the Investor Protection Trust by EQ7Al75w

VIEWS: 7 PAGES: 23

									Abstract

       The Massachusetts Executive Office of Elder Affairs (EOEA) seeks to create a Financial

Planners Intervention Project with a goal of promoting the financial security of older adults with

dementia or cognitive impairment. EOEA will develop an intervention to train bankers and

financial planners to recognize and respond to the early stages of financial self-neglect or abuse

among consumers with Alzheimer’s disease and related disorders. The intervention will be

completed through implementing the following objectives:

1. Improve current EOEA intake and investigation procedures and training curricula to better

address the challenges specific to financial planning and to serving consumers with Alzheimer’s.

2. Improve the capacity of the Massachusetts financial industry to meet the needs of consumers

with dementia.

3. Enhance EOEA’s capacity to promptly intervene in cases of financial exploitation

       Performance measures may include: 1) an increase in calls to regional Protective

Services and law enforcement related to financial abuse or self-neglect; 2) an increase in

Protective Services cases resulting in reduced risk; 3) more timely identification and intervention

of financial exploitation for consumers with dementia; and 4) improved knowledge of dementia

and financial risk among financial planners and bankers.

       Products will include 1) an enhanced training curriculum for bankers that includes an

overview of dementia; 2) a new curriculum for financial planners that includes an overview of

dementia and related financial risks; 3) a new set of intervention protocols for financial planners

with customers at risk of financial abuse or self-neglect due to dementia; 4) new EOEA protocols

for better and more timely intervention for consumers with dementia at risk of financial

exploitation or self-neglect.

                                                                                                      1
Problem Statement

        According to the Investment Company Institute, Americans now hold over $17.5 billion

in retirement assets, $13.1 of which is privately managed.1 These nest eggs are at risk of

premature, unintended and unwanted depletion due to mismanagement and exploitation related

to Alzheimer’s disease, a fatal disease that slowly deprives people of the ability to remember,

perform complex tasks and, eventually, make even the most basic decisions. Alzheimer’s

disease is the leading cause of dementia, which is defined by the American Psychiatric

Association as the impairment of memory, social functioning and cognitive function, often

accompanied by loss of ability to speak, control one’s movements or recognize objects.2

        There are over 120,000 people in Massachusetts with Alzheimer’s disease or a related

disorder.3 This number is expected to grow to 140,000 by 2025 if no cure is found.

Approximately one person in ten aged 65 and over has Alzheimer’s. Approximately half of

those aged 85 and over have the disease.

        People with Alzheimer’s disease are more susceptible to abuse in the form of exploitation

and self-neglect, due to their diminished capacity to make decisions and increased capacity for

unwarranted trust. Additionally, over 21 percent of people aged 70 to 79, and over have some

cognitive impairment that affects their ability to make financial decisions.4




1
  http://www.ici.org/pressroom/news/ret_10_q4
2
  Diagnostic and Statistical Manual for Mental Disorders, American Psychiatric Association, 2012
3
  For the purposes of this proposal, the words “Alzheimer’s” and “Alzheimer’s disease” will be used to describe
Alzheimer’s disease and all related dementia causing illnesses.
4
  Kasten, G, Kasten, M, “The Impact of Aging on Retirement Income Decision Making,” Journal of Financial
Planning; June 2011
                                                                                                                  2
Financial Self-Neglect

          Financial transactions represent a complex set of cognitive activity that is vulnerable to

dementia and age-related cognitive impairment.5 Financial skills among people with

Alzheimer’s disease are substantially impaired compared with healthy older adults.6

          Approximately half of individuals with mild Alzheimer’s are capable of fundamental

financial activities, such as cash transactions. Less than one quarter are capable of more

complex activities such as checkbook management, understanding bank statements and financial

judgment.7 By the middle stages of Alzheimer’s, all financial capacities are found to be severely

impaired.8,9,10 In many cases, financial capacity may be impaired well before diagnosis or

manifestation of other symptoms have occurred.11,12 Financial mismanagement due to dementia

or cognitive impairment can be catastrophic, beginning with difficulty paying bills and

ultimately leading to self-impoverishment and endangerment of assets needed for long term

care.13

Exploitation

          The number of people over the age of 65 that have been defrauded is staggering.

