An uncomfortable and thus often overlooked fact in this country is that an estimated 1 out of 10 people over the age 60 who live at home suffer some sort of abuse each year. This may come in various forms: financial exploitation, direct physical harm, or neglect—or some combination of each. The perpetrators may be caretakers or, sadly, even family members. And this is a problem that, unfortunately, isn’t solely relegated to a few small pockets of our society; it exists even among the rich and famous. At an emotional Senate hearing in 2011, the late Mickey Rooney described the emotional and financial abuse he had suffered at the hands of his stepchildren. As the American population ages, and, in particular, includes more of the “old old,” those who are over 90, this problem is likely to grow worse.
In recognition of this, President Obama’s Affordable Care Act included the Elder Justice Act, a bipartisan bill that had been pending in Congress for several years. It was the first comprehensive federal legislation to address elder abuse and has spurred efforts to collaborate across departments to better understand the problem and to address it more effectively. Under the aegis of the Elder Justice Coordinating Council:
- The Department of Justice has trained prosecutors to better identify cases of criminal elder abuse;
- HHS has funded data standardization efforts with state adult protective services to help understand the scope of the problem;
- The Consumer Financial Protection Bureau has produced educational materials to help various sectors (nursing homes, money managers, older Americans themselves) recognize the signs of financial abuse; and,
- The Federal Trade Commission launched a campaign to raise awareness of financial fraud aimed at the elderly, such as fundraising scams or identity theft.
These are modest steps in light of the scale of the issue, but represent an important beginning and can help lay the groundwork for stronger efforts in the future. And, at first read, the new Trump budget continues funding for elder abuse prevention, such as the data standardization work. However, it actually eliminates the main federal support for state adult protective services, which would undercut any Elder Justice Coordinating Council work that may be continued.
The blandly named Social Services Block Grant (SSBG) provides nearly $200 million annually for state adult protective service work—that is, the actual first responders in potential cases of elder abuse. These are the trained professionals that field the reports and investigate allegations. They are the ones who assess whether abuse is happening and what can be done to help the senior find their way out of an abusive situation.
SSBG was established during the Reagan Administration as a flexible source of funding for states to address a variety of needs—there are nearly 30 potential ways states can use this money, as they see fit. They range from services to people with disabilities to foster care to residential treatment. The goal was to help states make their own decisions about where to strengthen their safety net and to help them address gaps in federal funding streams.
Most states—37 in FY 2014—use SSBG to support their adult protective service systems to the tune of $190 million. This is the only federal funding for the day-to-day work of states in preventing or remedying elder abuse. According to HHS data, approximately 578,100 adults received adult protective services funded by SSBG in FY 2014.
Unfortunately, the Trump budget eliminates SSBG altogether. It does propose to continue providing $5 million for training and education aimed at elder abuse prevention, but there will be little left with which to either train and educate once SSBG is zeroed out, with nearly $200 million steered away from helping some of our society’s most vulnerable.