fact that safety net services like APS are currently being forced to reduce their caseload as a result of budget cuts in many communities. In response, CEJW’s Steering Committee has called for:

• Incorporating “safety net” indicators into future versions of the Scorecard, including the availability of APS, Ombudsmen, courts, Public guardians, and mental health services that are called upon to kick in when Long Term Services and Supports fall short.
• Alert California policy makers to the need to facilitate consumer choice, which includes expanding the pool of home health and personal care aides, enhancing training for them, and helping consumers with screening and supervision. 
• Advocate for the careful vetting of private health plans. One company that the state has considered contracting with to coordinate care for ADHC clients was the subject of  a Justice Department lawsuit  alleging that it had failed to provide services to hundreds of  Medicaid beneficiaries in another state. 
• APS Healthcare Pays $13 Million to Settle False Claims Act Case
• State turns to troubled firms after adult care cut

 

Copies of the Scorecard and the Summit proceedings are available at: http://thescanfoundationsummit.intuitwebsites.com/services.html

 

A fact sheet on California’s score It is available at:

http://www.thescanfoundation.org/sites/default/files/SCAN-FactSheet-22.pdf

 

 

New Directives to Victim Witness Advocates 

For the first time, the US Attorney General’s Guidelines for Victim and Witness Assistance Advocates acknowledge the need for special accommodations for victims and witnesses with physical and mental disabilities. Under the newly-updated guidelines, advocates are also directed to report elder and dependent adult abuse to adult protective services and law enforcement. The new Guidelines, described below, took effect on October 1, 2011.

Accommodation for Unique Vulnerabilities  

Department personnel should be aware of the unique challenges that may be

present when working with vulnerable victims and witnesses, such as the elderly

and persons with physical and mental disabilities. These vulnerable victims and

witnesses may  have difficulty  walking, hearing, or seeing, may be frail, on

significant medications, or in chronic pain. Some may  have an impaired level of

cognitive function, dementia, depression, shame, ambivalence, or fear, which

could  cause them to be particularly vulnerable and anxious about the criminal

justice system. For those vulnerable victims and witnesses  who are disabled and

homebound, prosecutors may consider the use of depositions, if feasible. 

Department personnel should consider helping to make arrangements for

transportation to and from court for those victims and witnesses who   may not

drive, have difficulty walking, or have other physical limitations that make it

difficult to attend court proceedings. Arrangements should be made for wheel­

chairs and assistive listening devises,  if needed.  To  the extent possible,

Department personnel should make arrangements with the court in advance to

accommodate physical limitations of victims and witnesses, if necessary.

 

 

Report Suspected Abuse  

Whenever Department personnel suspect that an elderly or otherwise vulnerable 

adult  victim or witness may be suffering from neglect, abuse, or exploitation

(whether or  not the individual is the subject of the matter being investigated or

prosecuted), Department personnel should promptly contact the local Adult

Protective Services agency or local law enforcement agency to report the

concerns. The grounds for reporting such  abuse may include physical evidence of

abuse, sudden personality changes, disinterest in old habits, and signs of care­

giver neglect. In addition, Department personnel should identify and provide

referrals to appropriate local social service agencies best able to meet the needs of

the victim. Department personnel should also be aware of possible nursing home 

abuse and report such to the Adult Protective Services or law enforcement

agency, or to the state Attorney General’s office.

  

For copies of the new guidelines, click here.  

http://www.justice.gov/olp/pdf/ag_guidelines2011.pdf

 

 

Alameda Elder Protection Court Singled out for Leadership

Alameda’s Elder Protection Court (EPC) was one of five courts evaluated as part of a national research project conducted by the American Bar Association Commission on Law and Aging and the University of Kentucky College of Public Health/Department of Gerontology. The court, which resides in the Superior Court of Alameda County, features a special civil and criminal docket for elder abuse cases. The other courts in the study are the Elder Justice Center of Hillsborough County, Florida; the “In-Home Emergency Protective Order Initiative” in Jefferson County, Kentucky; The “Elder Temporary Order of Protection” Initiative in Kings County, New York; and the “Elder Justice Center” in Palm Beach County, Florida.

 

The researchers, Lori Steigel of the ABA and Pam Teaster of UK assessed the courts according to criteria established by the ABA in its groundbreaking Recommended Guidelines for State Courts Handling Cases Involving Elder Abuse (Stiegel, 1995) and a set of performance standards recommended by researchers at Florida International University (Rothman, Dunlop, & Seff, 2006). Although all of the courts performed well (all five accomplished 87.5% of the relevant ABA recommended guidelines and 100% of the FIU standards), Alameda’s court was singled out for its community leadership. The report had this to say about the EPC:

 

Only in Alameda County is the court providing leadership in the community on the subject of elder abuse. It does this by sponsoring an Elder Access Committee, similar to the family violence coordinating councils that courts lead across the nation. The juxtaposition in stakeholder support between the EPC and the other initiatives seems to demonstrate that judicial leadership, or at least a strong relationship between the court and the elder abuse stakeholders, is essential to an initiative’s success.

 

Kudos to Honorable Julie Conger, who founded the Court and her successor, the Honorable Don Clay.  For copies of the report, click here.

 

Other News

 

Our Bodies, Ourselves Introduces Elder Abuse

Thanks to Holly Ramsey-Klawsnik, an expert in elder sexual abuse, APS trainer, and long time advocate, elder abuse has made it into the recently updated edition of the groundbreaking Our Bodies, Ourselves, which inspired the women’s health movement and has been read around the globe for 40 years. As a contributing author, Holly provided material on violence against older women and elder abuse in general, which appears for the first time. The new edition also lists the National Committee for the Prevention of Elder Abuse as a resource.