According to the Investor Protection Trust, one of every five citizens over the age of 65 has been




5
  Marson, D, Sawrie, S et al, “Assessing Financial Capacity in Patients with Alzheimer Disease: A Conceptual Model
and Prototype Instrument”, Arch Neurol, 2000, Vol. 57:877-884
6
  Moye, J and Marson, D, “Assessment of Decision-Making Capacity in Older Adults: An Emerging Area of Practice
and Research”, Journal of Gerontology: PSYCHOLOGICAL SCIENCES, 2007, Vol. 62B, No. 1:3-11
7
  Marson, Sawrie, et. al.
8
 Kasten, et. al.
9
  Marson, Sawrie, et. al.
10
   Moye, et. al.
11
   Kasten, et. al.
12
   Moye, et. al.
13
   Marson, Sawrie, et. al.
                                                                                                                 3
defrauded.14 The National Institute of Health reports that people with Alzheimer's are especially

at risk for fraud.15 Diminished or impaired cognitive capacity is closely linked with elder abuse,

financial exploitation and harmful, undue influence by a family member or stranger.16,17,18

People with cognitive impairment often exhibit increased credulity—the propensity to believe

things that are unproven or unlikely to be true, and increased gullibility—susceptibility to being

manipulated or deceived. Cognitive impairment, thus, limits a person’s ability to discriminate

between honorable and exploitive intentions of other people.19

        While EOEA’s Protective Services division has protocols in place to respond to such

cases and work with law enforcement as needed, the large volume and complexity of cases being

reported can lead to delays in intervention. Financial subtleties can be overlooked or

undervalued by Protective Services staff, most of whom do not have formal financial training.

Because monies disappear very quickly and frequently are irretrievable, a more in-depth and

timely assessment of immediate actions, in addition to more thorough and lengthy investigative

steps, is warranted due to the potential for serious financial loss.

A Role for Financial Planners

        EOEA offers several programs to protect low-income older adults from financial self-

neglect and exploitation. These include:




14
  (http://www.investorprotection.org/learn/research/?fa=eiffeSurvey on the Web.
15
   http://www.nia.nih.gov/Alzheimers/Publications/financesFS.htm
16
   Marson, D, Sawrie, S et al
17
   Lai, J and Karlawish, J, “Assessing the Capacity to Make Everyday Decisions: A Guide for Clinicians and an
Agenda for Future Research”, American Journal of Geriatric Psychiatry,2009, Vol.15:101-111
18
   Aceierno, R., Hernandez-Tejada, M et al, “National Elder Mistreatment Study”, U.S. Department of Justice, 2009
19
  Pinsker, D., McFarland, K. and Stone, V., “The Social Vulnerability Scale for Older Adults: An Exploratory and
 Confirmatory Factor Analytic Study”, Journal of Elder Abuse & Neglect,2011, Vol.23(3):246-272
                                                                                                                    4
    the Bank Reporting Project, a system of protocols and trainings for bankers to help them

     identify and respond to signs of financial exploitation or self-abuse among their older

     customers; and

    the Money Management Program, a free service that helps low-income older adults keep

     track of monthly expenses and pay bills on time.

        In addition, EOEA frequently refers low-income consumers with legal and financial

 difficulties to the Massachusetts Senior Legal Assistance Project, which provides legal advice

 and referral to reduced-rate and pro bono services.

        While older adults with higher incomes may have access to professional financial

management services and are unlikely to need or qualify for the services above, their financial

independence may still be in danger if their financial planners are not properly trained to

recognize and intervene in cases of financial mismanagement or exploitation due to dementia or

cognitive impairment.

        Much as police officers, fire fighters and medical professionals serve as first responders

in cases of physical, sexual and other types of abuse, financial institutions and their employees

form the critical first line of defense against financial exploitation, and can play a pivotal role in

its prevention. Indeed, financial planners, who work closely with clients, often for many years,

may be among the first to notice warning signs on bank and credit card statements that suggest a

person’s financial skills are deteriorating.20,21 Additionally, financial planners are in a unique

position to intervene in the case of potential self-neglect or exploitation due to the large amount




20
  Ehrenfeld, T, "How Can Advisors Help Patients Diagnosed with Dementia," Financial Planning February 2011
21
  MacDonald, J, "Detecting When Seniors Need Financial Help," Bankrate
(http://www.bankrate.com/brm/news/pf/Oct06_finances_and_senior_a1.asp)
                                                                                                             5
of trust placed in them by older adults, due in part to cognitive decline and in part to the

immediate importance of keeping one’s retirement portfolio safe.22

            While many prosecutors admit that retrieval of funds following fraud or exploitation is

very difficult, financial planners can play a critical role in identifying and arresting depletion of

funds before an elder’s assets are completely depleted. Moreover, there are several safeguards

that financial planners can put into place with consumers, such as investing assets into fixed

annuity vehicles, appointing a trusted individual with power of attorney, or developing a

