Highlights of 2023 Legislation: Collaborations, Teamwork, and Fighting Discrimination

Kendra Kuehn, MSW, APS TARC Subject Matter Expert

October 2023
 

As most state legislatures finish their work for 2023, many have passed significant measures impacting adult protective services (APS) programs, clients, and partners. In preparation for the next year, we’re taking the opportunity to look back at what’s happened across the country concerning adult maltreatment legislation. We look forward to more innovations in the coming year. 

Working with Financial Institutions. Financial exploitation continues to be a complex and persistent issue faced by APS programs. The most recently reported National Adult Maltreatment Reporting System (NAMRS) data for 2021 highlights that financial exploitation is one of the top maltreatment types experienced by APS clients, exceeded only by neglect and self-neglect. The California Right to Financial Privacy Act already allowed banks, credit unions, and savings associations to share records with APS, but these records were only for the 30 days before and after the occurrence of an alleged illegal act. With the enactment of Assembly Bill 386, the time frame is increased to 90 days prior to the act and 60 days following. It also expands the records to be shared to include new bank cards issued, change of address requests, and power of attorney or trust documents submitted or executed. In its support of the bill the County Welfare Directors Association noted that the longer timeframe allows APS to identify normal spending habits compared to what may be financial exploitation. 

Across the country, Connecticut (SB 1088) has implemented legislation allowing broker-dealers, investment advisors, and financial institutions such as banks to report financial exploitation, share records, and place a temporary hold on disbursements. The statute allows for the adult or their legal representative to petition the probate court to remove the transaction hold. The application considers factors such as the existence of an active APS investigation as well as a statement on why the transaction will not result in exploitation. 

Working with Law Enforcement. This year states also saw legislation to improve training and partnerships with law enforcement. Washington (SB 5370) clarified that APS and law enforcement must share information contained in reports and findings with each other when requested and consistent with confidentiality laws. During the session committee members noted the importance of ensuring interagency collaboration in supporting older adults and people with disabilities.

Texas (HB 568) expanded required training for peace officers (i.e., law enforcement) to include training on interacting with persons with Alzheimer’s disease and other dementias. In addition to recognizing symptoms and building communication techniques, the training must include identifying signs of abuse, neglect, and exploitation. West Virginia (SB 208) passed a similar bill which included training around autism spectrum disorders as well as Alzheimer’s disease and other dementias. Several other states have passed similar legislation in recent years, including in Ohio (HB 23) in 2022, which requires the attorney general’s office to consult with the Department of Aging on rules around training. Adults with dementia face greater risk of abuse, and the impact of abuse on mortality is greater in this population. Enhancing law enforcement knowledge is one way to begin to address this issue and bring more experience to partnering on APS cases.

Team Collaboration. The theme of coordination continued in the development of teams, taskforces, and councils. Nevada Assembly Bill 119 established the Vulnerable Adult Fatality Review Committee to meet at least twice a year to review deaths that are known to be caused by maltreatment or are suspected of being the result of maltreatment. Cases are chosen through a referral process. From this review the committee will provide recommendations, including legislative and policy changes, for preventing and addressing adult maltreatment. As Nevada embarks on its committee, Florida passed two statutes adjusted standing provisions around its elder fatality review team statute created in 2020. The measures were guided by recommendations from the two currently operating Florida elder fatality review teams. Florida Senate Bill 1540 expands the teams to encompass older adults and vulnerable adults, bringing it in line with APS eligibility practice. The bill also added exploitation to the types of abuse case reviewed — previously only abuse and neglect were cited. While physical abuse is often thought of as the most fatal, research has shown that elder financial exploitation has the second highest mortality rate of maltreatment types over five years, which is not statistically different from caregiver neglect and higher than physical abuse. The bill also expanded structures to allow teams to determine their own case selection process. Previously only the state attorney could refer cases for review. 

The existing teams also noted meaningful case discussion and information sharing has been limited because of confidentiality concerns. Florida Senate Bill 1542 supported these recommendations by strengthening confidentiality provisions and creating exemptions to public meetings and record requirements. Teams noted similar provisions were in place in domestic violence fatality review teams. Committee discussion and supporting documents highlighted how annual reports and recommendations improve the system, as seen here with confidentiality.

Several states are implementing teams and councils to strategize the way ahead. Texas (HB 728) has created a Statewide Interagency Aging Services Coordinating Council with representation from key agencies, including the Texas Department of Family and Protective Services. The council will develop a five-year state interagency aging services strategic plan, develop a biennial statewide interagency aging services expenditure proposal, and publish a yearly inventory of state-funded aging programs and services. Supporters highlighted that the council would help eliminate redundancy and expand innovations in an efficient and cost-effective way. 

Maryland (HB 1191/SB0797) is also looking at future strategic action with the establishment of a Task Force on Preventing and Countering Elder Abuse. The task force is specifically focused on developing recommended changes to existing state law, policy, and practice around elder abuse. Their final report is due in December 2024 and will help inform future changes in Maryland’s APS program. And from a different branch of state government, Pennsylvania Gov. Shapiro issued an executive order in May 2023 on the beginning of the state’s Master Plan for Older Adults. Pennsylvania has both a growing older adult population and large population of people with identified disabilities. The state is currently engaged in stakeholder engagement around topics such as outdoor space and buildings, housing, transportation, health services and community services, and respect and social inclusion. Pennsylvania joins a small but growing group creating master plans on aging. Five states have developed and are implementing master plans related to aging, and 12 have begun the process of developing a plan.

Long-Term Care Protections for LGBTQ+ Older Adults. The Oregon Department of Human Services’ 2021 LGBTQ+ Older Adult Survey highlighted concerns from respondents around discrimination in long-term care, higher rates of disability in the community, higher rates of maltreatment than the general public, and overall concerning gaps in services. The Oregon legislature (SB 99) responded by establishing a Bill of Rights for LGBTQIA2S+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, two spirit, nonbinary, or other minority gender identity or sexual orientation) older adult residents of long-term care and community-based care facilities and will be adding a LGBTQIA2S+ subcommittee to the Governor’s Commission on Senior Services. The act outlines requirements that facilities protect resident rights including choice of name and pronouns, choice of visitors, appropriate medical care, and general freedom from discrimination. Additionally, the legislation adds a LGBTQIA2S+ subcommittee of the Governor’s Commission on Senior Services. The larger commission provides recommendations to the governor and the Department of Human Services on coordination of agency services and identification of service gaps. The subcommittee will bring specific opportunities for addressing the needs of LGBTQ+ older adults including preventing maltreatment and reducing service gaps. Oregon joins New Jersey, Illinois, California, Massachusetts, the District of Columbia, and several other localities in creating long-term care protections for LGBTQ+ older adults.

The legislative activity of this past year reflects the growing awareness of the needs of aging adults and adults with disabilities. There is more to do, and we will continue to encourage development of new and creative approaches to supporting and addressing those needs.

Additional Resources

• Explore State Legislatures at a Glance with the National Council of State Legislatures and find out your state’s legislative session dates.
• Keep up with Congress at Congress.gov.