The Elder Justice Act & Other Federal Victims Legislation: What it Means for APS & APS Clients

1. The Elder Justice Act & Other Federal Victims Legislation: What it Means for APS & APS Clients Marie Therese Connolly, JD, Woodrow Wilson Scholar Bob Blancato, National Coordinator, Elder Justice Coalition Bill Benson, National Policy Advisor, NAPSA

2. Source: Congressional Research Service

3. Number of Components in the Elder Justice Act • H.R. 3490, Subtitle H, Sec. 6701 • Authorized for FY 2011-2014 • Amends Title XX of the SSA (Sec. 2011 & following) – Finance Committee & Ways & Means • Only portion of original version of EJA (note Sestak’s Elder Abuse Victims Act of 2009) • 9 Major Distinct Components (& Definitions)

4. Number of Components in the Elder Justice Act (2) • 13 Distinct Authorizations of Funding – Need Annual Appropriations – Otherwise, “Close but no cigar” • “Such Sums” • Varying amounts per FY • Fixed authorizations for some provisions – e.g., APS grants to states • Heavily LTC-focused • Who Will Administer/Implement? • AoA? • CMS? • Secretary? • Other?

5. EJA Component Parts • Elder Justice Coordinating Council – all feds • Authorization – such sums • Advisory Board on EAN & E – 27 public members • Authorization – such sums • Research Guidelines re human subject protections • Authorization -- $6.5 M then $7.0 M • Forensics Centers (4 Stationary Centers, 6 Mobile Centers) • Authorization -- $4M FY 11 (to $8 M)

6. EJA Component Parts • Enhancement of Long-Term Care • Grants & Incentives for LTC Staffing (Career Ladders, Wage & Benefit Increases, Technology, Adoption of Standards for Transactions re Clinical Data) • Authorization -- $20M FY 11 (drops to $15 M in FY 13-14) • Protecting Residents of LTC Facilities • National Training Institute for Surveyors (with National Complaint Intake System) • Authorization -- $12 M FY 11-14 • Grants to State Survey Agencies re complaint investigations systems • Authorization -- $5M FY 11-14

7. EJA Component Parts • Reporting to Law Enforcement of Crimes Occurring in Federally Funded LTC Facilities (to Secretary & Law Enforcement) • Includes owners, operators, employees, managers, agents, contractors of LTC facilities • CMPs for failure to do so; higher CMPs when residents harmed by crime • Additional Penalties for Retaliation • No Appropriation

8. EJA Component Parts • National Nurse Aide Registry • Study & report to Coordinating Council & Congress – 18 mos. • Congress (Finance, W&Ms, E&C) “shall, as they deem appropriate, take action on the recommendations • Authorization – such sums • Evaluation • No Appropriation • “Tap” – not less than 2% appropriated for each program

9. EJA Component Parts – LTC Ombudsman Grants & Training • Grants to States • Improve capacity of LTCOPs to respond to/resolve complaints about abuse & neglect • Pilot programs with state & local ombudsman entities • National support (e.g., Nat’l LTCO Resource Center) • Authorizes $5 million in FY 08, $7.5 million in FY 09 & $10 million in FY 10 & FY 11 • Ombudsman Training Programs re elder abuse, neglect & exploitation – authorized at $10 million for FY 2008-2011

10. What the EJA means for Adult Protective Services (APS) • First dedicated federal funding for APS • $100 million in new money to states for APS • $25 million in new money for APS demo grants • $3-4 million for HHS for a federal “home” for APS

11. What the EJA means for APS: A “Federal Home” • Establish functions with respect to Adult Protective Services (APS) to be administered by the Secretary to provide leadership to the states’ programs. Authorizes $3m FY 11 & $4m FY 12-14 • Functions include providing funding and support to state and local adult protective services offices that investigate reports of abuse, neglect and exploitation of elders and vulnerable adults; collecting and disseminating information on abuse in coordination with the Department of Justice; developing and disseminating information on best practices; conducting research and providing technical assistance to states that provide or fund protective services.

12. What the EJA means for APS: State Funding Adult Protective Service Grant Program (State Formula Grants) -- Use of Funds • Authorizes $100 million • Funds may be used only by states and local governments to provide adult protective services & may only be used for APS. • State receiving funds would be required to provide these funds to the agency or unit of state government having legal responsibility for providing adult protective services in the state. • Each state would be required to use these funds to supplement and not supplant other federal, state, and local public funds expended to provide adult protective services. • California: If $100 million: $9.958 milllion =170 FTEs at $60,000 each; 85 FTEs at $120,000

13. What the EJA means for APS: National Demonstration Grants State Adult Protective Service Grants (Demonstration Program) – Authorizes $25 million “Would require the Secretary to establish grants to states for adult protective service demonstration programs. Funds may be used by state and local units of government to conduct demonstration programs that test: training modules developed for the purpose of detecting or preventing elder abuse; methods to detect or prevent financial exploitation and elder abuse; whether training on elder abuse forensics enhances the detection of abuse by employees of state or local government; and other related matters. States would be required to submit applications to the Secretary.”

14. Implementation of the EJA • “Show me the money” (“Jerry Maguire) – the battle & challenges for appropriations • Significance for APS • Who will be responsible for what at HHS? • What is the timetable especially sans appropriations – e.g., no action taken until appropriations? • Those items not requiring appropriations – e.g., reporting of crimes in LTC facilities

15. Appropriations • 2011 Advocacy Effort: You are all needed • California has a lot of members on the Appropriations Committees (full & Labor, HHS Subs) – but all members needed – see www.elderjusticecoalition.com • Importance of APS funds – new money to states • Your Governor’s Office (& national orgs) • California Legislature (& national orgs) • State orgs – e.g., C4A & CWDA (Nat’l reps)

16. Appropriations – Past as Prologue? • The Track Record • Congress (and States) • Aging Network • Elder Abuse Victims – just another client group? • OAA Reauthorization • “Be bold” notion • Pick right vehicles (e.g. APS & OAA) • Pyrrhic victories – little sustained joy

17. OAA appropriations: Title III(in thousands) Source: CRS Report for Congress: Older Americans Act: History of Appropriations, FY1966-FY2004 FY 2011 Administration on Aging Justification of Estimate for Appropriations Committees FY 2010 appropriations conference report, H.Rept. 111-366

18. OAA appropriations: Title VII(in thousands) n/s= not specified Source: CRS Report for Congress: Older Americans Act: History of Appropriations, FY1966-FY2004 FY 2011 Administration on Aging Justification of Estimate for Appropriations Committees FY 2010 appropriations conference report, H.Rept. 111-366

19. The Social Services Block Grant (SSBG)A few (choice) words

20. Our kids will thank us