“withdrawal policy statement” with the consumer detailing the goals, policies, strategies and

tactics clients and advisors agree on to guide future decision making around withdrawals. Under

such an agreement, a consumer can give a financial planner discretion on enforcing any and all

of the guidelines.23

            Additionally, there are communication strategies that financial planners can adopt to help

a cognitively impaired consumer understand and remember their recommendations. These

include using straightforward, jargon-free language, allowing time for the consumer to process

and respond to questions, and preparing a written summary of meetings.24

            Nonetheless, working with cognitively impaired seniors presents significant challenges

for financial planners. A financial planner acting on a request from someone who is not legally

competent to make decisions may be liable for negligence if the results of the request prove

harmful. Alternately, refusal to act on a request might make an advisor liable for violating the




22
     Kasten, et. al.
23
  Kasten, et. al.
24
  Starnes, S. 2010. “Is Your Firm Prepared for Alzheimer’s? How to Communicate with Clients with Dementia.”
Journal of Financial Planning (December 2010)
                                                                                                              6
“duty of loyalty” code, now being proposed by the Securities Exchange Commission.25 Not

surprisingly then, most financial planners say they are unprepared and uncomfortable working

with consumers with Alzheimer’s disease or cognitive impairment.26,27

Goals and Objectives

             The Massachusetts Executive Office of Elder Affairs seeks to create a Financial Planners

Reporting Project with a goal of promoting the financial security of older adults in Massachusetts

with dementia or age-related cognitive impairment. In order to achieve this goal, the EOEA

Protective Services Division, in partnership with the Alzheimer’s Association, Massachusetts

Chapter, the Massachusetts Attorney General’s Office and the Financial Planners Association of

Massachusetts (FPA-MA), will implement the following objectives:

Objective 1: Improve current detection and reporting procedures and training curricula

surrounding financial self-neglect and exploitation to better prepare bankers and financial

planners for the challenges of serving consumers with Alzheimer’s disease and related disorders.

Objective 2. Improve the capacity of the Massachusetts financial industry to identify, address

and prevent financial self-neglect and exploitation among elders with dementia and age-related

cognitive impairment.

Objective 3. Enhance EOEAs capacity to promptly intervene in cases of financial exploitation

Target Population

             The target population for this proposal will the 120,000 people in Massachusetts living

with Alzheimer’s disease, older adults with cognitive impairment, and family caregivers of these


25
     Ibid.
26
   Fidelity Investments. 2009. “Fidelity Investments Study Shows Financial Advisers Want Help with Impact
of Alzheimer’s on Their Practices.” Press Release (July 20).
27
   Hinchcliff, Dorothy. 2009. “Most Advisers Unprepared for Clients with Alzheimer’s.” Financial planner (July
20).
                                                                                                             7
individuals. This population was chosen because of its higher susceptibility to fraud and

financial self-neglect.

        The vast majority of people with Alzheimer’s disease are aged 65 and older. According

to the U. S. Census, 81.1 of Massachusetts residents in this age group are white, 6.8 are black,

5.4 are Asian and 9.6 are Hispanic (of any race). Just over half are female, and 81.7 are living at

or above 150 percent of the poverty line. While there is no demographic information specific to

people with dementia in Massachusetts, a national study shows that 68.5 percent of people with

dementia are female, 83.4 percent are white, 12.4 percent are black and 4.2 are Hispanic.

Overall, people with dementia have lower levels of education than those without.28

Proposed Intervention

        Implemented in 1996, the Massachusetts Bank Reporting Project outlines a simple

protocol for reporting suspicious circumstances to elder Protective Services and law

enforcement. While ensuring that banks do not violate banking privacy guidelines, the project

allows for the detection and reporting of suspected exploitation and scams, collaboration with

elder Protective Services, and a delineation of circumstances under which financial information

and records may be released. This project also outlines a wide range of preventative measures to

protect older and more vulnerable banking customers.

        The Project produced a Training Manual (attached), a detailed guide of reporting

protocols that includes sections on recognizing and responding to financial exploitation,

reporting protocols, prevention strategies, and a detailed compendium of aging service resources.

While the manual has been a highly valuable tool in training over 2,000 bankers to better


28
  Plassman, BL; Langa, KM; Fisher, GG; Heeringa, SG; Weir, DR; et al. “Prevalence of dementia in the United States:
The Aging, Demographics, and Memory Study.” Neuroepidemiology 2007;29(1–2):125–132.

