While conditions for older Americans have improved markedly since passage of the Older Americans Act of 1965 (OAA), many elderly still are denied their basic rights and benefits, and suffer abusive situations ranging from financial exploitation to severe neglect. They may need advocacy on their behalf because their physical or mental disabilities, social isolation, limited educational attainment or limited financial resources prevent them from being able to protect, or advocate for, themselves.
Title VII, the Vulnerable Elder Rights Protection Program, was created by Congress in the 1992 Amendments to the OAA to protect and enhance the basic rights and benefits of vulnerable older people. The Administration on Aging (AoA), which administers Title VII at the federal level, encourages its nationwide network of 57 State and Territorial Units on Aging (SUA's), their 655 Area Agencies on Aging, and 221 Tribal Organizations to focus their efforts on issues affecting those elderly who are the most socially and economically vulnerable.
Title VII has a dual focus. First, it brings together and strengthens four advocacy programs--the Long-Term Care Ombudsman Program; Programs for the Prevention of Abuse, Neglect and Exploitation; State Elder Rights and Legal Assistance Development Programs; and Insurance/ Benefits Outreach, Counseling and Assistance Programs--and calls for their coordination and linkage in each state.
Second, Title VII calls on the SUA's to take a holistic approach to elder rights advocacy by coordinating the Title VII programs and by fostering collaboration among other legal services programs and advocates in each state to address those issues of highest priority for the most vulnerable elderly. Combining state advocacy programs under a single title has fostered increased collaboration among advocates within a state--and between states--to assist older people, their families, and representatives, while strengthening the mission of each program.
Funds for the Long-Term Care Ombudsman Program, and Programs for Prevention of Elder Abuse, Neglect and Exploitation are currently funded under Title III, Grants for State and Community Programs on Aging. There is no current OAA appropriation for Insurance/ Benefits Outreach activities, the State Elder Rights and Legal Assistance Development Program, or for elder rights activities to assist Native American Organizations.
The Long-Term Care Ombudsman Program
The Ombudsman Program assists residents of long-term care facilities, their families and friends to voice concerns and correct conditions that affect the quality of their care. The program also promotes policies and practices that improve the quality of life in nursing and board and care homes and other adult care facilities. The AoA provides leadership and support to state long-term care ombudsman programs and funds the National Ombudsman Resource Center to provide training and technical assistance to ombudsmen.
Working through hundreds of grassroots programs, ombudsmen and ombudsman volunteers monitor private and publicly-subsidized long-term care facilities. They educate consumers and providers about residents' rights and good care practices, including alternatives to chemical and physical restraints that limit individual freedom, leading to physical and emotional deterioration. The ombudsmen's role in preventing neglect and even abuse of residents is one of their most important functions.
According to the latest data from states (1995), there were 565 local or regional ombudsman programs employing over 900 paid staff and 6,400 certified volunteer ombudsmen. A total of 218,455 complaints were filed by 162,338 residents, family members, ombudsman facility workers, and others. Over 70 percent of these complaints were totally or partially resolved to the resident's/ complainant's satisfaction.
Activities to Prevent Elder Abuse, Neglect, and Exploitation
The goal of these activities is to develop and strengthen efforts to prevent and treat elder abuse, neglect, and exploitation. State Elder Abuse Prevention activities strengthen both prevention and treatment programs through statewide and local professional training and public education initiatives.
Following passage of the 1992 OAA Amendments, states increased the use of funds to support statewide and local coordination among elder abuse prevention programs (e.g., multidisciplinary teams, interagency working groups, and coalitions), and to strengthen coordination with other state and local programs and services to protect vulnerable adults, particularly older individuals.
The AoA provides leadership for state elder abuse prevention activities, and is emphasizing increased: (1) coordination among service systems and disciplines to prevent elder abuse and combat crimes against the elderly; (2) knowledge among professionals serving the elderly about elder abuse; (3) public awareness of elder abuse and the seriousness of crimes against the elderly; and (4) public education of the elderly to enable them to avoid being victimized, abused, or exploited.
The AoA has participated in the development of the American Medical Association's (AMA) "Diagnostic and Treatment Guidelines on Elder Abuse and Neglect." The AMA distributed the "Guidelines" to physicians across the country so that they could identify victims of abuse more readily. The AoA worked with the American Bar Association's Commission on Legal Problems in its development of recommendations for state courts handling elder abuse cases. The AoA also joined with the Police Executive Research Forum, the Justice Department, and the American Association of Retired Persons (AARP) to improve the law enforcement community's response to crimes against the elderly and elder abuse.
These programs have been supported by awarding OAA Title IV research and demonstration funds to establish the National Center on Elder Abuse. The Center has supported state and local elder abuse prevention programs by providing a national information clearinghouse at the University of Delaware, conducting short-term studies relating to elder abuse and its prevention, and providing training and technical assistance.
