On October 11, 2012, Dr. Mark Lachs, Director, NYC Elder Abuse Center, testified before two cabinet members of the United States Senate, providing recommendations to the Elder Justice Coordinating Council on Health Insurance Portability and Accountability Act (HIPAA) and Institutional Review Board (IRB) issues related to the investigation of elder abuse. He described the challenges faced by elder abuse researchers under HIPAA and IRB guidelines.
Coinciding with presentations from Mark Lachs and other elder justice leaders, HHS Secretary Kathleen Sebelius announced that the NYS Office for the Aging (NYSOFA) received an HHS elder abuse prevention grant. The NYC Elder Abuse Center (NYCEAC), a highly collaborative initiative comprised of many NYC government and nonprofit organizations, is a key partner on the NYSOFA project.
Launched in 2009, NYCEAC aims to bring innovative solutions to the problem of elder abuse utilizing an unprecedented level of coordination. NYCEAC is able to carry out its mission with the dedicated efforts of its partners and Steering Committee Members. As the phenomena of elder abuse traverses many health and social welfare systems, Dr. Lachs explained, “Elder abuse cannot be treated in a silo.” Risa Breckman, LCSW, Deputy Director of NYCEAC states, “Elder justice is fundamentally a human rights issue as freedom from fear and personal safety is at its core. With this crucial HHS funding, we can help restore health and security to victimized older adults and prevent abuse from happening to others.”
The New York State Office for the Aging (NYSOFA; Director, Greg Olsen Greg, appointed by Governor Cuomo) will fund two enhanced multidisciplinary teams (E-MDTs), each with a unique feature of a forensic accountant, to investigate and intervene in cases of financial exploitation of older adults. NYSOFA’s project partners include NYS Office of Children and Family Services Bureau of Adult Services (OCFS), the NYC Elder Abuse Center (NYCEAC), and Lifespan of Greater Rochester, Inc. (hereafter partners) and will implement in two New York State pilot sites: Manhattan (New York County) and Finger Lakes region (Monroe, Cayuga, Livingston, Ontario, Seneca, Wayne and Yates counties).
The goal is to pilot an intervention that prevents financial exploitation and elder abuse by bringing together entities with resources and skills to form a coordinated E-MDT that will provide improved and effective systems collaboration and specialized responses, resulting in restored safety and security to older adults. The project will focus on frail adults aged 60 and older residing in the pilot sites, showing financial exploitation signs, and who have high risk elder abuse victimization characteristics.
In his recent testimony, Dr. Lachs listed six recommendations to the Elder Justice Coordinating Council which he believes will empower a dedicated, multidisciplinary group of individuals working to protect a vulnerable population:
- Convene an expert panel of ethicists, clinicians, and other community clinicians to explore and address HIPAA and IRB issues surrounding elder abuse; this instead of placing elder abuse under a general rubric of “domestic violence.”
- Encourage hospital and physician education about current HIPAA provisions regarding Domestic Violence disclosure, as the law is often interpreted and invoked erroneously to the detriment of victims.
- Encourage research in several areas with a focus on decision-making by protective service workers, while developing methods and techniques for accessing victims and protecting them to the greatest extent possible while permitting their participation in elder abuse research.
- Encourage IRBs be composed of members with research and clinical experience in domestic violence generally and elder abuse specifically.
- Provide guidance to the growing number of elder abuse teams multidisciplinary teams on how they may (a) Serve victims in an interdisciplinary fashion while maintaining HIPAA compliance; (b) Participate in elder abuse intervention research (and refer clients to such research).
- Advocate for a national voice and national leadership in the field at the federal level, so that these and other priorities be effectively implemented. The absence of a unified front in this regard is, ironically, an ageist state of affairs.