                                                                                                                  8
safeguard the assets of their older customers, it was created without specific attention to the

needs and challenges of people with Alzheimer’s disease and related disorders. Details

concerning specific warning signs of Alzheimer’s, communication strategies that can improve

quality of interactions, or available resources are not included in the curriculum.

       Moreover, the protocols and curriculum, while relevant to bankers, are not tailored to the

specific needs and responsibilities of financial planners. Many warning signs discussed in the

Bank Reporting Project training, such as change in ATM machine use, do not apply to

management of financial investments. However, a parallel set of warning signs may exist in the

financial planning world that should, at a minimum facilitate questions as to the underlying

reasons for suspicious behaviors. These signs may include a radical change in investing strategy

that is not consistent with the needs of an older adult, or requests for large, penalty-laden

liquidations. Signs may exist of a family member or other acquaintance offering inappropriate

and exploitative advice or coercion surrounding financial decisions. Moving of assets in order to

pay for a suspect ‘dream opportunity’ should cause serious concerns among financial planners.

       For financial planners and institutions, the identification of potential exploitation does

not, by itself, protect the consumer or prevent exploitation. In certain circumstances, it may

actually place the consumer at greater threat from the exploiting party if no other actions occur.

It is therefore critical that these early warning signs be reported to the appropriate authorities,

whether Elder Protective Services or law enforcement.

Objective 1. Improve current detection and reporting procedures and training curricula.

Action 1: Update the current Bank Reporting Project training curriculum to address the needs of

consumers with dementia.



                                                                                                      9
       To address gaps surrounding consumers with dementia, EOEA’s Protective Services

Division will convene a Financial Reporting Project Work Group (the Work Group) to review

the current Bank Reporting Project curriculum and training model and determine where they

sufficiently meet the needs of consumers with dementia, and what elements are missing that

could enable the banking industry to better serve this population. The Work Group will consist

of the EOEA Director of Protective Services, a regional Protective Services manager, and

representatives from the Alzheimer’s Association, Massachusetts Chapter, Alzheimer’s Services

of Cape Cod and the Islands, the Massachusetts Bankers Association, the Massachusetts Chapter

of the National Academy of Elder Law Attorneys (MA-NAELA), and the Financial Planning

Association of Massachusetts (FPA-MA).

       Based on its findings, the Work Group will expand the training curriculum and manual to

include a section on Alzheimer’s disease and related disorders. The training session, which is

currently 2.5 hours, will be expanded to include a 15 minute overview of Alzheimer’s disease.

Anticipated topics include an overview of signs and symptoms of cognitive impairment or

dementia, alternate causes of inappropriate financial transactions (depression, mismanagement of

medication, etc.), privacy issues, legal options such as use of a durable power of attorney,

assessing financial risk, financial management resources and strategies for communicating with a

person with Alzheimer’s, strategies for including family caregiver in the discussion and a

discussion of community resources.

       Current bank reporting protocols, which detail reporting procedures to law enforcement

and referral procedures to EOEA programs such as the Money Management Program, home care

and the home delivered meal programs, will be amended to facilitate referrals to the Alzheimer’s

Association, Alzheimer’s Services of Cape Cod and the Islands, National Academy of Elder Law

                                                                                                 10
Attorneys for private pay legal services, and the Massachusetts Senior Legal Assistance Project

for pro bono legal services.

           The Work Group will meet a minimum of three times during the first nine months of the

grant in order to develop the new training, as well as the protocols and training discussed below

in Objective 1, Actions 2 and 3. The Alzheimer’s module for the Bankers training will be

finalized by the end of the second grant quarter.

Action 2. Develop a set of reporting protocols for financial planners serving older adults and

people with Alzheimer’s disease and related disorders.

           The Work Group will examine the Bank Reporting Project protocols and determine

which components apply to the needs of financial planners and their customers. The U.S.

Bureau of Labor Statistics defines a financial planner as a professional who assesses the financial

needs of individuals and helps them with investments, tax laws, and insurance decisions in order

to help them meet their short-term and long-term goals, such as education expenses and

retirement.29

           Based on its findings, the Work Group will develop a set of Financial Planner Protocols

for Consumers with Dementia or Age-Related Cognitive Impairment for financial planners and

institutions seeking to protect their clients who may no longer be capable of making financial

decisions or recognizing potential fraud or exploitation due to diagnosed or perceived dementia.