State Elder Rights and Legal Assistance Development Program
Under this program, SUA's have established programs to provide leadership in improving the quality and availability of legal and advocacy assistance to ensure a comprehensive system of elder rights. States have designated a legal assistance program developer and established a focal point for conducting policy review, analysis, and advocacy on issues including guardianship, age discrimination, pensions and health benefits, consumer protection, protective services, public benefits and dispute resolution.
The State Outreach, Counseling, and Assistance Program
States have implemented the State Outreach, Counseling, and Assistance Program for Insurance and Public Benefits in a variety of ways to respond to needs in their states, and coordinated activities with related counseling and outreach programs. States emphasized areas such as pensions, outreach to those eligible for Supplemental Security Income and Food Stamps, and expansion of health insurance counseling and assistance efforts.
Under Title IV of the OAA, the AoA has awarded grants to establish legal services hotlines in a number of states. These hotlines provide information and assistance to the at-risk elderly.
The AoA is participating in the AARP's Telemarketing Fraud Project--a national education campaign designed to end a crime that costs Americans an estimated $40 billion each year. In December 1996, the AoA took part in "Operation Unload," named after the boiler room operations commonly used by fraudulent telemarketers.
The AoA joined with 200 Operation Unload volunteers, including older persons, state Attorneys General, and state presidents of AARP, to warn some 2,100 elderly that their names appeared on "mooch" lists and that they were being targeted by fraudulent telemarketers. The AoA also has asked members of the national network on aging to assist in developing ways to distribute the AARP's educational materials directly to older persons.
For information regarding these programs at the state and local levels, and legal services for the elderly, including legal services hotlines, call the AoA's Eldercare Locator at 1-800-677-1116.
Additional information is available from:
Administration on Aging
U.S. Department of Health and Human Services
330 Independence Avenue, SW Washington, DC 20201
Telephone: (202) 619-0724
TDD: (202) 401-7575
Fax: (202) 260-1012
Resources. . .
National Center on Elder Abuse, Research and Demonstration Department, American Public Welfare Association, Suite 500, 810 First St., NE, Washington, DC 20002, (202) 682-2470, operates the Clearinghouse on Abuse and Neglect of the Elderly, provides technical assistance, training and research studies, also has publications for consumers and professionals.
National Long-Term Care Ombudsman Resource Center, National Citizens' Coalition for Nursing Home Reform, Suite 202, 1424 16th St., NW, Washington, DC 20036, (202) 332-2275, provides technical assistance to ombudsman programs and has a newsletter.
American Bar Association's Commission on Legal Problems of the Elderly, 740 15th St., NW, Washington, DC 20005, (202) 662-8690, has publications and programs for legal service providers.
Black Elderly Legal Assistance Support Project, National Bar Association, 1225 11th St., NW, Washington, DC 20001, (202) 842-3900, offers programs and publications for legal service programs and providers.
National Clearinghouse for Legal Services, Inc. 2nd Fl., 205 W. Monroe St., Chicago, IL 60606, (312) 263-3830, offers legal research and related services to professionals.
Pension Rights Center, Suite 704, 918 16th St., NW, Washington, DC 20006, (202) 296-3776, has a pension attorney referral service, case consultation panel, pleadings bank for attorneys representing pension participants, and consumer publications.
Directory of Legal Services for Older Adults and Benefits Checklist available from: Brookdale Center on Aging, 425 E. 25th St., New York, NY 10010, (212) 481-5069.
Comprehensive Guide to Delivery of Legal Services to Older People and National Study of Guardianship Systems available from: Center for Social Gerontology, 2307 Shelby Ave., Ann Arbor, MI 48103, (313) 665-2071.
Eldercare Initiative in Consumer Law, National Consumer Law Center, Suite 400, 18 Tremont St., Boston, MA 02108, (617) 523-7398, offers technical assistance for legal programs and publications for providers and consumers.
Legal Counsel for the Elderly, 601 E St., NW, Washington, DC 20049, (202) 434-2120, offers assistance for legal providers and programs, also has publications for providers and consumers.
Legal Services for the Elderly, 17th Fl., 130 W. 42 St., New York, NY 10036, (212) 391-0120, offers assistance and publications for legal service providers.
National Eldercare Legal Assistance Project, National Senior Citizens Law Center, Suite 700, 1815 H St., NW, Washington, DC 20006, (202) 887-5280, provides case management, technical assistance, training and legal assistance support services to aging legal services networks. Also offers technical assistance with Medicare claims and Part A benefit appeals and has publications for professionals.
American Association of Retired Persons, 601 E St., NW, Washington, DC 20049, (202) 434-2277 has publications dealing with legal rights and the elderly.
National Committee for the Prevention of Elder Abuse, c/o Institute on Aging, the Medical Center of Massachusetts, 119 Belmont St., Boston, MA 01602, (508) 793-6166, issues Journal of Elder Abuse.