The Role of Elder Justice Coordinators in the U.S. Attorneys’ Offices
by David Degnan, Assistant US Attorney, Elder Justice Coordinator for the US Attorney's Office for the Eastern District of Pennsylvania
National prevalence studies indicate that at least 10% of older Americans experience some form of elder abuse in a given year, with an additional 5% being the victim of financial fraud. The consequences of harms generally, and financial harms in particular, are devastating for older Americans, especially those on fixed incomes or living in long-term care facilities. Older victims who lose part of–or their entire—life savings are unable to recoup those losses. Most are unable to engage in gainful employment and the likelihood of financial recovery is slim. The strain of financial loss leads to poor health outcomes and, for many, early mortality.
The federal government recognizes the hardship borne by victims of elder abuse, neglect, and financial fraud and exploitation. To bolster society’s response, Congress passed the Elder Abuse Prevention and Prosecution Act (EAPPA). This 2017 law is intended to cultivate a more vigorous response across professions at the federal, state and local level. To coordinate the implementation of EAPPA, the Attorney General named Antoinette T. Bacon as the first-ever National Elder Justice Coordinator.
Although not all financial crimes fall within the ambit of federal law enforcement, many do. A few financial crimes involving older adults that implicate federal enforcement actions are international lottery scams, money mules, tech support scams, and grandparent scams. Likewise, federal intervention is generally warranted only in cases of abuse and neglect of a beneficiary of a federally funded health care program (e.g., Medicare). We also prosecute representative payees for misuse of Social Security and Veterans Administration benefits. To ensure an aggressive and uniform response throughout the country, EAPPA mandates the appointment of an Elder Justice Coordinator (EJC) in each of the 94 U.S. Attorneys’ Offices to affirmatively pursue financial fraud, neglect and exploitation of older adults.
Designated by the U.S. Attorney in each district, the EJC is an Assistant U.S. Attorney with expertise in either civil or criminal federal law. In my district, the Eastern District of Pennsylvania, we have an EJC designated in both the civil and criminal divisions of the office. EJCs are sometimes seasoned prosecutors of gross neglect by health care providers or financial exploitation; some EJCs are fairly new to this area of the law.
EAPPA requires extensive training for EJCs to ensure they are prepared to pursue these cases. The Department of Justice arranges for EJC training at the National Advocacy Center, the federal prosecutor training institute on the campus of the University of South Carolina. In addition to this intensive training, the Department hosts a number of webinars featuring the Department’s Consumer Protection Branch, the Nursing Home Initiative, and other federal partners. EJCs receive a periodic newsletter with information and resources on financial fraud and exploitation to further strengthen their capacity.
As I mentioned, EJCs vary tremendously, but let me describe for you my experience becoming an EJC. I was named EJC in the civil division of the Eastern District of Pennsylvania in 2018. For the past 12 years, however, I have been an Assistant U.S. Attorney in this office, focusing much of my work on pursuing civil remedies against health care providers who knowingly bill federal health care programs for services not rendered or for services so grossly inadequate as to render them worthless. Health care providers I have prosecuted include nursing homes, assisted living facilities, and adult care homes for people with intellectual or mental disabilities. Just recently, my office, along with other DOJ partners, successfully resolved for $15.5 million allegations that Guardian Elder Care Holdings performed unnecessary rehabilitation therapy on skilled nursing facility residents to boost federal reimbursement. The settlement also requires Guardian to enter into a corporate integrity agreement with the Department of Health and Human Services, Office of Inspector General, in order to promote future compliance. Federal intervention thus plays an important role in these cases. In addition to money damages, our civil remedies include monitoring, injunctive relief, and potential exclusion from participation in federal health care programs.
To identify cases in their jurisdiction, some EJCs join state or local task forces, engaging in community outreach, and developing relationships with elder justice professionals in their district. I meet regularly with county elder justice task forces in my district. My office also leads a regional elder justice task force, which includes members from federal and local law enforcement agencies, the state courts, and numerous advocacy groups for older adults.
One of our most important relationships is with adult protective services (APS). Whether through individual connections or through task forces and multidisciplinary teams, every EJC gets to know APS caseworkers in their jurisdiction. Developing a cooperative relationship benefits both APS and EJCs. For example, when APS receives a report of an older adult involved in an international romance scam, their state statute may prohibit their involvement in that type of case (e.g., where the offender is a stranger). However, this may be the type of case that the EJC could pursue with a referral from APS. Conversely, an EJC may have a case in which it is discovered that an older adult is experiencing some other form of abuse that falls outside of federal jurisdiction, necessitating a report to APS.
EAPPA mandates our involvement in community outreach to raise awareness, but also as a vehicle for identifying cases. I, and other EJCs, recognize the valuable social services provided by APS in our community, which complements the work of federal and local law enforcement. We look forward to working with APS on these important yet challenging cases. Please reach out to me (or your local EJC) to discuss cases and so that we may learn from one another. I know we share the common goals of holding offenders accountable while protecting older Americans, goals that can best be achieved when we work together.
Contact the U.S. Attorney’s Office in your jurisdiction to find your local EJC. You may also visit my U.S. Attorney’s Office Elder Justice Task Force site at https://www.justice.gov/usao-edpa/elder-justice-task-force. The DOJ’s Elder Justice Initiative site can be found at https://www.justice.gov/elderjustice.
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