In developing the financial planner reporting guidelines, the Work Group will draw from the

Bank Reporting Project Reporting and Investigation Protocols. The protocols include eight

actions steps to take when confronting suspected exploitation or self-neglect, including:

determining the reason for large transactions, verifying the consumer’s authorization, providing a
29
     http://www.bls.gov/ooh/Business-and-Financial/Personal-financial-advisors.htm#tab-2

                                                                                                 11
fraud alert form, facilitating conversations between the consumer and security staff or

management, and responding to immediate danger, when it is appropriate to notify Protective

Services, when it is appropriate to notify the police, and legal guidelines for protecting consumer

privacy when contacting an outside agency. The Work Group will examine how these action

steps might differ in the context of managing an individual’s investment portfolio versus

managing access to standard savings or checking accounts and, accordingly, modify these steps

for inclusion in the new financial planner protocols.

Action 3. Develop a curriculum to train financial planners regarding protocols for intervention

when a client is believed to be at risk of financial self-neglect or exploitation due to possible

dementia or age-related cognitive impairment.

       The Work Group will develop a training manual and curriculum for financial planners to

walk them through the new protocols in detail. The Work Group will draw from the Bank

Reporting Project Training Manual. Building on lessons learned, the curriculum will be

designed to be delivered in four hours or less and will include:

   Section 1. A review of symptoms and signs of Alzheimer’s disease and related disorders,

    and strategies for communicating with a person with dementia or age-related cognitive

    impairment, delivered by Protective Services staff.

   Section 2. A review of reporting protocols and case examples, delivered by Protective

    Services staff.

   Section 3. A discussion of legal and privacy issues, delivered by a financial planner or elder

    law attorney.

       Elder Affairs will hire a Protective Services Training Coordinator, who will help develop

both the new manual and the Alzheimer’s module for the Bank Reporting Project training. The
                                                                                                    12
protocols, training curriculum and manual will be complete by the end of the third grant quarter.

Copies of the manual will be distributed to all training participants, as well as to other financial

planners, elder law attorneys, and other professionals requesting the manual.

Objective 2. Improve the capacity of the Massachusetts financial industry to meet the needs of

consumers with dementia.

Action 1. Incorporate new Alzheimer’s module into Bank Reporting Project training.

       Elder Affairs currently implements at least one series of Bank Reporting Project training

sessions every two years (one series consists of three to six training sessions throughout the

state), reaching approximately thirty to seventy bank personnel (security, compliance and other

management) per training. The trainings will be expanded by 15 minutes to include the new

Alzheimer’s curriculum discussed in Objective 1, Action 1, above. During years 2 and 3 of the

grant, EOEA will work with the Massachusetts Bankers Association to explore the possibility of

placing the Alzheimer’s training module on line, so that people who have already attended the

Bank Reporting Project training can receive the Alzheimer’s portion without having to attend the

entire training a second time.

Action 2. Conduct outreach to Financial Planners to promote the new protocols and curricula.

       The Protective Services Training Coordinator will work with the current Protective

Services Regional Manager to reach out to financial advisory firms and financial planners to

advocate that they adopt the reporting protocols for consumers at risk for self-neglect or

exploitation due to Alzheimer’s disease or related disorders, and to recruit training participants

and host sites. Protective Services will work with the Massachusetts Secretary of State

Securities Division, which oversees regulation of financial planners in Massachusetts, and the

Financial Planning Association of Massachusetts (FPA-MA) to compile a list of financial

                                                                                                       13
advisory firms and independent financial planners and develop strategies to promote the

trainings. The Training Coordinator will work with other Protective Services staff to develop

marketing materials that emphasize the long-term legal, financial and public relations benefits of

participating in such a program. Outreach will be conducted by Protective Services staff via

phone and mail.

       The Training Coordinator will also promote the new protocols to agencies within the

aging service delivery system, including councils on aging, the Family Caregiver Support

Program, the Alzheimer’s Association, Alzheimer’s Services of Cape Cod and the Islands, and

the statewide Home Care Program, to ensure that case workers and other staff who suspect

financial self-neglect or exploitation will know to refer the consumer to Protective Services for

intervention.

       During Year 1 of the grant, Protective Services will focus on Massachusetts’ 900

independent financial planners, with at least one training taking place during the fourth quarter,

reaching a total of 200 financial planners. The Work Group will reconvene at the beginning of

Year 2 of the project to review evaluation surveys from training participants, discuss strengths

and weaknesses of the training, and revise the training as needed.