 

California Forensics Centers Meet to Compare Notes

On October 3, representatives from the four elder abuse forensics centers in California that are participating in an Archstone Foundation-funded cross-site evaluation met to compare notes and exchange information. The meeting was convened by Dr. Kate Wilber and a University of Southern California evaluation team that includes Melanie Gironda, Adria Navarro, Julia Wysong, Jeanine Cho, and Zachary Gassoumis. The team is comparing and contrasting the four models used by the centers in terms of their structures, processes, outputs, and outcomes.  All four Centers currently use a standardized referral form that they helped develop in recent years and are now in the process of  adopting a standardized data collection instrument to track outputs and outcomes that will be used in learning more about  investigation, prosecution, conservatorships. and APS recidivism rates.

 

The Sum of Their Parts: Surveying Elder Justice Summits and Coalitions

CEJW Steering Committee member Adria Navarro, Assistant Professor, Azusa Pacific University and Technical Advisory Group (TAG) members Georgia Anetzberger, Consultant, Iris Freeman, Associate Director, Center for Elder Justice & Policy, William Mitchell College of Law, and Kathleen Quinn Executive Director, National Adult Protective Services Association will be comparing notes on states' elder justice advocacy efforts during the “The Sum of Their Parts: Surveying Elder Justice Summits and Coalitions” at the upcoming GSA conference in Boston, MA.  Joining them is Art Mason (Program Director, Lifespan) who will speak on New York’s mature coalitions and renewed summits. Included will be implications for the implementation of the Elder Justice Act.

 

Senior-Focused Legislation Approved by the Governor

 

Click here to download the PDF

 

 

New Reports and Resources

 

From the National Center for State Courts (NCSC)

• NCSC recently released a report that offers a “ballpark estimate” of open guardianship cases in the US and outlines court-related activities in 2010 that were aimed at improving guardianship processes.  The report is available on NCSC’s web site at  http://eldersandcourts.org/ (under “Latest News”).
• NCSE has also developed an elder abuse curriculum for state judicial educators as part of a project funded by the Retirement Research Foundation of Chicago. It includes an instructor’s manual, handouts, PowerPoint files, and evaluation forms.  The curriculum is designed so that it can be modified by individual states to include state demographics, laws, and reporting requirements.  It’s a three-part module (Physiology of Aging, Identifying Elder Abuse and Neglect, and Crafting Court Responses).

 

Incapacitated Adults: Oversight of Federal Fiduciaries and Court-Appointed Guardians Need Improvement

This new report by the Government Accountability Office (GAO) calls for better oversight of court-appointed guardians. The report, which  looks at guardians appointed by the Social Security Administration (SSA), Veterans Affairs (VA), and state courts, addresses the screening of potential fiduciaries and guardians; monitoring of fiduciaries and guardians; information sharing among SSA, VA, and state courts; and federal support for court oversight of guardians. The GAO recommended that the Department of Health and Human Services consider funding evaluations of practices for monitoring guardians. It also recommended that the SSA determine how it can disclose certain information about beneficiaries and fiduciaries to state courts under current law, and propose legislative changes if necessary to further such disclosure. To download the report, click here.

 

Making Restitution Real: Five Case Studies on Improving Restitution Collection

The National Center for Victims of Crime (NCVC) recently released Making Restitution Real: Five Case Studies on Improving Restitution Collection. Included among the models profiled is the Vermont Restitution Fund and Center for Crime Victim Services Restitution Unit.

 

The restitution fund was created in 2002 through a 15% surcharge on criminal and traffic fines. When the court orders restitution, a restitution judgment order is sent to the Restitution Unit, which can advance restitution payments of up to $10,000 to individual crime victims. For business crime victims and amounts above the $10,000 cap, the unit collects from offenders and disburses the money to victims.

 

The Restitution unit is structured and operates like a collection agency. Collection analysts manage a caseload of offenders who owe restitution, maintaining regular contact with offenders and using a number of collection tools to promote compliance. Since July 1, 2004, the unit has advanced a little over $6 million to 5,600 individual crime victims and its collection rate is 24%. One positive outcome has been the coordination between the Restitution unit and the victims Compensation program, which has tripled the amount of restitution ordered to the Compensation program. Moving forward, the unit will work with the Vermont legislature to improve collection rates. Lessons learned from the project include the realization that decoupling restitution from probation was a mistake. The ability to tell offenders that they won’t be released from probation until they pay their restitution is a motivation to pay.

 

Worth Reading:

Assessing Knowledge of Elder Financial Abuse: The First Step in Enhancing Prosecutions 

Anyone who’s prosecuted, followed, or testified in an elder financial abuse case knows it can be daunting. In this fascinating paper, authors Sharon Gibson and  Edie Greenepropose and evaluate a novel form of psychological expertise in financial abuse trials—social framework testimony--to reeducate jurors who are misinformed about aspects of elder financial abuse in hopes of enhancing prosecutions. The article is slated for publication next year in the Journal of Elder Abuse and Neglect [24 (4)] but the authors have offered CEJW a sneak preview.  To download, click here.

  

USA Today Analyzes Restitution

A USA TODAY analysis of Justice Department records found that although federal judges have ordered hundreds of the nation's biggest swindlers to repay millions of dollars they stole during the past decade, so far, the government has collected about 2 cents on the dollar. The article goes on to describe  difficulties prosecutors are likely to face in the coming years, as they try to wring money from scam artists who profited from the nation's housing and financial crises. For more, click here.

http://www.usatoday.com/news/washington/2011-03-07-1Afines07_ST_N.htm