       During Years 2 and 3 of the grant, Protective Services will continue to train independent

financial planners, and will reach out to larger broker/dealer firms to recruit host sites and

participants and advocate for adoption of the reporting protocols. A minimum of five trainings

for both independent and firm-affiliated financial planners will take place during year 2, and six

trainings will take place during year three. Elder Affairs estimates that it will reach over half of

the 900 independent financial planners during the three year grant period. Additional numbers of

broker/dealer-affiliated financial planners will also be trained.

                                                                                                   14
        The Protective Services Training Coordinator and Protective Services Regional Manager

will conduct the trainings. The Regional Manager will work with the Mass NAELA and FPA-

MA to recruit elder law attorneys or financial planners to lead the sections on the training

covering more complex financial, legal and privacy issues. It has been Elder Affairs experience

with the Bank Reporting Project that financial professionals are more responsive when receiving

such information from a peer.

        Additionally, both the Training Coordinator and Regional Manager will participate in

professional trainings from the Alzheimer’s Association (and other specialists) in order to

acquire the skills and knowledge needed to present the full range of topics covered in Section 1

of the curriculum. These will include, but not be limited to, the following:

   Habilitation Train the Trainer Program, which provides information about the nature of

    Alzheimer’s disease, the diagnostic process, related disorders, stages, and treatments.

   Legal and Financial Issues, a presentation by an elder law attorney that provides information

    about wills, durable power of attorney, protection of assets, and health care proxy.

        In addition, Protective Services staff will consult independently with the Alzheimer’s

Association and Alzheimer’s Services of Cape Cod and the Islands during the development of

the curricula to fill in any gaps in information needed to present the Alzheimer’s portion of the

training.

Objective 3. Enhance EOEAs capacity to promptly intervene in cases of financial exploitation.

        Intakes for Protective Services cases are currently performed by staff at Massachusetts’

Elder Abuse Hotline or by Information and Referral staff at the regional Area Agencies on Aging

that host the regional Protective Services divisions. Protective Services staff investigate new

cases to determine whether the allegations fall within the jurisdiction of Protective Services, the
                                                                                                    15
level of risk, and the services available to alleviate the risk. However, whereas consumers

generally know to contact law enforcement in cases where a person is physically threatened,

most consumers and protective services lack the financial expertise to identify a situation in

which a person’s financial well-being may be imperiled.

       Elder Affairs will address this gap, and the potential increase in referrals due to the new

financial planner training, by hiring a Financial Specialist to identify and prioritize cases of

potential exploitation or self-neglect that warrant immediate attention in order to prevent serious

financial loss before it is too late. The Financial Specialist will review intakes prior to screening

by regional Protective Services staff in order to evaluate the level of emergency and response

time necessary. Based on that evaluation, the Specialist will make recommendations to the

Protective Services agency on appropriate short term and long term interventions to alleviate the

immediate risk of financial loss. Recommendations may include freezing accounts, flagging

accounts with a financial institution, or establishing specialized accounts. In certain instances, a

recommendation may include notification of or consultation with the District Attorney early in

the case to enhance the potential for prosecution.

       Additionally, the Financial Specialist will assist in analyzing cases with Protective

Services case workers and recommend additional preventative opportunities for inclusion in the

new training curriculum to address such situations. The Specialist will assess the current

caseload and consult with the Work Group to establish best practices for interventions for people

with cognitive impairment.

       EOEA will work with the Massachusetts Attorney General’s Office to create a set of

protocols for Protective Services staff that outline when to refer a case to the Attorney General to

investigate when fraud is suspected. As with the Bank Reporting protocols, as modified under

                                                                                                   16
this project, procedures will be developed for referral to the Alzheimer’s Association and

Alzheimer’s Services of Cape Cod and the Islands for educational programming and support

groups; to the Money Management Program for assistance managing monthly expenses; to the

National Academy of Elder Law Attorneys for private pay legal services; and to the

Massachusetts Senior Legal Assistance Project for pro bono legal services.

Partnerships and Collaboration.

       Elder Affairs will draw on the expertise of the following community partners in

implementing this intervention:

   Alzheimer’s Association, Massachusetts/New Hampshire Chapter. A founding chapter of the

    national Alzheimer’s Association, the Massachusetts/New Hampshire Chapter has been

    providing education and support to families affected by Alzheimer’s disease and related

    disorders since 1980. Last year, it served over 20,000 people through support groups,

    educational programs, training for professionals, and its 24-hour helpline. Alzheimer’s

    Association staff will serve on a work group to develop the new protocols and curricula for

    this intervention, will provide training to EOEA staff, and will serve as a source of

    information and support to families referred to them by Protective Services staff and

    financial planners and bankers receiving training. Additional support to this project may be

    provided by Alzheimer’s Services of Cape Cod and the Islands which, while not affiliated

    with the Alzheimer’s Association, provides a comparable set of services and expertise.

   The Financial Planning Association of Massachusetts is dedicated to helping people improve

    their lives by emphasizing the benefits of financial planning. With over 900 members in

    Massachusetts, FPA-MA promotes a professional code of ethics, continuing professional

    education and philanthropic community involvement. FPA-MA will serve on the Work
                                                                                                  17
    Group to develop the new curriculum, will serve as a source for training facilitators, and will

    promote the trainings to its membership.

   The Massachusetts Chapter of the National Academy of Elder Law Attorneys is an

    association of lawyers who work with older clients, disabled clients of all ages, and their

    families. Established in 1987, NAELA provides its members with education, information,

    networking and assistance with the many specialized issues involved with legal services for

    seniors and people with special needs. MA-NAELA will serve on the Work Group to

    develop the new curriculum, will serve as a source for training facilitators, and will promote

    the trainings to its membership.

   The Office of the Massachusetts Attorney General will consult with EOEA to ensure that

    reporting protocols are consistent with privacy laws and other Massachusetts laws designed

    to protect consumers, and will advise EOEA regarding when to refer cases for investigation.

   The Massachusetts Senior Legal Assistance Project is a statewide, federally-funded coalition

    of legal assistance providers dedicated to providing legal advice to low-income older adults

    and connecting them with information and resources to help them navigate complex legal

    issues. Project staff will serve on the Work Group to develop the new curriculum and will

    accept referrals from bankers and financial planners whose customers are in need of pro bono

    legal services.

   The Massachusetts Banker’s Association provides education and support to banking

    professionals in Massachusetts in order to promote professionalism, ethical standards and

    consumer safety and satisfaction. The Association has been a valuable partner with EOEA in

    developing the Bank Reporting Project protocols and training and will be a critical resource

    to EOEA as it develops the new training for this intervention.
                                                                                                  18
Performance Measures.

       Currently, EOEA’s Protective Services Division documents all cases in the Adult

Protective Services (APS) case management system. Intake information includes:

   name of the reporter

   reporter’s relationship to the elder

   reporter’s relationship to the incident

   mandated reporter type (if applicable)

   detailed information about the elder, the incident being reported, and the alleged perpetrator.

   Allegation type (abuse, neglect, exploitation and self-neglect)

   Allegation sub-type (physical, sexual and emotional)

   Outcome (risk level reduced, risk level increased or risk level unchanged)

       While the final performance measures for this project will be determined by the AoA

national evaluator, in consultation with participating State Units on Aging, possible evaluation

measures could include any change in number of reports that are filed by banks and by financial

institutions and any change in overall outcomes. Additional criteria could include an analysis of

outcomes prior to and after the hiring of the Financial Specialist.

       The Training Coordinator will work with regional Protective Services Agency staff to

ensure that they input reporters’ relationship to incident as “financial institution” into APS and

any other reporting mechanisms. Additionally, the Training Coordinator will work with other

Protective Services staff and the Regional Manager to develop a pre- and post-training survey to

measure any increase in the level of knowledge of Alzheimer’s disease and related financial risks

among participating financial planners.


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       An Evaluation Consultant will be retained by EOEA during years 2 and 3 of the project

to work with AoA and its national evaluator to develop evaluation measures that advance the

existing body of knowledge on elder abuse. The Specialist will work with the national evaluator

to develop or modify enrollment materials, appropriate consent documents, the collection and

reporting of data, including data on performance measures and administrative data, on a semi-

annual basis. The consultant will examine quarterly reports of cases filed by financial services

professionals in the context of evaluation measure developed by the national evaluator.

Project Management.

       Jonathan Fielding, Regional Protective Services Manager, EOEA, will serve as Project

Director for this intervention, overseeing working with the Director of Protective Services,

Training Coordinator, Protective Services Specialist, Curriculum Developer/Project Developer,

and community partners to develop the new protocols and curriculum and implement trainings.

Mr. Fielding holds a Master of Science in Child and Family Studies, as well as a Master of

Education in Counseling Psychology.

       Since 1993, he has worked in the Elder Protective Services system as a supervisor and

Regional Manager, providing technical and clinical guidance to regional Protective Services and

guardianship agencies. He has been involved in developing new policies, program standards and

clarifying existing regulations, including those regarding self-neglect. He currently oversees the

Massachusetts Bank Reporting Project, in conjunction with the Massachusetts Bankers

Association and the Attorney General’s Office, providing training to thousands of bank

personnel regarding early detection of elder financial exploitation, and how to appropriately,

safely and legally report and collaborate with Elder Protective Services.



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       Deborah Fogarty, Director of Protective Services, EOEA, will be responsible for overall

development and implementation of policies, standards and operational procedures for Protective

Services and related programs, assessing resource needs and evaluation of service delivery

performance of the direct service agencies. She will chair the Financial Work Group as it

develops curricula, guidelines and reporting protocols and will directly supervise the Regional

Manager working on the project.

       Ms. Fogarty worked in the Middlesex County District Attorney’s Office for ten years as a

Victim Witness Advocate and Deputy Chief of the Victim Witness Bureau before moving to

Norfolk County to direct the District Attorney’s Victim Witness program. Prior to moving to

Elder Affairs in 2008, Deborah was the Director of the Victim Compensation and Assistance

Division in the Office of the Attorney General. She has a B.S. in Criminal Justice from

Northeastern University, an M.A. in Sociology from University of Massachusetts Boston.

       The Training Coordinator (1 FTE; to be hired) will be responsible for the day to day

implementation of the Financial Reporting Project. Under the direction of the Director and

Regional Manager, the Coordinator will be responsible for outreach to the financial services field

to inform them of the protocols developed and the training available. The Coordinator will be

the liaison to the Alzheimer’s Association, the Attorney General’s Office and the Association of

Elder Law Attorneys during the grant cycle. Qualified candidates will have strong writing skills,

experience developing and presenting training curricula and, ideally, experience either in

finance, aging services or law enforcement.

       The Financial Specialist (1 FTE; to be hired) will review and prioritize cases that warrant

emergency interventions, and will review the current to identify and implement best practices for

more timely and effective intervention in financial exploitation and self-neglect cases. Qualified

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candidates will have a degree in economics or business, or equivalent experience, and an interest

or experience in aging services.

       The Evaluation Consultant (0.5 FTE, to be hired, years 2 and 3 only) will track the data

in the Adult Protective Services case management system based on data elements identified to

track reports from the financial services industry, in close consultation with the AoA national

evaluator.

Organizational Capability Statement.

       EOEA is Massachusetts’ State Unit on Aging. It is a cabinet level department of the

Commonwealth of Massachusetts with a staff of over 120, overseeing a statewide network of

agencies that includes 27 AAAs/ASAPs and 349 Councils on Aging and senior centers in

communities across the state. This network reaches out to elders in need of services that include

home care, caregiver support, nutrition programs, Protective Services, health and wellness

services, housing options, and insurance counseling.

       Through its Protective Services Division, Massachusetts’ State Adult Protective Services

agency, it oversees twenty-one designated regional Protective Services Agencies and the Elder

Abuse Hotline, which are responsible for receiving reports of abuse, neglect, self-neglect and

financial exploitation of elders (age 60 and older living in the community) from mandated and

non-mandated reporters. Protective Services caseworkers investigate instances of possible

reportable abuse and, if confirmed, offer the elder a choice of services designed to alleviate or

end the abuse and prevent recurrence. Caseworkers work with the elder, family and community

agencies to provide medical, mental health, legal and social services.

       Protective Services casework may include services such as:

   Counseling;

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   Safety planning;

   Substance abuse treatment;

   Mental health services;

   Family intervention;

   Homemaker/health aide services;

   Emergency food or fuel;

   Transportation;

   Housing;

   Legal assistance;

   Financial assistance;

   Medical services and therapies; and,

   Advocacy.

        The program allows for a thorough assessment of each elder’s situation, provides a

comprehensive system for advocacy and service provision to remedy or eliminate the effects of

abuse, provides a twenty-four hour per day response system to address ongoing issues and

concerns, assists older adults to make informed choices about their personal lives and care, and

provides a system to help elders remain safely in the community as long as possible

        The goal of the Protective Services Program is to prevent, remedy or eliminate the effects

of abuse on older adults, with a focus on promoting freedom and safety. An elder’s right to self-

determination is respected to the fullest extent possible, and the least restrictive, least disruptive,

appropriate service alternatives are used to meet the needs of the elder.




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